The Effectiveness of Combination Toothbrushing and Suctioning for Oral hygiene Protocol in Reducing VAP in Intubated Patient: A Systematic Review of Randomized Controlled Trials

Titis Wening Setyoharsih; Saryono Saryono; Desiyani Nani

doi:10.55606/ijhs.v6i2.7574

Authors

Titis Wening Setyoharsih Akademi Keperawatan Al-Hikmah 2 Brebes
Saryono Saryono Universitas Jenderal Soedirman
Desiyani Nani Universitas Jenderal Soedirman

DOI:

https://doi.org/10.55606/ijhs.v6i2.7574

Keywords:

Intubated Patient, Oral Hygiene, Suctioning, Toothbrushing, VAP

Abstract

Intubated patients admitted to intensive care units (ICUs) are highly susceptible to impaired oral immunity, resulting in rapid oral microbial colonization, dental plaque accumulation, dry mouth, and other oral health problems. Poor oral hygiene is strongly associated with ventilator-associated pneumonia (VAP), a leading cause of morbidity and mortality among mechanically ventilated patients. This study aimed to evaluate the effectiveness of combining toothbrushing and suctioning during oral hygiene in reducing the incidence of VAP in intubated patients. A systematic review was conducted using the PICO framework and PRISMA guidelines to identify and analyze relevant studies. The findings showed that oral hygiene interventions included swabbing, toothbrushing, suctioning, mouth rinsing, and oral moisturizing. Although not all reviewed studies demonstrated a statistically significant reduction in VAP incidence with the combined use of toothbrushing and suctioning, several reported lower VAP rates compared with swabbing alone. Variations in outcomes were likely influenced by differences in oral care protocols, mouthwash solutions, toothbrush types, suction devices, and intervention frequency. Overall, comprehensive oral hygiene incorporating toothbrushing and suctioning appears to improve oral health and may contribute to reducing VAP risk when supported by standardized evidence-based nursing protocols.

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References

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