Effectiveness of supervised implementation of an oral health care protocol on ventilator-associated pneumonia patients in intensive care units: a double-blind multicenter randomized controlled trial

Summary: Background: The available scientific evidence suggests a significant association between oral bacteria and the incidence of ventilator-associated pneumonia (VAP). Aims: The aim of this study was to determine the effectiveness of an oral health protocol in the prevention of ventilator-associated pneumonia. Methods: In this multi-center RCT, conducted in the intensive care units of neurological patients in three general teaching hospitals of two provinces located in the west of the Iran, a consecutive sample of 200 intubated patients were initially recruited. Patients were randomly allocated to the intervention (received oral health care based on evidence-based oral health protocol) or control (routine oral health care) groups. Both groups received their prescribed treatment regimen for seven consecutive days. The percentage of VAP diagnoses as main outcome assessed using clinical pulmonary infection score (CPIS). Findings: The rate of VAP in the intervention and control groups was 5% and 64%, respectively. The intervention reduced the risk of VAP by 97% and this difference was statistically significant (P <0.001). The chance of VAP occurrence in patients with lower levels of consciousness in univariate and multivariate analysis was significantly higher (OR: 2.38; 95%CI: 1.11–5.26) P <0.05). Conclusion: The results of our study suggest that the use of a dynamic supervised oral health care guideline is more effective than the routinely used protocols in the intensive care units of hospitals

Use of rubber dam among dentists working in the west part of Iran

BACKGROUND AND AIM: Although Rubber dam (RD) usage is one of the ideal and standard methods for isolating the teeth in several operative procedures of dentistry, General Dental Practitioners often neglect it. Many studies within several countries have reported various frequencies for RD application. There is no such study for Iran, so we conducted a study to report the frequency of its application and the effective factors. METHODS: This cross-sectional study carried out across the west part of Iran in 2013. A total of 525 general Dental Practitioners from the public and private sectors selected by stratified random sampling using a list from 3 big western cities of Iran. The data were collected using self-administrated checklist. RESULTS: The prevalence of RD application among General Dental Practitioner was 0.2% (confidence interval 95%: 0.196-0.204). RD instrument was existed in around 7.0% of cases. The main reason of the General Dental Practitioner to avoid RD application was supposing it is time-consuming procedure and causing patients stress (58.9%). CONCLUSION: Despite the advantages of RD application, its usage is not recognized as a routine and common method of isolation during dental procedures even roots canal therapy by Iranian General Dental Practitioners. KEYWORDS: Rubber Dam, Isolation, Endodontic Treatment, General Dental Practitione