Summary
Across 15 randomized trials (10,742 patients), daily toothbrushing was linked to lower hospital-acquired pneumonia (risk ratio 0.67, 95% confidence interval 0.56 to 0.81) and lower intensive care unit mortality (risk ratio 0.81). The effect was clearest in mechanically ventilated patients.
Key points
- Daily toothbrushing was associated with lower risk of hospital-acquired pneumonia (risk ratio 0.67, 95% confidence interval 0.56 to 0.81) and of death in intensive care (risk ratio 0.81).
- The pneumonia reduction was significant in patients on mechanical ventilation (risk ratio 0.68) but not in those who were not.
- In intensive care, toothbrushing was linked to 1.24 fewer days on a ventilator and 1.78 fewer days in intensive care.
- Brushing twice a day and brushing more often gave similar estimates, and results held in the 7 studies at low risk of bias.
- Design: systematic review and meta-analysis of 15 randomized trials in 10,742 hospitalized adults.