{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T19:04:28Z","timestamp":1770750268053,"version":"3.50.0"},"reference-count":30,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T00:00:00Z","timestamp":1655769600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Perioperative oral management is performed to prevent postoperative complications, but its indication and management method are unclear. This study aimed to investigate salivary bacterial counts pre-and postoperatively, and factors related to increased bacterial count postoperatively. We included 121 patients who underwent surgery under general anesthesia and perioperative oral management. The bacterial count in saliva was determined preoperatively, and first and seventh days postoperatively using the dielectrophoresis and impedance measurement methods. The relationships between salivary bacterial count and various variables were analyzed using one-way analysis of variance, Spearman\u2019s rank correlation coefficient, and multiple regression analysis. The salivary bacterial count increased significantly on the first day postoperatively but decreased on the seventh day. Multivariate analysis showed that age (p = 0.004, standardized coefficient \u03b2 = 0.283) and xerostomia (p = 0.034, standardized coefficient \u03b2 = 0.192) were significantly correlated with increased salivary bacterial count preoperatively. Salivary bacterial count on the day after surgery was significantly increased in patients with a large number of bacterial counts on the day before surgery after preoperative oral care (p = 0.007, standardized coefficient \u03b2 = 0.241) and postoperative fasting (p = 0.001, standardized coefficient \u03b2 = \u22120.329). Establishing good oral hygiene before surgery and decreasing salivary bacterial count are necessary in patients with a high risk of postoperative surgical site infection or pneumonia, especially in older adults or postoperative fasting.<\/jats:p>","DOI":"10.3390\/ijerph19137552","type":"journal-article","created":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T04:39:55Z","timestamp":1655786395000},"page":"7552","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Number of Bacteria in Saliva in the Perioperative Period and Factors Associated with Increased Numbers"],"prefix":"10.3390","volume":"19","author":[{"given":"Yuki","family":"Sakamoto","sequence":"first","affiliation":[{"name":"Department of Dentistry and Oral Surgery, Kansai Medical University Medical Center, Osaka 5708507, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arisa","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Department of Dentistry and Oral Surgery, Kansai Medical University Medical Center, Osaka 5708507, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makiko","family":"Moriyama","sequence":"additional","affiliation":[{"name":"Department of Dentistry and Oral Surgery, Kansai Medical University Medical Center, Osaka 5708507, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiko","family":"Otsuka","sequence":"additional","affiliation":[{"name":"Park Dental Clinic, Kanagawa 2510025, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1188-7570","authenticated-orcid":false,"given":"Madoka","family":"Funahara","sequence":"additional","affiliation":[{"name":"School of Oral Health Sciences, Kyusyu Dental University, Fukuoka 8038580, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sakiko","family":"Soutome","sequence":"additional","affiliation":[{"name":"Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 8528102, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Umeda","sequence":"additional","affiliation":[{"name":"Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical, Sciences, Nagasaki 8528102, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuka","family":"Kojima","sequence":"additional","affiliation":[{"name":"Department of Dentistry and Oral Surgery, Kansai Medical University Hospital, Osaka 5731191, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e19129","DOI":"10.1097\/MD.0000000000019129","article-title":"A multicenter retrospective investigation on the efficacy of perioperative oral management in cancer patients","volume":"99","author":"Yamada","year":"2020","journal-title":"Medicine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e25119","DOI":"10.1097\/MD.0000000000025119","article-title":"The effects of perioperative oral management on perioperative serum albumin levels in patients treated surgically under general anesthesia: A multicenter retrospective analysis in Japan","volume":"100","author":"Yamada","year":"2021","journal-title":"Medicine"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"257","DOI":"10.3747\/co.27.5963","article-title":"A clinical investigation of the association between perioperative oral management and prognostic nutritional index in patients with digestive and urinary cancers","volume":"27","author":"Otagiri","year":"2020","journal-title":"Curr. Oncol."},{"key":"ref_4","first-page":"901","article-title":"Current characteristics of infective endocarditis in Japan-An analysis of 848 case in 2000 and 2001","volume":"67","author":"Nakanishi","year":"2003","journal-title":"Circ. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e7436","DOI":"10.1097\/MD.0000000000007436","article-title":"Effect of perioperative oral care on prevention of postoperative pneumonia associated with esophageal cancer surgery: A multicenter case-control study with propensity score matching analysis","volume":"96","author":"Soutome","year":"2017","journal-title":"Medicine"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1089\/sur.2015.158","article-title":"Preventive effect on post-operative pneumonia of oral health care among patients who undergo esophageal resection: A multi-center retrospective study","volume":"17","author":"Soutome","year":"2016","journal-title":"Surg. Infect."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"4155","DOI":"10.1007\/s00520-019-05242-w","article-title":"Joint Research Committee of Japanese Society of Oral Care. Prevention of postoperative pneumonia by perioperative oral care in patients with esophageal cancer undergoing surgery: A multicenter retrospective study of 775 patients","volume":"28","author":"Soutome","year":"2020","journal-title":"Supportive Care Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1159\/000121903","article-title":"Impact of preoperative dental plaque culture for predicting postoperative pneumonia in esophageal cancer patients","volume":"25","author":"Akutsu","year":"2008","journal-title":"Dig. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"17","DOI":"10.2302\/kjm.2017-0017-OA","article-title":"The effect of improving oral hygiene through professional oral care to reduce the incidence of pneumonia post-esophagectomy in esophageal cancer","volume":"68","author":"Yamada","year":"2019","journal-title":"Keio J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1688","DOI":"10.1002\/bjs.10915","article-title":"Preoperative oral care and effect on postoperative complications after major cancer surgery","volume":"105","author":"Ishimaru","year":"2018","journal-title":"Br. J. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e12545","DOI":"10.1097\/MD.0000000000012545","article-title":"Effect of perioperative oral management on the prevention of surgical site infection after colorectal cancer surgery: A multicenter retrospective analysis of 698 patients via analysis of covariance using propensity score","volume":"97","author":"Nobuhara","year":"2018","journal-title":"Medicine"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Nobuhara, H., Matsugu, Y., Soutome, S., Hayashida, S., Hasegawa, T., Akashi, M., Yamada, S., Kurita, H., Nakahara, H., and Nakahara, M. (2022). Perioperative oral care can prevent surgical site infection after colorectal cancer surgery: A multicenter, retrospective study of 1926 cases analyzed by propensity score matching. Surgery, in press.","DOI":"10.1016\/j.surg.2022.02.015"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Itohara, C., Matsuda, Y., Sukegawa-Takahashi, Y., Sukegawa, S., Furuki, Y., and Kanno, T. (2020). Relationship between oral health status and postoperative fever among patients with lung cancer treated by surgery: A retrospective cohort study. Healthcare, 8.","DOI":"10.3390\/healthcare8040405"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1016\/j.surg.2018.11.020","article-title":"Effects of perioperative oral care on prevention of postoperative pneumonia after lung resection: Multicenter retrospective study with propensity score matching analysis","volume":"165","author":"Iwata","year":"2019","journal-title":"Surgery"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1007\/s00520-020-05525-7","article-title":"Effects of preoperative dental examination and oral hygiene instruction on surgical site infection after hepatectomy: A retrospective study","volume":"29","author":"Hasegawa","year":"2021","journal-title":"Supportive Care Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1007\/s00520-010-0853-6","article-title":"Oral health care reduces the risk of postoperative surgical site infection in inpatients with oral squamous cell carcinoma","volume":"19","author":"Sato","year":"2011","journal-title":"Supportive Care Cancer"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"526","DOI":"10.2334\/josnusd.18-0380","article-title":"Perioperative changes in oral bacteria number in patients undergoing cardiac valve surgery","volume":"61","author":"Suzuki","year":"2019","journal-title":"J. Oral. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"B\u00e1gyi, K., Haczku, A., M\u00e1rton, I., Szab\u00f3, J., G\u00e1sp\u00e1r, A., Andr\u00e1si, M., Varga, I., T\u00f3th, J., and Klekner, A. (2009). Role of pathogenic oral flora in postoperative pneumonia following brain surgery. BMC Infect. Dis., 9.","DOI":"10.1186\/1471-2334-9-104"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1097\/00003246-199206000-00007","article-title":"Colonizaition of dental plaque by respiratory pathogens in medical intensive care patients","volume":"20","author":"Scannapieco","year":"1992","journal-title":"Crit. Care Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1097\/00003246-199802000-00032","article-title":"Colonization of dental plaque: A source of nosocomial infections in intensive care unit patients","volume":"26","author":"Fourrier","year":"1998","journal-title":"Crit. Care Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.ooe.2004.08.003","article-title":"Multivariate analysis of risk factors for wound infection in head and neck squamous cell carcinoma surgery with opening of mucosa. Study of 260 surgical procedures","volume":"41","author":"Penel","year":"2005","journal-title":"Oral Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1046\/j.1532-5415.2002.50106.x","article-title":"Oral care reduces pneumonia in older patients in nursing homes","volume":"50","author":"Yoneyama","year":"2002","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Hayashida, S., Funahara, M., Sekino, M., Yamaguchi, N., Kosai, K., Yanamoto, S., Yanagihara, K., and Umeda, M. (2016). The effect of tooth brushing, irrigation, and topical tetracycline administration on the reduction of oral bacteria in mechanically ventilated patients: A preliminary study. BMC Oral Health, 16.","DOI":"10.1186\/s12903-016-0224-x"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1902\/jop.1972.43.1.38","article-title":"The plaque control record","volume":"43","author":"Grake","year":"1972","journal-title":"J. Periodontal."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1111\/j.1741-2358.2004.00037.x","article-title":"Usefulness of new wetnedd tester for diagnosis of dry mouth in disabled patients","volume":"21","author":"Kakinoki","year":"2004","journal-title":"Gerodontology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1016\/j.ijom.2015.06.002","article-title":"Efficacy of topical antibiotic administration on the inhibition of perioperative oral bacteria growth on oral cancer patients: A preliminary study","volume":"44","author":"Funahara","year":"2015","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e8891","DOI":"10.1097\/MD.0000000000008891","article-title":"Prevention of surgical site infection after oral cancer surgery by topical tetracycline: Results of a multicenter randomized control trial","volume":"96","author":"Funahara","year":"2017","journal-title":"Medicine"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1186\/s12903-018-0689-x","article-title":"Clinical observation of tongue coating of perioperative patients: Factors related to the number of bacteria on the tongue before and after surgery","volume":"18","author":"Funahara","year":"2018","journal-title":"BMC Oral Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/jtxs.12356","article-title":"Aging-related changes in quantity and quality of saliva: Where do we stand in our understanding?","volume":"50","author":"Xu","year":"2019","journal-title":"J. Texture Stud."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1016\/j.jds.2021.09.031","article-title":"Effect of decreased tongue pressure on dysphagia and survival rate in elderly people requiring long-term care","volume":"17","author":"Sakamoto","year":"2021","journal-title":"J. Dent. Sci."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/13\/7552\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:36:12Z","timestamp":1760139372000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/13\/7552"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,21]]},"references-count":30,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["ijerph19137552"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19137552","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,21]]}}}