Control of oral biofilm and its relationship with the reduction of respiratory infections in ICU patients: a review of clinical trials

Authors

DOI:

https://doi.org/10.33448/rsd-v9i10.8594

Keywords:

Intensive Care Unit; Dental care; Oral health

Abstract

This study aimed to evaluate, through a review of clinical trials, the importance of dental care and oral health care for patients in Intensive Care Units (ICUs), for the control of oral biofilm and respiratory infections. A search was carried out in the MEDLINE / PubMed and LILACS databases, using the descriptors “Dental Care”, “Hospital Dental Staff”, “Intensive Care Unit”, “Dentist, including only randomized clinical trials, published until July 2020, without restriction of language and country of study. The selected studies were submitted to initial screening based on the reading of titles, abstracts and full article, with duplicate studies being excluded. 43 articles were found, of which, only 10 randomized clinical trials were included in the present review. Considering the results found in the present review, the oral health of patients in ICUs, when neglected, can represent an important source of dissemination of respiratory infections, which highlights the importance of dental care and oral care in a hospital environment , with the use of 0.12% chlorhexidine, not associated with tooth brushing, to control oral biofilm and reduce the incidence of respiratory infections.

References

Amaral, C.O.F., Marques, J.A., Bovolato, M.C., Parizi, A.G.S., Oliveira, A. & Straioto, F.G. (2013). Importância do cirurgião-dentista em Unidade de Terapia Intensiva: avaliação multidisciplinar. Revista da Associação Paulista Cirurgião-Dentista, 67(2),107-111.

Araújo, R.J.G., Vinagre, N.P.L. & Sampaio, J.M.S. (2009). Avaliação sobre a participação de cirurgiões-dentistas em equipes de assistência ao paciente. Acta Scientiarum. Health Sciences, 31(2), 153-157. https://doi.org/10.4025/actascihealthsci.v31i2.6181.

Bellissimo-Rodrigues WT, Menegueti MG, Gaspar GG, Nicolini EA, Auxiliadora-Martins M, Basile-Filho A, Martinez R, & Bellissimo-Rodrigues, F. (2014). Effectiveness of a dental care intervention in the prevention of lower respiratory tract nosocomial infections among intensive care patients: a randomized clinical trial. Infection Control & Hospital Epidemiology, 35(11),1342-8. https://doi.org/10.1086/678427.

Bellissimo-Rodrigues, W.T., Menegueti, M.G., Gaspar, G.G., de Souza, H.C.C., Auxiliadora-Martins, M., Basile-Filho, A., Martinez, R. & Bellissimo-Rodrigues, F. (2018). Is it necessary to have a dentist within an intensive care unit team? Report of a randomised clinical trial. International Dental Journal, 68(6), 420-427. https://doi.org/10.1111/idj.12397

Conselho Federal de Odontologia (Brasil). Resolução nº. 162, de 03 de novembro de 2015. Reconhece o exercício da Odontologia Hospitalar pelo cirurgião-dentista. Diário Oficial da União 16 novembro de 2015; Seção 1. Obtido em: http://cfo.org.br/wpcontent/ uploads/2015/12/ResolucaoCFO- 162-15.pdf.6.

Brasil. Ministério da Saúde; Agência Nacional de Vigilância Sanitária; Resolução RDC n. 7, de 24 de fevereiro de 2010. Dispõe sobre os requisitos mínimos para o funcionamento de Unidades de Terapia Intensiva e dá outras providências (2010). Obtido em: http://bvsms.saude.gov.br/bvs/saudelegis/anvisa/2010/res0007_24_02_2010.html.

Baker, D.P., Day, R. & Salas, E. (2006). Teamwork as an essential component of high-reliability organizations.Health Services Research, 41(4 Pt 2),1576-1598. https://doi.org/10.1111/j.1475-6773.2006.00566.x

Brito, L.F.S., Vargas, M.A.O. & Leal, S.M.C. (2007). Higiene oral em pacientes no estado de síndrome do déficit no autocuidado. Revista Gaúcha de Enfermagem, 28(3), 359-367.

Carcereri, D.L., Amante, C.J., Reibnitz, M.T., Mattevi, G.S., Da Silva, G.G., Padilha, A.C.L. & Rath, I.B.S. (2011). Formação em odontologia e interdisciplinariedade: o Pró Saúde da UFSC. Revista da ABENO, 11(1), 62-70.

Chacko, R., Rajan, A., Lionel, P., Thilagavathi, M., Yadav, B. & Premkumar, J. (2017). Oral decontamination techniques and ventilator-associated pneumonia. British Journal of Nursing, 26, 594–599. https://doi.org/10.12968 / bjon.2017.26.11.594.

de Lacerda Vidal, C.F., Vidal, A.K.L., Monteiro Jr, J.G.M., Cavalcanti, A., Henriques, A.P.T., Oliveira, M., ... & Lacerda, H.R. (2017). Impact of oral hygiene involving toothbrushing versus chlorhexidine in the prevention of ventilator-associated pneumonia: a randomized study. BMC Infectious Diseases, 17 (1),112. https://doi.org/ 10.1186/s12879-017-2188-0.

Fernandes, A., Emiliano, G., Martins, A.R. & Souza, G. (2016). Conhecimento e prática de saúde bucal por pacientes internados e equipe hospitalar. Revista Ciência Plural, 6;2(3),3-16.

Fourrier, F., Dubois, D., Pronnier, P., Herbecq, P., Leroy, O., Desmettre, T., … & PIRAD Study Group (2005). Effect of gingival and dental plaque antiseptic decontamination on nosocomial infections acquired in the intensive care unit: a double-blind placebo-controlled multicenter study. Clinical care medicine, 33(8), 1728-1735. https://doi.org/10.1097/01.ccm.0000171537.03493.b0.

Gaetti-Jardim, E., Setti, J.S., Cheade, M.F.M. & De Mendonça, J.C.G. (2013). Atenção odontológica a pacientes hospitalizados: revisão da literatura e proposta de protocolo de higiene oral. Revista de Atenção à Saúde, 11(35),31-36. https://doi.org/10.13037/rbcs.vol11n35.1769.

Gazola, M.F., Ceretta, L.B., Tuon, L., Ceretta, R.A., Simões, P.W. & Sônego, F.G. (2015). Promoção a saúde bucal de crianças internadas em um hospital infantil de alta complexidade de um município do sul catarinense. Revista Inova Saúde, 4(2),32-44. http://dx.doi.org/10.18616/is.v4i2.2233

Godoi, A.P.T., Francesco, A.R., Duarte, A., Kemp, A.P.T. & Silva-Lovato, C.H. (2009). Hospital odontology in Brazil. A general vision. Revista de Odontologia UNESP, 38(2),105-109.

Gomes, S.F. & Esteves, M.C.L. (2012). Atuação do cirurgião-dentista na UTI: um novo paradigma. Revista Brasileira de Odontologia, 69(1), 67-70.

Halm, M. A., & Armola, R. (2009). Effect of oral care on bacterial colonization and ventilator-associated pneumonia. American journal of critical care: an official publication, American Association of Critical-Care Nurses, 18(3), 275–278. https://doi.org/10.4037/ajcc2009842.

Hua, F., Xie, H., Worthington, H. V., Furness, S., Zhang, Q., & Li, C. (2016). Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia. The Cochrane database of systematic reviews, 10(10), CD008367. https://doi.org/10.1002/14651858.CD008367.pub3.

Kishimoto, H., & Urade, M. (2007). Mechanical tooth cleaning before chlorhexidine application. American journal of respiratory and critical care medicine, 175(4), 418. https://doi.org/10.1164/ajrccm.175.4.418a.

Kusahara, D.M., Peterlini, M.A.S., & Pedreira, M.L.G. (2007). Colonização orofaríngea de crianças à admissão em uma unidade de cuidados intensivos. Acta Paulista de Enfermagem, 20(4), 421-427. https://doi.org/10.1590/S0103-21002007000400006.

Lorente, L., Lecuona, M., Jiménez, A., Palmero, S., Pastor, E., Lafuente, N., Ramos, M. J., Mora, M. L., & Sierra, A. (2012). Ventilator-associated pneumonia with or without toothbrushing: a randomized controlled trial. European journal of clinical microbiology & infectious diseases: official publication of the European Society of Clinical Microbiology, 31(10), 2621–2629. https://doi.org/10.1007/s10096-012-1605-y.

Mattevi, G.S., Figueiredo, D.R., Patrício, Z.M., & Rath, I.B.S (2011). A participação do cirurgião-dentista em equipe de saúde multidisciplinar na atenção à saúde da criança no contexto hospitalar. Ciência & Saúde Coletiva, 16(10), 4229-4236. https://doi.org/10.1590/S1413-81232011001100028.

Morais, T.M.N., Silva, A., Avi, A.N.R.L., Souza, P.H.R., Knobel, E. & Camargo, L.F.A. (2006). A importância da atuação odontológica em pacientes internados em unidades de terapia intensiva. Revista Brasileira de Terapia Intensiva, 18(4),412-417.

Nair, G. B., & Niederman, M. S. (2015). Ventilator-associated pneumonia: present understanding and ongoing debates. Intensive care medicine, 41(1), 34–48. https://doi.org/10.1007/s00134-014-3564-5.

Needleman, I. G., Hirsch, N. P., Leemans, M., Moles, D. R., Wilson, M., Ready, D. R., Ismail, S., Ciric, L., Shaw, M. J., Smith, M., Garner, A., & Wilson, S. (2011). Randomized controlled trial of toothbrushing to reduce ventilator-associated pneumonia pathogens and dental plaque in a critical care unit. Journal of clinical periodontology, 38(3), 246–252. https://doi.org/10.1111/j.1600-051X.2010.01688.x.

Özçaka, Ö., Başoğlu, O. K., Buduneli, N., Taşbakan, M. S., Bacakoğlu, F., & Kinane, D. F. (2012). Chlorhexidine decreases the risk of ventilator-associated pneumonia in intensive care unit patients: a randomized clinical trial. Journal of periodontal research, 47(5), 584–592. https://doi.org/10.1111/j.1600-0765.2012.01470.x.

Pereira, A.S., Shitsuka, D.M., Pereira, F.J., & Shitsuka, R. (2018). Metodologia da pesquisa científica. [e-book]. Santa Maria. Ed. UAB/NTE/UFSM.

Pobo, A., Lisboa, T., Rodriguez, A., Sole, R., Magret, M., Trefler, S., Gómez, F., Rello, J., & RASPALL Study Investigators (2009). A randomized trial of dental brushing for preventing ventilator-associated pneumonia. Chest, 136(2), 433–439. https://doi.org/10.1378/chest.09-0706.

Reilly, P.G., & Glaffey, N.M. (2005). História da sepsia bucal como causa de doenças. In: Williams RC, Offenbacher S. Periodontologia 2000. São Paulo: Ed. Santos.

Rello, J., Afonso, E., Lisboa, T., Ricart, M., Balsera, B., Rovira, A., Valles, J., Diaz, E., & FADO Project Investigators (2013). A care bundle approach for prevention of ventilator-associated pneumonia. Clinical microbiology and infection: the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 19(4), 363–369. https://doi.org/10.1111/j.1469-0691.2012.03808.x.

Rocha, A.L., & Ferreira, E. (2014). Odontologia hospitalar: a atuação do cirurgião dentista em equipe multiprofissional na atenção terciária. Arquivos em Odontologia, 50(4),154-160.

Scannapieco, F. A., Bush, R. B., & Paju, S. (2003). Associations between periodontal disease and risk for nosocomial bacterial pneumonia and chronic obstructive pulmonary disease. A systematic review. Annals of periodontology, 8(1), 54–69. https://doi.org/10.1902/annals.2003.8.1.54.

Santos, P.S., & Soares-Junior, L.A. (2012). Medicina bucal: A prática na odontologia hospitalar. São Paulo:Santos.

Sebastian, M. R., Lodha, R., Kapil, A., & Kabra, S. K. (2012). Oral mucosal decontamination with chlorhexidine for the prevention of ventilator-associated pneumonia in children - a randomized, controlled trial. Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 13(5), e305–e310. https://doi.org/10.1097/PCC.0b013e31824ea119.

Souza, A.F., Guimarães, A.C., & Ferreira, E.F. (2013). Avaliação da implementação de novo protocolo de higiene bucal em um centro de terapia intensiva para prevenção de pneumonia associada à ventilação mecânica. REME Revista Mineira de Enfermagem, 17(1),177-184.

Tablan, O. C., Anderson, L. J., Besser, R., Bridges, C., & Hajjeh, R., C.D.C. Healthcare Infection Control Practices Advisory Committee (2004). Guidelines for preventing health-care--associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports, 53(RR-3), 1–36.

Tuon, F. F., Gavrilko, O., Almeida, S., Sumi, E. R., Alberto, T., Rocha, J. L., & Rosa, E. A. (2017). Prospective, randomised, controlled study evaluating early modification of oral microbiota following admission to the intensive care unit and oral hygiene with chlorhexidine. Journal of global antimicrobial resistance, 8, 159–163. https://doi.org/10.1016/j.jgar.2016.12.007.

Published

21/10/2020

How to Cite

SIMÕES, T. M. S.; FERNANDES NETO, J. de A.; FERREIRA, A. C. D.; SOUSA, J. A. de; MEDEIROS, C. L. S. G. de .; CATÃO, M. H. C. de V. Control of oral biofilm and its relationship with the reduction of respiratory infections in ICU patients: a review of clinical trials. Research, Society and Development, [S. l.], v. 9, n. 10, p. e8339108594, 2020. DOI: 10.33448/rsd-v9i10.8594. Disponível em: https://www.rsdjournal.org/index.php/rsd/article/view/8594. Acesso em: 19 apr. 2024.

Issue

Section

Review Article