Oral health and ventilator associated pneumonia
Research type
Research Study
Full title
A single centre pilot prospective study to determine the association between oral health and development of ventilator associated pneumonia (VAP)
IRAS ID
248445
Contact name
Fionnuala Lundy
Contact email
Sponsor organisation
Queen's University Belfast
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Oral health is considered an important aspect of overall patient care during any hospital admission. Hospital protocols frequently exist to outline a specific regime of oral care for each patient. Despite this, current evidence suggests that throughout a patient’s hospital stay their oral health often deteriorates. This is frequently the case in a critical care setting, particularly in patients who require machines to support their breathing (mechanical ventilation). As oral health deteriorates, the number of micro-organisms often increases, and alongside this there is frequently a change in the variety of species. The type of bacteria living in certain parts of the mouth have been shown to vary between different sites particularly in the presence of disease such as gum disease and tooth decay.
Several types of bacteria found in the mouth are known to play a role not only in oral disease but also in systemic (whole body) disease and infection. One such infection is ventilator associated pneumonia (VAP). This is a lung infection which occurs in patients who are mechanically ventilated and is thought to affect up to 1 in 4 patients. VAP has the potential to significantly increase cost of care, length of both intensive care unit (ICU) and hospital stay, as well as mortality.
There is growing evidence from scientific studies that respiratory pathogens (bacteria with the potential to cause lung disease) found in dental plaque increase as oral health deteriorates and are often indistinguishable from those same pathogens found in the lungs. In mechanical ventilation the artificial tube which supports breathing (endotracheal tube) may impair the patient’s normal defence mechanisms thereby providing an uninterrupted pathway for oral bacteria to transfer to the lungs.
In mechanically ventilated patients, further analysis of their oral health on presentation, and changes in the diversity of the plaque layer throughout ventilation may provide better insight into the effect of oral health and specific oral bacteria on a patient’s risk of developing VAP.REC name
HSC REC B
REC reference
19/NI/0094
Date of REC Opinion
10 Jul 2019
REC opinion
Further Information Favourable Opinion