Funahara Madoka, Imakiire Akira, Funahara Ryuichiro, Oyama Haruka, Soutome Sakiko, Nakamichi Atsuko
School of Oral Health Sciences, Faculty of Dentistry, Kyushu Dental University, Kitakyushu, JPN.
Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JPN.
Cureus. 2024 Dec 10;16(12):e75494. doi: 10.7759/cureus.75494. eCollection 2024 Dec.
Toothbrushing, during which dental plaque is brushed off into the oral cavity, can increase the risk of aspiration pneumonia in older adults and intubated patients.
This study examined brushing methods to prevent the spread of bacteria in the oral cavity. Six participants who required assistance with brushing received toothbrushing from a dental hygienist. Toothbrushing was performed using a toothbrush soaked in water (Water group), gel (Gel group), povidone-iodine solution (PV-I group), or a mixture of a moisturizing gel and povidone-iodine gel (PV-I+Gel group). The number of bacteria in the saliva before and after brushing was measured using a delayed real-time polymerase chain reaction, which can quantify the number of viable bacteria.
In the Water group, salivary bacterial counts increased significantly after brushing. The bacterial counts in the Gel and PV-I groups increased slightly after brushing; however, the increase was less than that observed in the Water group. In the PV-I+Gel group, the number of bacteria in the saliva was significantly reduced after brushing.
In patients at risk for aspiration pneumonia, toothbrushing should be performed with a mixture of PV-I and a moisturizing gel. This method is a novel approach that reduces the risk of aspiration pneumonia in intubated patients and older adults requiring care, and its clinical application is expected in the future.
刷牙过程中牙菌斑会被刷入口腔，这可能会增加老年人和插管患者发生吸入性肺炎的风险。
本研究探讨了预防口腔内细菌传播的刷牙方法。六名需要协助刷牙的参与者由一名牙科保健员为其刷牙。分别使用浸泡在水中的牙刷（水组）、凝胶（凝胶组）、聚维酮碘溶液（PV-I组）或保湿凝胶与聚维酮碘凝胶的混合物（PV-I+凝胶组）进行刷牙。使用能定量活菌数量的延迟实时聚合酶链反应测量刷牙前后唾液中的细菌数量。
在水组中，刷牙后唾液细菌计数显著增加。凝胶组和PV-I组刷牙后细菌计数略有增加；然而，增加幅度小于水组。在PV-I+凝胶组中，刷牙后唾液中的细菌数量显著减少。
对于有吸入性肺炎风险的患者，应使用聚维酮碘和保湿凝胶的混合物进行刷牙。这种方法是一种新的途径，可降低插管患者和需要护理的老年人发生吸入性肺炎的风险，预计未来将在临床中应用。
