Perioperative Oral Care and Pneumonia Prevention

Perioperative oral care encompasses a suite of interventions—ranging from professional dental cleaning and patient education to use of antiseptic mouthwashes—delivered before, during and after surgical procedures. Its principal aim is to reduce the oral microbial load and maintain mucosal integrity so as to prevent aspiration of pathogenic organisms into the lower respiratory tract. Aspiration pneumonia remains a leading complication in high-risk surgical populations, notably among older adults, oncology patients and those requiring prolonged mechanical ventilation. By targeting biofilm removal, controlling salivary colonisation and optimising dentition status, perioperative oral care not only mitigates the incidence of postoperative pneumonia but also shortens hospital stays, lessens intensive care admissions and curbs healthcare costs. Growing evidence supports integration of dental professionals into perioperative teams, alongside standardised oral hygiene protocols, to achieve sustained reductions in pulmonary complications and to enhance overall surgical outcomes on a global scale.

Research from Nature Portfolio

Recent analyses of perioperative patients in acute care settings have illuminated the economic and clinical impact of oral bacterial burden. Large-scale administrative data from a single tertiary hospital revealed that patients with elevated oral bacterial counts incurred higher daily hospital costs, particularly in subgroups treated for cardiovascular or malignant disease. Although length of stay remained comparable, multivariate models identified oral bacterial number as an independent predictor of increased medical expenditure. These findings underline the potential for routine quantification of oral microbial load and targeted antiseptic interventions to curb not only postoperative infectious events but also associated financial strains on health systems.

Perioperative Oral Care and Pneumonia Prevention publication trend

The graph below shows the total number of articles in perioperative oral care and pneumonia prevention across all publications each year (not limited to Nature Index journals).

Technical terms

Perioperative oral care: A coordinated set of dental hygiene procedures administered around the time of surgery to lower microbial load in the mouth.

Aspiration pneumonia: Lung infection resulting from inhalation of oropharyngeal secretions containing pathogenic microorganisms.

Charlson comorbidity index: A weighted scoring system used to predict mortality by categorising and quantifying comorbid conditions.

16S rRNA gene sequencing: A molecular technique for characterising bacterial communities by analysing conserved regions of the ribosomal RNA gene.

References

1. Relationship of oral bacterial number with medical hospitalization costs in analysis of Diagnosis Procedure Combination database from single institution in Japan. Scientific Reports (2024).
2. Palatal microbiota associated with membranous substances in older Japanese individuals undergoing tube feeding in long-term care: A cross-sectional study. Heliyon (2023).
3. Effect of perioperative oral care on prevention of postoperative pneumonia associated with esophageal cancer surgery. Medicine (2017).