{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T20:37:09Z","timestamp":1792701429003,"version":"4.5.0"},"reference-count":32,"publisher":"Cambridge University Press (CUP)","issue":"11","license":[{"start":{"date-parts":[[2016,5,10]],"date-time":"2016-05-10T00:00:00Z","timestamp":1462838400000},"content-version":"unspecified","delay-in-days":556,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:sec id=\"S0899823X00193316_ab1\"><jats:title>Objective.<\/jats:title><jats:p>To evaluate whether dental treatment may enhance oral antisepsis, thus preventing more effectively lower respiratory tract infections (LRTIs) among critically ill patients<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X00193316_ab2\"><jats:title>Design.<\/jats:title><jats:p>Observer-blind randomized clinical trial.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X00193316_ab3\"><jats:title>Setting.<\/jats:title><jats:p>General intensive care unit (ICU) for adult patients.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X00193316_ab4\"><jats:title>Patients.<\/jats:title><jats:p>We analyzed data from 254 adult patients who stayed for at least 48 hours in the ICU.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X00193316_ab5\"><jats:title>Intervention.<\/jats:title><jats:p>Patients were randomized by means of rolling dice. The experimental group (<jats:italic>n<\/jats:italic> = 127) had access to dental care provided by a dental surgeon, 4\u20135 times a week. Besides routine oral hygiene, care also included teeth brushing, tongue scraping, removal of calculus, atraumatic restorative treatment of caries, and tooth extraction. The control group (<jats:italic>n<\/jats:italic> = 127) had access to routine oral hygiene only, which included the use of chlorhexidine as a mouth rinse, which was performed by the ICU nurse staff.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X00193316_ab6\"><jats:title>Results.<\/jats:title><jats:p>The primary study outcome was the LRTI incidence, which was 8.7% in the experimental group and 18.1% in the control group (adjusted relative risk [RR], 0.44 [95% confidence interval (CI), 0.20\u20130.96]; <jats:italic>P<\/jats:italic> = .04). Ventilator-associated pneumonia rates per 1,000 ventilator-days were 16.5 (95% CI, 9.8\u201329.5) in the control group and 7.6 (95% CI, 3.3\u201315.0) in the experimental group (<jats:italic>P<\/jats:italic> &lt; .05). Mortality rates were similar between both study groups: 31.5% in the control group versus 29.1% in the experimental group (adjusted RR, 0.93 [95% CI, 0.52\u20131.65]; <jats:italic>P<\/jats:italic> = .796). No severe adverse events related to oral care were observed during the study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X00193316_ab7\"><jats:title>Conclusion.<\/jats:title><jats:p>Dental treatment was safe and effective in the prevention of LRTI among critically ill patients who were expected to stay at least 48 hours in the ICU.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X00193316_ab8\"><jats:title>Trial registration.<\/jats:title><jats:p>Brazilian Clinical Trials Registry, affiliated with the World Health Organization\u2019s International Clinical Trial Registry Platform: U1111-1152-2671.<\/jats:p><jats:p><jats:italic>Infect Control Hosp Epidemiol<\/jats:italic> 2014;35(11):1342\u20131348<\/jats:p><\/jats:sec>","DOI":"10.1086\/678427","type":"journal-article","created":{"date-parts":[[2014,10,2]],"date-time":"2014-10-02T18:30:02Z","timestamp":1412274602000},"page":"1342-1348","source":"Crossref","is-referenced-by-count":63,"title":["Effectiveness of a Dental Care Intervention in the Prevention of Lower Respiratory Tract Nosocomial Infections among Intensive Care Patients: A Randomized Clinical Trial"],"prefix":"10.1017","volume":"35","author":[{"given":"Wanessa T.","family":"Bellissimo-Rodrigues","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayra G.","family":"Menegueti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilberto G.","family":"Gaspar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edson A.","family":"Nicolini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Auxiliadora-Martins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anibal","family":"Basile-Filho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Martinez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Bellissimo-Rodrigues","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2016,5,10]]},"reference":[{"key":"S0899823X00193316_ref643","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.175.4.418a"},{"key":"S0899823X00193316_ref644","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2006.04.003"},{"key":"S0899823X00193316_ref640","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-198510000-00009"},{"key":"S0899823X00193316_ref648","first-page":"412","article-title":"Importance of dental work in patients under intensive care unit","volume":"18","author":"Morais","year":"2006","journal-title":"Rev Bras Ter Intensiva"},{"key":"S0899823X00193316_ref635","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD008367.pub2"},{"key":"S0899823X00193316_ref650","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000181731.53912.D9"},{"key":"S0899823X00193316_ref642","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2672.92.5s1.14.x"},{"key":"S0899823X00193316_ref625","doi-asserted-by":"publisher","DOI":"10.1378\/chest.122.6.2115"},{"key":"S0899823X00193316_ref629","doi-asserted-by":"publisher","DOI":"10.1590\/S0037-86822012000500001"},{"key":"S0899823X00193316_ref638","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2008.03.002"},{"key":"S0899823X00193316_ref646","doi-asserted-by":"publisher","DOI":"10.1186\/cc11675"},{"key":"S0899823X00193316_ref634","doi-asserted-by":"publisher","DOI":"10.1086\/605722"},{"key":"S0899823X00193316_ref621","doi-asserted-by":"publisher","DOI":"10.1590\/S1413-86702007000500009"},{"key":"S0899823X00193316_ref641","doi-asserted-by":"publisher","DOI":"10.1046\/j.1198-743x.2001.00253.x"},{"key":"S0899823X00193316_ref651","doi-asserted-by":"publisher","DOI":"10.1086\/518518"},{"key":"S0899823X00193316_ref620","doi-asserted-by":"publisher","DOI":"10.1590\/S1020-49892008000900006"},{"key":"S0899823X00193316_ref624","doi-asserted-by":"crossref","first-page":"2323","DOI":"10.1001\/jama.2009.1754","article-title":"International study of the prevalence and outcomes of infection in intensive care units","volume":"302","author":"Jean-Louis","year":"2009","journal-title":"JAMA"},{"key":"S0899823X00193316_ref622","doi-asserted-by":"publisher","DOI":"10.1590\/S0037-86822012005000003"},{"key":"S0899823X00193316_ref628","doi-asserted-by":"publisher","DOI":"10.1086\/593193"},{"key":"S0899823X00193316_ref630","doi-asserted-by":"publisher","DOI":"10.1378\/chest.109.6.1556"},{"key":"S0899823X00193316_ref647","unstructured":"Minist\u00e9rio da Sa\u00fade. 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