title: Dental hygiene intervention to prevent nosocomial pneumonias.
abstract: Nosocomial and ventilator associated pneumonias that plague critically ill, elderly and long-term care residents could be reduced with effective oral hygiene practices facilitated collaboratively between nurses and dental hygienists.
  
  
  BACKGROUND
  Nosocomial pneumonias, specifically aspiration pneumonias and ventilator-associated pneumonias in the elderly and infirm have become a major health care issue, The provision of oral care in hospital and hospital-like facilities presents challenges that can prevent patients from receiving optimal oral care One sequela can be aspiration pneumonia which ranks first in mortality and second in morbidity among all nosocomial infections. Since aspiration pneumonia is linked to the colonization of oral bacteria in dental plaque and biofilm, it is time to look for creative solutions to integrating the expertise of dental hygienists into health care teams in these institutional settings.
  
  
  METHODS
  A comprehensive review of the literature was conducted regarding the etiology and prevalence of health care related pneumonias. Evidence describing the challenges and barriers that the nurses, nursing staff, and dental hygienists face in the provision of oral care in hospitals and long-term care facilities is provided. Intercollaborative solutions to providing optimal oral care in hospitals and long-term care facilities are suggested.
  
  
  CONCLUSIONS
  Dental hygienists have the expertise and practice experience to provide oral care in hospitals, long-term care and residential facilities. They can contribute to solving oral care challenges through intercollaboration with other health care team members. Yet, there are long-standing systemic barriers that must be addressed in order to provide this optimal care. Dental hygienists becoming better assimilated within the total health care team in hospital and residential facilities can positively impact the suffering, morbidity and mortality associated with aspiration pneumonias.
authors.affiliation: Applied and Clinical Research, Department of Dental Hygiene, Nebraska Center for Materials and Nanoscience, University of Nebraska Medical Center, College of Dentistry, Lincoln, NE 68583-0740, USA. Electronic address: cbarnes@unmc.edu.
authors.forename: Caren M
authors.initials: CM
authors.lastname: Barnes
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D003756:Dental Hygienists; D003777:Dental Prophylaxis / Q000379:methods*; D006297:Health Services Accessibility; D006801:Humans; D010348:Patient Care Team; D011014:Pneumonia / Q000517:prevention & control*; D011015:Pneumonia, Aspiration / Q000517:prevention & control; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control
keywords: Dental hygiene, prevention; critically ill aspiration pneumonia; nosocomial infections; nursing home; ventilator associated pneumonia barriers to oral care