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Sakai H, Kurita H, Kondo E, Tanaka H, Shimane T, Hashidume M, Yamada SI. Dental and oral management in the perioperative period of surgery: A scoping review. JAPANESE DENTAL SCIENCE REVIEW 2024; 60:148-153. [PMID: 38633513 PMCID: PMC11021219 DOI: 10.1016/j.jdsr.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/27/2024] [Accepted: 03/25/2024] [Indexed: 04/19/2024] Open
Abstract
Dental and oral management (DOM) is a long-established treatment modality. This scoping review aimed to narratively review previous studies, examine the effects of perioperative DOM, and identify the available evidence. A literature search was conducted using the PubMed electronic database for studies published between January 1, 2000, and March 8, 2022. The search yielded 43 studies, most of which were published in the last 10 years. The results of this study confirmed that improved perioperative oral hygiene is effective in preventing postoperative pneumonia. Our results also suggested that preoperative DOM is effective in preventing postoperative surgical site infections. Perioperative DOM is effective in reducing the incidence of postoperative pneumonia, SSI, and postsurgical complications. Further studies are needed to elucidate the various mechanism of DOM and to examine efficient intervention methods and timing.
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Affiliation(s)
- Hironori Sakai
- Department of Oral and Maxillofacial Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto-shi, Nagano-ken 390-0872, Japan
| | - Hiroshi Kurita
- Department of Oral and Maxillofacial Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto-shi, Nagano-ken 390-0872, Japan
| | - Eiji Kondo
- Department of Oral and Maxillofacial Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto-shi, Nagano-ken 390-0872, Japan
| | - Hirokazu Tanaka
- Department of Oral and Maxillofacial Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto-shi, Nagano-ken 390-0872, Japan
| | - Tetsu Shimane
- Department of Oral and Maxillofacial Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto-shi, Nagano-ken 390-0872, Japan
| | - Masao Hashidume
- Department of Oral and Maxillofacial Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto-shi, Nagano-ken 390-0872, Japan
| | - Shin-Ichi Yamada
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 3190 Gofuku, Toyama-shi, Toyama-ken 930-8555, Japan
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Isomura ET, Fujimoto Y, Matsukawa M, Yokota Y, Urakawa R, Tanaka S. General Factors and Dental-Related Risk Factors for Postoperative Pneumonia or Infectious Complications: A Retrospective Study. J Clin Med 2023; 12:jcm12103529. [PMID: 37240635 DOI: 10.3390/jcm12103529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
Numerous studies report that perioperative oral care decreases the frequency of postoperative pneumonia or infection. However, no studies have analyzed the specific impact of oral infection sources on the postoperative course, and the criteria for preoperative dental care differ among institutions. This study aimed to analyze the factors and dental conditions present in patients with postoperative pneumonia and infection. Our results suggest that general factors related to postoperative pneumonia, including thoracic surgery, sex (male > female), the presence or absence of perioperative oral management, smoking history, and operation time, were identified, but there were no dental-related risk factors associated with it. However, the only general factor related to postoperative infectious complications was operation time, and the only dental-related risk factor was periodontal pocket (4 mm or higher). These results suggest that oral management immediately before surgery is sufficient to prevent postoperative pneumonia, but that moderate periodontal disease must be eliminated to prevent postoperative infectious complication, which requires periodontal treatment not only immediately before surgery, but also on a daily basis.
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Affiliation(s)
- Emiko Tanaka Isomura
- Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita 565-0871, Japan
- Unit of Dentistry, Osaka University Hospital, 2-15 Yamadaoka, Suita 565-0871, Japan
| | - Yukari Fujimoto
- Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita 565-0871, Japan
| | - Makoto Matsukawa
- Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita 565-0871, Japan
| | - Yusuke Yokota
- Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita 565-0871, Japan
| | - Ryuta Urakawa
- Department of Pharmacy, Osaka University Dental Hospital, 1-8 Yamadaoka, Suita 565-0871, Japan
- Department of Clinical Pharmacy Research and Education, Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita 565-0871, Japan
| | - Susumu Tanaka
- Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita 565-0871, Japan
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Kawano T, Shigeishi H, Fukada E, Yanagisawa T, Kuroda N, Takemoto T, Sugiyama M. Changes in bacterial number at different sites of oral cavity during perioperative oral care management in gastrointestinal cancer patients: preliminary study. J Appl Oral Sci 2018; 26:e20170516. [PMID: 29898181 PMCID: PMC6010331 DOI: 10.1590/1678-7757-2017-0516] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/29/2018] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE The objective of this study was to clarify differences in bacterial accumulation between gastrointestinal cancer patients who underwent severely invasive surgery and those who underwent minimally invasive surgery. MATERIAL AND METHODS We performed a preliminary investigation of gastrointestinal cancer patients who were treated at the Department of Surgery, Takarazuka Municipal Hospital, from 2015 to 2017 (n=71; 42 laparoscopic surgery, 29 open surgery) to determine changes in bacterial numbers at different sites of the oral cavity (tongue dorsum, gingiva of upper anterior teeth, palatoglossal arch), as well as mouth dryness and tongue coating indices. Specifically, patients received professional tooth cleaning (PTC), scaling, tongue cleaning, and self-care instruction regarding tooth brushing from a dental hygienist a day before the operation. Professional oral health care was also performed by a dental hygienist two and seven days after surgery. Oral bacteria numbers were determined using a bacterial counter with a dielectrophoretic impedance measurement method. RESULTS The number of bacteria at all three examined sites were significantly higher in the open surgery group when compared to the laparoscopic surgery group on the second postoperative day. Relevantly, bacterial count in samples from the gingiva of the upper anterior teeth remained greater seven days after the operation in patients who underwent open surgery. Furthermore, the dry mouth index level was higher in the open surgery group when compared to the laparoscopic surgery group on postoperative days 2 and 7. CONCLUSIONS Even with regular oral health care, bacterial numbers remained high in the upper incisor tooth gingiva in gastrointestinal cancer patients who received open surgery. Additional procedures are likely needed to effectively reduce the number of bacteria in the gingival area associated with the upper anterior teeth.
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Affiliation(s)
- Tomoko Kawano
- Hiroshima University, Graduate School of Biomedical & Health Sciences, Program of Oral Health Sciences, Department of Public Oral Health, Hiroshima, Japan.,Takarazuka Municipal Hospital, Department of Dentistry & Oral Surgery, Takarazuka, Japan
| | - Hideo Shigeishi
- Hiroshima University, Graduate School of Biomedical & Health Sciences, Program of Oral Health Sciences, Department of Public Oral Health, Hiroshima, Japan
| | - Eri Fukada
- Hiroshima University, Graduate School of Biomedical & Health Sciences, Program of Oral Health Sciences, Department of Public Oral Health, Hiroshima, Japan
| | - Takamichi Yanagisawa
- Takarazuka Municipal Hospital, Department of Dentistry & Oral Surgery, Takarazuka, Japan
| | - Nobukazu Kuroda
- Takarazuka Municipal Hospital, Department of Surgery, Takarazuka, Japan
| | - Toshinobu Takemoto
- Hiroshima University, Graduate School of Biomedical & Health Sciences, Program of Oral Health Sciences, Department of Oral Health Management, Hiroshima, Japan
| | - Masaru Sugiyama
- Hiroshima University, Graduate School of Biomedical & Health Sciences, Program of Oral Health Sciences, Department of Public Oral Health, Hiroshima, Japan
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Mizuno H, Mizutani S, Ekuni D, Tabata-Taniguchi A, Maruyama T, Yokoi A, Omori C, Shimizu K, Morimatsu H, Shirakawa Y, Morita M. New oral hygiene care regimen reduces postoperative oral bacteria count and number of days with elevated fever in ICU patients with esophageal cancer. J Oral Sci 2018; 60:536-543. [DOI: 10.2334/josnusd.17-0381] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
| | - Shinsuke Mizutani
- Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University
- OBT Research Center, Faculty of Dental Science, Kyushu University
| | - Daisuke Ekuni
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
- Advanced Research Center for Oral and Craniofacial Sciences, Okayama University Dental School
| | - Ayano Tabata-Taniguchi
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Takayuki Maruyama
- Center for Innovative Clinical Medicine, Okayama University Hospital
| | - Aya Yokoi
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Chie Omori
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Kazuyoshi Shimizu
- Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Hiroshi Morimatsu
- Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Yasuhiro Shirakawa
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Manabu Morita
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Implementing the Free Water Protocol does not Result in Aspiration Pneumonia in Carefully Selected Patients with Dysphagia: A Systematic Review. Dysphagia 2016; 32:345-361. [DOI: 10.1007/s00455-016-9761-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 11/08/2016] [Indexed: 10/20/2022]
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Yoshioka M, Hinode D, Yamamoto Y, Furukita Y, Tangoku A. Alteration of the oral environment in patients undergoing esophagectomy during the perioperative period. J Appl Oral Sci 2013; 21:183-9. [PMID: 23739864 PMCID: PMC3881879 DOI: 10.1590/1678-7757201302338] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 01/04/2013] [Accepted: 01/18/2013] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE During the perioperative period, oral ingestion is changed considerably in esophagectomy patients. The aim of this study was to investigate oral environment modifications in patients undergoing esophageal cancer treatments due to changes in dietary intake and swallowing functions. MATERIAL AND METHODS Thirty patients who underwent operation for removal of esophageal cancer in Tokushima University Hospital were enrolled in this study. RESULTS It was found that 1) the flow rate of resting saliva decreased significantly at postoperative period by deprived feeding for one week, although it did not recover several days after oral ingestion began, 2) the accumulation of dental plaque and the number of mutans streptococci in saliva decreased significantly after operation, while both increased relatively quick when oral ingestion began, and 3) the swallowing function decreased significantly in the postoperative period. CONCLUSIONS These results suggest that dental professionals should emphasize the importance of oral health care and provide instructions on plaque control to patients during the perioperative period of esophageal cancer treatment.
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Affiliation(s)
- Masami Yoshioka
- Department of Oral Health and Welfare, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
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Abstract
Tooth brushing in critically ill patients has been advocated by many as a standard of care despite the limited evidence to support this practice. Attention has been focused on oral care as the evidence accumulates to support an association between the bacteria in the oral microbiome and those respiratory pathogens that cause pneumonia. It is plausible to assume that respiratory pathogens originating in the oral cavity are aspirated into the lungs, causing infection. A recent study of the effects of a powered toothbrush on the incidence of ventilator-associated pneumonia was stopped early because of a lack of effect in the treatment group. This review summarizes the evidence that supports the effectiveness of tooth brushing in critically ill adults and children receiving mechanical ventilation. Possible reasons for the lack of benefit of tooth brushing demonstrated in clinical trials are discussed. Recommendations for future trials in critically ill patients are suggested. With increased emphasis being placed on oral care, the evidence that supports this intervention must be evaluated carefully.
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Affiliation(s)
- Nancy J Ames
- Clinical Center, National Institutes of Health in Bethesda, Maryland 20892, USA.
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Hakuta C, Mori C, Ueno M, Shinada K, Kawaguchi Y. Evaluation of an oral function promotion programme for the independent elderly in Japan. Gerodontology 2009; 26:250-8. [DOI: 10.1111/j.1741-2358.2008.00269.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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