Natural history of dental plaque accumulation in mechanically ventilated adults: a descriptive correlational study.
OBJECTIVE
The purpose of this study was to describe the pattern of dental plaque accumulation in mechanically ventilated adults. Accumulation of dental plaque and bacterial colonisation of the oropharynx is associated with a number of systemic diseases including ventilator associated pneumonia.


METHODS
Data were collected from mechanically ventilated critically ill adults (n=137), enrolled within 24 hours of intubation. Dental plaque, counts of decayed, missing and filled teeth and systemic antibiotic use was assessed on study days 1, 3, 5 and 7. Dental plaque averages per study day, tooth type and tooth location were analysed.


METHODS
Medical respiratory, surgical trauma and neuroscience ICU's of a large tertiary care centre in the southeast United States.


RESULTS
Plaque: all surfaces >60% plaque coverage from day 1 to day 7; molars and premolars contained greatest plaque average >70%. Systemic antibiotic use on day 1 had no significant effect on plaque accumulation on day 3 (p=0.73).


CONCLUSIONS
Patients arrive in critical care units with preexisting oral hygiene issues. Dental plaque tends to accumulate in the posterior teeth (molars and premolars) that may be hard for nurses to visualise and reach; this problem may be exacerbated by endotracheal tubes and other equipment. Knowing accumulation trends of plaque will guide the development of effective oral care protocols.
University of Texas Health Science Center at Houston, School of Nursing, 6901 Bertner Ave, Houston, TX 77030, USA. Deborah.j.jones@uth.tmc.edu
Deborah J
DJ
Jones
Cindy L
CL
Munro
Mary Jo
MJ
Grap
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003773:Dental Plaque / Q000378:metabolism* / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control*; D012121:Respiration, Artificial / Q000009:adverse effects / Q000451:nursing; D015144:Southeastern United States