ABSTRACT
Providing oral hygiene merely replaces activities intensive care unit patients would perform for themselves, if able. Mouthcare should therefore: maintain hygiene, keep the oral cavity moist, promote comfort, protect from infection, prevent trauma and prevent dental decay. Plaque is not water-soluble, so mouthwash solutions are not a substitute for brushing. Infection is usually bacterial, but Candida, the most common fungal infection, can be recognised by white spots and, like most oral fungi, is usually susceptible to nystatin. Oral assessment should include each aspect of the cavity: lips, gums, teeth, tongue, hard palette, soft tissue, salivary production, evidence of any infection, and evidence of any cuts/purpura/blood. Ventilator-associated pneumonia is a major cause of morbidity and mortality in intensive care units. Mouthcare is too easily forgotten in the physiological crises of critical illness, but problems developing from their time in intensive care unit can cause long-term or permanent oral/dental disease.
