Mechanical Ventilation: The Benefits of Incorporating Dental Personnel and Oral Hygiene Protocols

Abstract

The oral cavity is a portal of entry for pathogenic organisms to circulate throughout the body. Without proper oral hygiene care and maintenance, patients under respiratory distress are left susceptible to potentially harmful diseases. Mechanical ventilation is a fundamental component of modern treatment facilitated in managing intubated patients due to upper respiratory diseases. Although ventilation therapy is essential, it bypasses the filtration mechanisms and salivary clearance necessary to prevent infection of the respiratory system. A combination of immunosuppression and poor oral hygiene increases the risk for potential virulent organisms to develop within the oral cavity. Appropriate measures to combat this increased risk, include routine mechanical removal of plaque, use of antiseptic mouth rinse, saliva substitutes, and assessment of oral diseases. Unfortunately, implementation of care for the oral cavity is lacking due to the insufficient education and training for non-oral health care providers. The recent coronavirus disease 2019 (Covid-19) pandemic has exacerbated the use of mechanical ventilators, increasing the cases of ventilation-associated pneumonia (VAP). Promoting interprofessional relationships could establish improved oral health protocols for mechanically ventilated patients. Additionally, incorporation of dental personnel to a multidisciplinary team would benefit other medical providers in the care of ventilated patients. This new discipline has potential to eliminate disparity between health of the oral cavity and systemic health. Although there is significant research indicating positive outcomes, further investigation is needed on effective standard of care for ventilated patients by inclusion of dental personnel in healthcare facilities.