Search

Objective: This a cross-sectional study to evaluate the association between oral health findings and ventilator-associated pneumonia (VAP) among critically ill patients in intensive care units (ICU)., Material and Methods: Data were collected from medical records, and a detailed oral physical examination was performed on 663 critically ill patients on mechanical ventilation. Data were statistically analysed using univariate and logistic regression models relating the development of VAP with the oral findings., Results: At oral physical examination, the most frequent findings were tooth loss (568-85.67%), coated tongue (422-63.65%) and oral bleeding (192-28.96%). Patients with a coated tongue or oral bleeding on the first day of ICU hospitalization developed more VAP than did patients without these conditions (20.14 vs 13.69%, p = 0.02; 23.44 vs 15.50%, p = 0.01, respectively). In the logistic regression, a coated tongue and oral bleeding were considered independent risk factors for VAP development (OR = 1.61 (1.03-2.51) and OR = 1.69 (1.08-2.66), respectively)., Conclusions: The presence of a coated tongue and oral bleeding in ICU admission could be considered markers for the development of VAP., Clinical Relevance: The results of this paper reinforce the importance of proper maintenance of oral hygiene before intubation, which may lead to a decrease in the incidence of VAP in the ICU.

Aim: The current study was designed to determine prevalence of various tongue lesions and their association with age, gender, systemic illness, deleterious habits, and distribution over the surfaces of tongue. It also explored the awareness and knowledge of subjects in relation to presence of tongue lesions, etiological factor, symptoms, and treatment received if any., Methods: The present study was conducted on 1360 randomly selected dental outpatients from 1/10/2013 to 30/09/2014. Examination of tongue included surface changes, size, movements, and the presence of mucosal lesions. The subjects were asked about the knowledge, symptoms, and treatment obtained in case of awareness regarding the lesion., Results: The prevalence of tongue lesions was found to be 13.75%. The most prevalent lesion was found to be coated tongue. The majority of the lesions were located on dorsum of tongue and not related with age, gender, habit, and systemic condition. A considerable number of subjects were aware of the changes on their tongue but negligible number sought any treatment., Conclusions: The presence of tongue lesions in the study population was found be significant. Hence, general dental practitioners and health care providers should be educated about the diagnosis, etiology, investigations, and proper management of such tongue lesions.

Background: The influence of gastric Helicobacter pylori infection on the development of oral pathoses remains unclear. The aim of this study is to examine the influence of gastric H. pylori infection on occurrence of halitosis and coated tongue., Materials and Methods: Ninety-eight patients with dyspepsia were included in the study and their salivary samples and gastric biopsies were analyzed for the presence of H. pylori by Nested-PCR. Halitosis and coated tongue were assessed at the initial examination and 3 months after systemic eradication therapy against H. pylori., Results: Gastric biopsies of 66 patients were positive for H. pylori. Only one saliva sample was H. pylori positive. At initial examination, halitosis was observed in 20 patients (30.3%) out of 66 who had gastric H. pylori infection and in only 3 patients (9.4%) out of 32 without H. pylori infection (p = 0.0236). Coated tongue was diagnosed in 18 (27.2%) patients with the infection compared to only 2 (6.25%) patients negative for gastric H. pylori (p = 0.0164). Patients with gastric infection were treated with the triple eradication therapy (Amoxicillin, Clarythromycin, Pantoprazol) and their gastric biopsies and oral status were examined 3 months later. Halitosis was significantly more prevalent in the group of patients with persistent H. pylori infection (42.1%) compared to only 6.4% of patients in the group where infection was successfully eradicated (p = 0.0012). Coated tongue was diagnosed in 47.4% of patients where H. pylori was still present after eradication therapy and in only 6.4% where eradication succeeded (p = 0.0003)., Conclusion: Our findings suggest that eradication of gastric H. pylori significantly alleviates halitosis and coated tongue, the two oral conditions that may be considered as extragastric manifestations of this common chronic bacterial infection.