Pre-operative dental brushing can reduce the risk of postoperative pneumonia in esophageal cancer patients

Surgery. 2010 Apr;147(4):497-502. doi: 10.1016/j.surg.2009.10.048. Epub 2009 Dec 11.

Abstract

Background: The presence of pathogens in dental plaque is a risk factor associated with postoperative pneumonia in esophageal cancer patients. The effectiveness of pre-operative dental brushing to decrease the risk of postoperative pneumonia in esophageal cancer patients was evaluated prospectively.

Methods: A total of 86 thoracic esophageal cancer patients who underwent an esophagectomy were investigated. Patients were divided into 2 groups: the control group (41 patients) and the pre-operative dental brushing group (45 patients). The patients in the brushing group were assigned to brush their teeth 5 times a day. After the operation, the frequency of postoperative pneumonia and need for tracheostomy for pulmonary treatment was calculated.

Results: Postoperative pneumonia was decreased markedly from 32% to 9% (P = .013), and the frequency of postoperative pneumonia requiring tracheostomy decreased from 12% to 0% in the dental brushing group, respectively. Limiting the patients who had positive pathogenic bacteria in their dental plaque on their admission, the frequency of postoperative pneumonia was decreased from 71% (5 of 7 patients) in the control group to 17% (2 of 12 patients) in the dental brushing group (P = .045).

Conclusion: Frequent pre-operative dental brushing is performed easily and seems to prevent postoperative pneumonia in esophageal cancer patients.

MeSH terms

  • Antibiotic Prophylaxis
  • Bacteria / isolation & purification
  • Bacteria / pathogenicity
  • Bacterial Infections / prevention & control
  • Dental Plaque / complications
  • Dental Plaque / microbiology
  • Dental Plaque / prevention & control*
  • Esophageal Neoplasms / surgery*
  • Humans
  • Pneumonia / epidemiology
  • Pneumonia / prevention & control*
  • Postoperative Complications / prevention & control*
  • Preoperative Care*
  • Risk Factors
  • Thoracic Neoplasms / surgery*
  • Toothbrushing / methods*