Preventing Hospital-Acquired Pneumonia: The Impact of Dental Hygiene on Lung Health

2023-12-24 09:54:00

A new analysis of more than 2,700 patients shows that maintaining good dental hygiene can prevent people from developing pneumonia in hospital, with fewer cases of common lung infections associated with daily tooth brushing.

Selena Ehrenzeler and Michael Klumbas, two epidemiologists who specialize in infectious diseases at Brigham and Women’s Hospital in Boston, compiled data from 15 clinical trials in which people either brushed their teeth several times a day, or rinsed their mouths with antiseptic mouthwash or swabs, Or salt water.

Cleaning the mouth prevents bacteria or other pathogens

While the logic of good oral hygiene seems pretty straightforward—cleaning the mouth can prevent bacteria or other pathogens from creeping into the throat to cause lung infections like pneumonia—the evidence so far is a bit mixed, especially for hospitalized patients who can’t Brush their teeth without help.

Ehrenzeler and Klumbas sought to clarify this, by analyzing data from 2,786 patients who participated in one of 15 clinical trials, and found that rates of hospital-acquired pneumonia were lower among patients who were randomized to daily tooth brushing, two or more times daily.

Hospital-acquired pneumonia is a common but deadly lung infection that can actually make patients sicker. From studies conducted around the world, its incidence ranges from 1 in 50 to 1 in 200 hospital admissions.

Seriously ill patients who are admitted to hospital may be particularly vulnerable to infection and then find themselves in an environment teeming with drug-resistant germs. Overall, 5 to 10 percent of hospital patients develop an infection of some kind during their stay.

Hospitals are doing their best to prevent the spread of pathogens. But the research suggests that incorporating toothbrushing into the care of patients on ventilators and encouraging other patients to do the same may be a low-cost way to improve oral health and reduce cases of pneumonia.

“It’s rare in the world of hospital preventive medicine to find something like this that’s effective and inexpensive,” Klompas says. “Rather than using a new device or medication, our study suggests that something as simple as brushing your teeth can make a big difference.”

Brushing teeth reduced pneumonia rates

Dental cleaning significantly reduced pneumonia rates among patients receiving breathing support devices, which incidentally accounted for most of the numbers in the studies analyzed. This reduction was equivalent to one case of pneumonia prevented for every 12 patients who were kept on mechanical ventilation and had their teeth brushed.

“The results of our study underscore the importance of implementing an oral health routine that includes dental cleaning for hospitalized patients, especially those on mechanical ventilation who may require assistance from care staff,” Klomps said.

The analysis provides “compelling data that reinforces the idea that routine dental cleaning is an essential component of standard care for patients on ventilators,” says Roopak Datta, an epidemiologist at Yale University School of Medicine Hospital who was not involved in the research.

According to the scientific journal “sciencealert”, no noticeable effect was found among hospitalized patients who did not receive mechanical ventilation. This may be because only two of the 15 studies in the analysis included patients who were not connected to artificial respiration, and thus the benefit of brushing teeth. The reduction in pneumonia remains uncertain in that group.

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