A Crossover Trial of a Novel Toothbrushing Method for Prevention of Aspiration Pneumonia: Toothpaste With Povidone-Iodine and Moisturizing Gel Mixture.

INTRODUCTION

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.