The impact of periodontal condition on hospital infection rates

Clues of the relationship between oral and systemic diseases, since 2100 B.C., have been reported. Oral health and care, specially periodontal, are responsible for prevention and reduction of microorganisms dissemination. In critically ill patients, potential pathogens can be cultured from the oral cavity. They can relocate in the lungs, resulting in hospital infections – mainly pneumonia – whose database is scare in Brazil and Espírito Santo. Objective: The aim of the present study was to examine the dental status, mainly the periodontal condition of the Intensive Care Unit(ICU) patients of a University's Hospital(UH) and its association with hospital infections. Methods: This study was approved by the ethics committee. All patients were examined by the same dentist for their systemic and oral condition within the first 48 hours of hospitalization and the association between deficient oral condition and hospital infection was established. New mechanical and chemical (0,12 % chlorhexidine digluconate) methods of oral hygiene were introduced in order to compare the hospital infections rate of the studied patients and the ones hospitalized before the beginning of the study. Results: A total of 81 patients were admitted from June to September, one refused to participate and it was not possible to oral examine another. Out of the 80 analyzed, 50% used mechanical ventilation. Of the 79 oral examinations analyzed, 36.7% were edentulous and 63.29% were toothed, from these 56% had plaque indices between 91% and 100% and 69.62% had xerostomia. Among the patients, 63.29% had periodontitis (8% had mild,14% moderate and 78% had advanced periodontitis) and 3.75% caught nosocomial pneumonia. Conclusion: A relationship between advanced periodontitis and nosocomial pneumonia was estabilished, and a decrease in its rate – of 4.52% (June-Sep 2009) to 3.75% (June-Sep 2010) – in the ICU of UH resulted from the introduction of the new methods.