The Introduction of an Oral Surgical Service in an Intensive Care Unit Serving a Deprived Inner City Population

Much of the population of Glasgow has poor oral health. Poor oral hygiene is associated with the development of ventilator-associated pneumonia (VAP). In a survey of Scottish intensive care units (ICUs), none incorporated oral surgical review into their care. We evaluated the introduction of oral surgical review into our routine practice. An oral surgeon who was experienced in oral care provision in the critically ill reviewed patients who were expected to be mechanically ventilated for more than 48 hours. Oral health was assessed and interventions documented. One hundred patients were examined and forty-seven patients underwent oral surgical intervention. Thirteen patients required dental extraction. Of the patients not requiring additional oral care, 24/53 (45%) were edentulous. Our findings demonstrate that the oral care needs of this patient group were not being met by the current unit oral hygiene protocol. Further work is required to determine the optimal way to provide such a service cost effectively, and its impact on VAP prevention.