Unit of Periodontology, International Centre for Evidence-Based Oral Health, UCL Eastman Dental Institute, London, UK.
J Clin Periodontol. 2011 Mar;38(3):246-52. doi: 10.1111/j.1600-051X.2010.01688.x. Epub 2011 Jan 11.
To investigate the effect of a powered toothbrush on colonization of dental plaque by ventilator-associated pneumonia (VAP)-associated organisms and dental plaque removal.
Parallel-arm, single-centre, examiner- and analyst-masked randomized controlled trial. Forty-six adults were recruited within 48 h of admission. Test intervention: powered toothbrush, control intervention: sponge toothette, both used four times per day for 2 min. Groups received 20 ml, 0.2% chlorhexidine mouthwash at each time point.
The results showed a low prevalence of respiratory pathogens throughout with no statistically significant differences between groups. A highly statistically significantly greater reduction in dental plaque was produced by the powered toothbrush compared with the control treatment; mean plaque index at day 5, powered toothbrush 0.75 [95% confidence interval (CI) 0.53, 1.00], sponge toothette 1.35 (95% CI 0.95, 1.74), p=0.006. Total bacterial viable count was also highly statistically significantly lower in the test group at day 5; Log(10) mean total bacterial counts: powered toothbrush 5.12 (95% CI 4.60, 5.63), sponge toothette 6.61 (95% CI 5.93, 7.28), p=0.002.
Powered toothbrushes are highly effective for plaque removal in intubated patients in a critical unit and should be tested for their potential to reduce VAP incidence and health complications.
研究电动牙刷对呼吸机相关性肺炎（VAP）相关病原体定植和牙菌斑清除的影响。
平行臂、单中心、 examiner- 和 analyst-masked 随机对照试验。46 名成年人在入院后 48 小时内被招募。试验干预：电动牙刷，对照干预：海绵牙线，每天使用四次，每次两分钟。两组均在每次使用 20ml、0.2%洗必泰漱口液。
结果显示，呼吸道病原体的患病率较低，组间无统计学差异。与对照组相比，电动牙刷在牙菌斑的减少方面具有显著统计学意义；第 5 天菌斑指数，电动牙刷 0.75 [95%置信区间（CI）0.53，1.00]，海绵牙线 1.35（95%CI 0.95，1.74），p=0.006。第 5 天，试验组总细菌活菌数也具有显著统计学意义降低；Log(10)总细菌计数均值：电动牙刷 5.12（95%CI 4.60，5.63），海绵牙线 6.61（95%CI 5.93，7.28），p=0.002。
电动牙刷在重症监护病房的插管患者中对牙菌斑的清除非常有效，应测试其降低 VAP 发生率和健康并发症的潜力。
