Comparative Study of Bacterial Growth Inhibitory Effect of Three Types of Mouthwashes Marketed in Japan Containing Povidone Iodine, Benzethonium Chloride, and Chlorhexidine Gluconate by Bacterial Culture

Purpose: Pathogenic microorganisms in saliva are thought to be a major cause of surgical site infection in patients who have undergone surgery for head and neck or upper digestive tract cancers, and a common cause of postoperative pneumonia and aspiration pneumonia in elderly people. Gargling with a mouthwash containing an antiseptic agent is recommended to control salivary pathogen populations, but it is not clear which antiseptic agents are most effective. The purpose of this study is to examine the potencies of three antiseptic mouthwashes marketed in Japan against salivary bacteria.</jats:p

Clinical observation of tongue coating of perioperative patients: factors related to the number of bacteria on the tongue before and after surgery

Background: Increased amount of tongue coating has been reported to be associated with increased bacteria count in the saliva and aspiration pneumonia in elderly people. However, the implications of tongue coating for prevention of postoperative complications in patients undergoing major oncologic or cardiac surgery has not been well documented. The purpose of this study is to investigate the number of bacteria on the tongue before and after surgery and factors affecting it. Methods: Fifty-four patients who underwent oncologic or cardiac surgery under general anesthesia at Nagasaki University Hospital were enrolled in the study. Various demographic, tumor-related, treatment-related factors, and the number of bacteria on the tongue and in the saliva were examined, and the relationship among them was analyzed by Mann-Whitney U test, Spearman rank correlation coefficient, or multiple regression. Results: Before surgery, no significant factors were correlated with the number of bacteria on the tongue, and there were no relationship between bacteria count on the tongue and that in the saliva. On the next day after surgery, bacteria on the tongue increased, and sex, periodontal pocket depth, feeding condition, dental plaque, blood loss, and bacteria in the saliva were correlated with bacteria on the tongue by a univariate analysis. A multivariate analysis showed that feeding condition, and amount of dental plaque were correlated with the number of bacteria. Conclusions: Increased number of bacteria on the tongue was associated with feeding condition and amount of dental plaque. Further studies are necessary to clarify the clinical significance of dental coating in perioperative oral management of patients undergoing oncologic or cardiac surgery