EFFICACY OF ORAL CARE PROTOCOLS IN PREVENTING CLINICAL COMPLICATIONS IN INTENSIVE CARE PATIENTS: AN INTEGRATIVE REVIEW

Abstract

Oral health is closely related to systemic health, especially in patients admitted to Intensive Care Units (ICUs). Proper oral hygiene contributes to the prevention of infections and clinical complications, such as Ventilator-Associated Pneumonia (VAP). The aim of this study was to analyze the effectiveness of oral care protocols in improving oral health and preventing clinical complications in hospitalized patients. An integrative literature review was conducted through PubMed, BVS, and SciELO databases between 2018 and 2025. After screening and applying inclusion and exclusion criteria, 10 articles were selected. The studies showed that standardized oral hygiene protocols significantly reduce the incidence of VAP, improve oral health indices, and favor better clinical outcomes. It is concluded that the implementation of care protocols and the integration of dentists into multidisciplinary teams are essential measures to promote health and reduce infectious complications in critically ill patients.

Author Biographies

Mateus de Sena Costa Santos, Universidade Estadual do Rio Grande do Norte

Dentist graduated from Facene/RN, specialist in Public Health, Radiology and Imaging, and Stomatology. Master’s degree in Health and Society from UERN. Professor of Dentistry at UNINASSAU Mossoró and professional in the Family Health Strategy in Apodi/RN. Also holds a technical degree in Information Technology from IFRN.

Fabio Kaian Silva Costa, Uninassau - Mossoró

Undergraduate Dentistry student at UNINASSAU Mossoró. Member of the Scientific Committee of the Mossoró Academic League of Preventive and Social Dentistry (LAMOP). Worked as a monitor for the Dental Materials course and participated in extension projects and experiences in the Brazilian Public Health System (SUS). Currently, he is a scholarship intern at the Dental Office of PROPEG/UERN.

Rosiane da Silva Dantas, Universidade do Estado do Rio Grande do Norte

Bachelor’s degree and teaching degree in Nursing from the State University of Rio Grande do Norte, Caicó campus. Currently, she is a resident in the Multiprofessional Residency Program in Primary Care, Family Health, and Community Health at the State University of Rio Grande do Norte.

Pedro Arthur Barros da Silva , Uninassau - Mossoró

Undergraduate Dentistry student at UNINASSAU Mossoró, currently in the 7th semester. Has experience in academic tutoring in General Anatomophysiology and Pre-Clinical Practices, as well as participation in research and extension projects with scientific publications. Served as Marketing Director of the Mossoró Academic League of Orofacial Harmonization (LAMHOF). Has academic interests in Implant Dentistry, Dental Diagnosis, and Health Promotion.

References

AUSTRÍACO-LEITE, H. L. et al. Avaliação odontológica de pacientes em unidade de terapia intensiva (UTI) pediátrica. CES Odontología, v. 31, n. 2, p. 6-14, 2018. Disponível em: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1055558 Acesso em: 18 fev. 2025. DOI: https://doi.org/10.21615/cesodon.31.2.1

BELLISSIMO-RODRIGUES, Wanessa Teixeira et al. Is it necessary to have a dentist within an intensive care unit team? Report of a randomised clinical trial. International dental journal, v. 68, n. 6, p. 420-427, 2018. DOI: https://doi.org/10.1111/idj.12397

BLUM, D. F. C. et al. Influência da presença de profissionais em odontologia e protocolos para assistência à saúde bucal na equipe de enfermagem da unidade de terapia intensiva. Estudo de levantamento. Revista Brasileira de Terapia Intensiva, v. 29, n. 3, p. 391-393, 2017. Disponível em: https://pubmed.ncbi.nlm.nih.gov/29044309/ Acesso em: 20 fev. 2025.

DALE, Craig M. et al. Effect of oral chlorhexidine de-adoption and implementation of an oral care bundle on mortality for mechanically ventilated patients in the intensive care unit (CHORAL): a multi-center stepped wedge cluster-randomized controlled trial. Intensive Care Medicine, v. 47, p. 1295-1302, 2021. DOI: https://doi.org/10.1007/s00134-021-06475-2

GIULIANO, Karen K. et al. Cuidados bucais como prevenção para pneumonia hospitalar não ventilatória: um estudo randomizado por conglomerados de quatro unidades. AJN The American Journal of Nursing , v. 121, n. 6, p. 24-33, 2021.

KARIMI, Sharare et al. Eficácia da implementação supervisionada de um protocolo de saúde bucal em pacientes com pneumonia associada à ventilação mecânica em unidades de terapia intensiva: um ensaio clínico randomizado, multicêntrico, duplo-cego e controlado. Infection Prevention in Practice , v. 5, n. 3, p. 100295, 2023.

LUDOVICHETTI, F. S. et al. Preventive oral hygiene and ventilator-associated pneumonia in paediatric intensive care unit. European Journal of Paediatric Dentistry, v. 23, n. 4, p. 298-302, 2022. Disponível em: https://pubmed.ncbi.nlm.nih.gov/36511909/ Acesso em: 18

fev. 2025.

METHODS IN MEDICINE, Computational and Mathematical. Retracted: The Impact of Improved Oral Care Methods on the Oral Health of Patients Undergoing Transoral Mechanical Ventilation. 2023. DOI: https://doi.org/10.1155/2023/9823261

MIRANDA, A. L. V.; ROCHA, L. A. da. Educação em saúde bucal para profissionais de saúde de uma Unidade de Terapia Intensiva Pediátrica. Revista Eletrônica Acervo Saúde, v. 24,​n.​8,​p.​1-7,​2024.​Disponível​em: https://acervomais.com.br/index.php/saude/article/view/15028/8899 Acesso em: 19 fev. 2025. DOI: https://doi.org/10.25248/reas.e15028.2024

PINTO, A. C. S. et al. Efficiency of different protocols for oral hygiene combined with the use of chlorhexidine in the prevention of ventilator-associated pneumonia. Jornal Brasileiro de Pneumologia, v. 47, n. 1, p. 20 2021. Disponível em:

https://pubmed.ncbi.nlm.nih.gov/33503132/ Acesso em: 19 fev. 2025.

SHENG, Han et al. Application of double-sleeve endotracheal tube in infection control for icu patients: a randomized controlled trial. Head & face medicine, v. 21, n. 1, p. 12, 2025. DOI: https://doi.org/10.1186/s13005-025-00488-8

SILVEIRA, B. L. et al. The health professionals’ perception related to the importance of the dental surgeon in the Intensive Care Unit. Revista Gaúcha de Odontologia, v. 68, 2020. Disponível em: https://www.scielo.br/j/rgo/a/vnWKddtw6yWRyJBPJdTNGnL/ Acesso em: 19 fev. 2025. DOI: https://doi.org/10.1590/1981-863720200001520190055

SOLE, Mary Lou et al. Nursing oral suction intervention to reduce aspiration and ventilator events (NO‐ASPIRATE): A randomized clinical trial. Journal of advanced nursing, v. 75, n. 5, p. 1108-1118, 2019. DOI: https://doi.org/10.1111/jan.13920

ZAMBRANO, Thainah Bruna Santos et al. Evaluation of brushing efficiency in reducing oral microbiota in mechanically ventilated patients admitted to an intensive care unit. Infection prevention in practice, v. 6, n. 1, p. 100346, 2024. DOI: https://doi.org/10.1016/j.infpip.2024.100346

ZHANG, Qi et al. Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia. Cochrane Database of Systematic Reviews, n. 12, 2020. DOI: https://doi.org/10.1002/14651858.CD008367.pub4

How to Cite

de Sena Costa Santos, M. ., Costa Nobrega, M. ., Martins Matos, W. ., Silva Costa, F. K., Rosana da Silva Sena, F. ., Batalha de Medeiros, A. P. ., da Silva Dantas, R. ., & Barros da Silva , P. A. . (2026). EFFICACY OF ORAL CARE PROTOCOLS IN PREVENTING CLINICAL COMPLICATIONS IN INTENSIVE CARE PATIENTS: AN INTEGRATIVE REVIEW. RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218, 7(5), e757979. https://doi.org/10.47820/recima21.v7i5.7979