Daily tooth brushing linked to lower rates of pneumonia in hospitalized patients

Researchers have found an inexpensive tool that can help reduce pneumonia rates in hospitalized patients – and it has bristles on one end.

A new study led by researchers at Brigham and Women’s Hospital and the Harvard Pilgrim Health Care Institute examined whether daily tooth brushing among hospitalized patients was associated with lower rates of hospital-acquired pneumonia and other outcomes.

The team combined results from 15 randomized clinical trials involving more than 2,700 patients and found that rates of hospital-acquired pneumonia were lower in patients who brushed their teeth daily compared to those who did not. The results were particularly convincing in patients receiving mechanical ventilation.

Their article, “Association Between Daily Teething and Hospital-Acquired Pneumonia: A Systematic Review and Meta-Analysis,” was published in JAMA Internal Medicine.

“The signal we see here toward lower mortality is striking: it suggests that regular toothbrushing in the hospital can save lives,” said corresponding author Michael Klompas, MD, MPH, a hospital epidemiologist and physician. specialist in infectious diseases at the BWH Department of Medicine. and professor of population medicine at the Harvard Pilgrim Health Care Institute.

“It is rare in the world of hospital preventive medicine to find something like this that is both effective and inexpensive. Instead of a new device or drug, our study indicates that something something as simple as brushing your teeth can make a big difference.”

Hospital-acquired pneumonia occurs when bacteria from the mouth enters a patient’s airways and infects their lungs. Frail patients or those with weakened immune systems are particularly likely to develop hospital-acquired pneumonia during their hospital stay. However, adopting a daily toothbrushing regimen can decrease the amount of bacteria in the mouth, potentially reducing the risk of hospital-acquired pneumonia.

The team conducted a systematic review and meta-analysis to determine the association between daily tooth brushing and hospital-acquired pneumonia. Using a variety of databases, researchers collected and analyzed randomized clinical trials from around the world comparing the effect of regular oral care with tooth brushing versus oral care without tooth brushing. teeth on the occurrence of nosocomial pneumonia and other outcomes.

The team’s analysis found that daily tooth brushing was associated with a significantly lower risk of hospital-acquired pneumonia and ICU mortality. Additionally, investigators identified that ICU patient tooth brushing was associated with fewer days of mechanical ventilation and shorter ICU length of stay.

Most of the studies reviewed by the team explored the role of a teeth-cleaning regimen in adults in intensive care. Only two of the 15 studies included in the authors’ analysis assessed the impact of toothbrushing in non-ventilated patients. Researchers hope that the protective effect of toothbrushing will extend to non-ICU patients, but additional studies in this population are needed to clarify whether this is indeed the case.

“The results of our study highlight the importance of implementing an oral health routine including tooth brushing for hospitalized patients. We hope that our study will help catalyze policies and programs to ensure that hospitalized patients brush their teeth regularly. perform this task themselves, we recommend assistance from a member of the patient’s care team,” Klompas said.