Volume 28, Issue 2 (July 2021)
J Birjand Univ Med Sci. 2021, 28(2): 106-119 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Sabzehkar F, Mogharab M, Sharifzadeh G, Kiani Z. Comparison of the effect of chamomile and chlorhexidine glucosan cleansing on dental plaque and mucosal lesions of ventilated patients in the intensive care unit. J Birjand Univ Med Sci. 2021; 28 (2) :106-119
URL: http://journal.bums.ac.ir/article-1-2829-en.html
URL: http://journal.bums.ac.ir/article-1-2829-en.html
1- Student Research Committee, Department of Nursing, Internal Surgical Nursing, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran , fsabzehkar@bums.ac.ir
2- Department of Nursing, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran
3- Social Determinants of Health Research Center, Department of Epidemiology, Birjand university of medical sciences, Birjand, Iran
4- Medical Toxicology & Drug Abuse Research Center, Department of Pharmacology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
2- Department of Nursing, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran
3- Social Determinants of Health Research Center, Department of Epidemiology, Birjand university of medical sciences, Birjand, Iran
4- Medical Toxicology & Drug Abuse Research Center, Department of Pharmacology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
Full-Text [PDF 661 kb]
(858 Downloads)
| Abstract (HTML) (2112 Views)
Full-Text: (693 Views)
ABSTRACT
Background and Aims: The use of methods with minimal complications and risk is of utmost importance in the promotion of oral hygiene in the care of intensive care unit (ICU) patients. The present study aimed to compare the effect of chamomile mouthwash and chlorhexidine gluconate on dental plaque and oral mucosal lesions of patients under ventilator in the intensive care unit.
Materials and Methods: This randomized controlled clinical trial was conducted on 50 eligible patients who were selected via available sampling method from among trauma patients in the ICU of Imam Reza (AS) Hospital in Birjand. They were assigned to two groups of chamomile extract 10% (n=25) and chlorhexidine gluconate 0.2% (n=25) by block randomization. In each group, the solution was used three times a day every 8 hours for 5 days. The instruments were the Backas Assessment Checklist (BOAS) and the Mucosal Plate (MPS).
Results: In both groups, the mean total score of oral mucosal lesions and dental plaque significantly decreased 2 and 5 days after the intervention, compared to the pre-intervention (P<0.001); nonetheless, the two groups were not significantly different in this regard (P>0.05). Furthermore, there was no statistically significant difference in the mean changes in the total scores of oral mucosal lesions and dental plaque at different times in the two groups (P>0.05).
Conclusion: Chamomile mouthwash and chlorhexidine mouthwash have similar beneficial effects on dental plaque and oral mucosal lesions of ventilated patients admitted to the ICU.
Materials and Methods: This randomized controlled clinical trial was conducted on 50 eligible patients who were selected via available sampling method from among trauma patients in the ICU of Imam Reza (AS) Hospital in Birjand. They were assigned to two groups of chamomile extract 10% (n=25) and chlorhexidine gluconate 0.2% (n=25) by block randomization. In each group, the solution was used three times a day every 8 hours for 5 days. The instruments were the Backas Assessment Checklist (BOAS) and the Mucosal Plate (MPS).
Results: In both groups, the mean total score of oral mucosal lesions and dental plaque significantly decreased 2 and 5 days after the intervention, compared to the pre-intervention (P<0.001); nonetheless, the two groups were not significantly different in this regard (P>0.05). Furthermore, there was no statistically significant difference in the mean changes in the total scores of oral mucosal lesions and dental plaque at different times in the two groups (P>0.05).
Conclusion: Chamomile mouthwash and chlorhexidine mouthwash have similar beneficial effects on dental plaque and oral mucosal lesions of ventilated patients admitted to the ICU.
1- Zakerimoghdam M, Aliasgharpour M. Intensive Care of Nursing in ICU, CCU and Dialysis. 4th ed. Tehran: AndishehRafie; 2006. p. 9-11.
2- Driscoll A, Currey J, George M, Davidson PM. Changes in health service delivery for cardiac patients: implications for workforce planning and patient outcomes. Aust Crit Care 2013; 26(2): 55-7. DOI: 10.1016/j.aucc.2012.08.001.
3- Blot S, Vandijck D, Labeau S. Oral Care of Intubated Patients. Clin Pulm Med. 2008; 15(3): 153-60. DOI: 10.1097/CPM.0b013e3181729250.
4- Feider LL, Mitchell P, Bridges E. Oral care practices for orally intubated critically ill adults. Am J Crit Care. 2010; 19(2): 175-83. DOI: 10.4037/ajcc2010816
5- Ranjbar H, Jafari S, Kamrani F, Alavi Majd H, Yaghmaei F, Asgari A. Effect of Chlorhexidine gluconate oral rinse on late onset ventilator associated pneumonia prevention and its interaction with severity of the illness. Iran J Crit Care Nurs. 2010; 3(2):81-6. Link
6- Johnstone L, Spence D, Koziol-McLain J. Oral hygiene care in the pediatric intensive care unit: practice recommendations. Pediatr Nurs 2010; 36(2): 85-96. Link
7- Browne JA, Evans D, Christmas LA, Rodriguez M. Pursuing excellence: development of an oral hygiene protocol for mechanically ventilated patients. Crit Care Nurs Q. 2011; 34(1): 25-30. DOI: 10.1097/CNQ.0b013e318204809b
8- Ruffell A, Adamcova L. Ventilator‐associated pneumonia: prevention is better than cure. Nurs Crit Care. 2008; 13(1): 44-53. DOI: 10.1111/j.1478-5153.2007.00248.x
9- Pedria M, Kusahara DM, Carvalho WB, Nunez SC, Peterilini MA. Oral care investigations and oropharyngeal colonization in children receiving mechanical ventilation. Am J Crit Care. 2009; 18(4): 319-28. DOI: 10.4037/ajcc2009121
10- Munro CL, Grap MJ, Jones DJ, McClish DK, Sessler CN. Chlorhexidine, toothbrushing, and preventing ventilator-associated pneumonia in critically ill adults. Am J Crit Care 2009; 18(5): 428-37. DOI: 10.4037/ajcc2009792
11- Firouzian A, Darvishi-Khezri H. Comparison of the antibacterial effects of Persica, Matrica and chlorhexidine gluconate mouthwashes and normal saline in mechanically ventilated ICU patients: A clinical trial. Feyz. 2016; 19(6): 486-94. Link
12- Maghareh Abed A, Yaghini J, Fallah A. Comparison of the Side Effects Of Two Common Iranian-made Chlorhexidine Mouthwashes. J Isfahan Dent Sch. 2011; 458-63. Link
13- Lindhe J, Lang NP, Karring T. Clinical periodontology and implant dentistry. 5th ed. Oxford: Blackwell Munksgaard; 2003.
14- Genuit T, Bochicchio G, Napolitano LM, McCarter RJ, Roghman MC. Prophylactic chlorhexidine oral rinse decreases ventilator-associated pneumonia in surgical ICU patients. Surg Infect (Larchmt). 2001; 2(1): 5-18. DOI: 10.1089/109629601750185316.
15- Hirata K, Kurokawa A. Chlorhexidine gluconate ingestion resulting in fatal respiratory distress syndrome. Vet Hum Toxicol 2002; 44(2): 89-91. Link
16- Baharvand M, Sarrafi M, Alavi K, Jalali Moghaddam E. Efficacy of topical phenytoin on chemotherapy-induced oral mucositis; a pilot study. DARU.. 2010; 18(1): 46-50. Link
17- Mazokopakis EE, Vrentzos GE, Papadakis JA, Babalis DE, Ganotakis ES. Wild chamomile (Matricaria recutita L.) mouthwashes in methotrexate-induced oral mucositis. Phytomedicine. 2005; 12(1-2): 25-7. DOI: 10.1016/j.phymed.2003.11.003.
18- Southern EN, McCombs GB, Tolle SL, Marinak K. The comparative effects of 0.12% chlorhexidine and herbal oral rinse on dental plaque-induced gingivitis. J Dent Hyg. 2006; 80(1): 12. Link
19- Atai Z, Abdollahi H, Naderipour S, Mohammadi S. [Comparison of antifungal and antibacterial effects of Persica Matrica and Iralwex with Chlorhexidine mouthwashes (An in vitro study)]. J Dent Sch Shahid Beheshti Univ Med Sci. 2007; 25(1): 585-592. [Persian] Link
20- Safarabadi M, Rezaei K, Ghaznavi-Rad E. Comparing the effect of Echinacea and chlorhexidine mouthwash on oral health in patients hospitalized in intensive care units.Complement Med J. 2012; 2 (3): 222-34. [Persian] Link
21- Silness P, Löe H. Periodontal disease in pregnancy, II: correlation between oral hygiene and periodontal condition. Acta Odentol Scand. 1964; 22(1): 121–135. DOI: 10.3109/00016356408993968
22- Henriksen BM, Ambjornsen E, Axell TE. Evaluation of a mucosal-plaque index (MPS) designed to assess oral care in groups of elderly. Spec Care Dentist. 1999; 19(4): 154–157. [PubMed:10765880] DOI: 10.1111/j.1754-4505.1999.tb01378.x.
23- Mojtahedzade F, Moslemi N, Sodagar A, Kiaee G, Kiaee B. The effects of herbal mouthwashes on periodontal parameters of patients undergoing fixed orthodontic treatment compared to chlorhexidine 0.2%. Dent Med. 2017; 30(1): 18-26. [Persian] Link
24- Rabienejad N, Karami V, Torkzaban P, Dastan D. Effect of Green Tea Mouthwash on Gingival Indices in Gingivitis Patients. Avicenna J Clin Med. 2018; 86 (24): 285-90. [Persian] DOI: 10.21859/ajcm.24.4.285.
25- Sofrata A, Brito F, Al-Otaibi M, Gustafsson A. Short term clinical effect of active and inactive Salvadora persica miswak on dental plaque and gingivitis. J Ethnopharmacol. 2011; 137(3): 1130-4. DOI: 10.1016/j.jep.2011.07.034.
26- Berry AM, Davidson PM, Masters J, Rolls K, Ollerton R. Effects of three approaches to standardized oral hygiene to reduce bacterial colonization and ventilator associated pneumonia in mechanically ventilated patients: a randomised control trial. Int J Nurs Stud. 2011; 48 (6): 681-8. DOI: 10.1016/j.ijnurstu.2010.11.004.
27- Moin Taghavi A, Ebrahim Nezhad Z. Clinical comparison of the effects of persica and chlorhexidne 0.2% on the dental plaque and gingival inflammation. J Dent Sch Shahid Beheshti Univ Med Sci. 2003; 20(3): 370-8.
27- Mojtahedzade F, Moslemi N, Sodagar A, Kiaee G. The effects of herbal mouthwashes on periodontal parameters of patients undergoing fixed orthodontic treatment compared to chlorhexidine 0.2%. Dent Med. 2017; 30 (1) :18-26. [Persian] Link
28- Estaji Z, Rad M, Rakhshani MH, Nejad-Moghadam MA. The comparison between chlorhexidine solution and toothbrush in preventing oral lesions in patients hospitalized in intensive care unit. J Sabzevar Uni Med Sci. 2014; 20(5): 747-56. [Persian] Link
29- Halm MA, Armola R. Effect of Oral Care on Bacterial Colonization and Ventilator- Associated Pneumonia. Am J Crit Care. 2009; 18(3): 275-8.
2- Driscoll A, Currey J, George M, Davidson PM. Changes in health service delivery for cardiac patients: implications for workforce planning and patient outcomes. Aust Crit Care 2013; 26(2): 55-7. DOI: 10.1016/j.aucc.2012.08.001.
3- Blot S, Vandijck D, Labeau S. Oral Care of Intubated Patients. Clin Pulm Med. 2008; 15(3): 153-60. DOI: 10.1097/CPM.0b013e3181729250.
4- Feider LL, Mitchell P, Bridges E. Oral care practices for orally intubated critically ill adults. Am J Crit Care. 2010; 19(2): 175-83. DOI: 10.4037/ajcc2010816
5- Ranjbar H, Jafari S, Kamrani F, Alavi Majd H, Yaghmaei F, Asgari A. Effect of Chlorhexidine gluconate oral rinse on late onset ventilator associated pneumonia prevention and its interaction with severity of the illness. Iran J Crit Care Nurs. 2010; 3(2):81-6. Link
6- Johnstone L, Spence D, Koziol-McLain J. Oral hygiene care in the pediatric intensive care unit: practice recommendations. Pediatr Nurs 2010; 36(2): 85-96. Link
7- Browne JA, Evans D, Christmas LA, Rodriguez M. Pursuing excellence: development of an oral hygiene protocol for mechanically ventilated patients. Crit Care Nurs Q. 2011; 34(1): 25-30. DOI: 10.1097/CNQ.0b013e318204809b
8- Ruffell A, Adamcova L. Ventilator‐associated pneumonia: prevention is better than cure. Nurs Crit Care. 2008; 13(1): 44-53. DOI: 10.1111/j.1478-5153.2007.00248.x
9- Pedria M, Kusahara DM, Carvalho WB, Nunez SC, Peterilini MA. Oral care investigations and oropharyngeal colonization in children receiving mechanical ventilation. Am J Crit Care. 2009; 18(4): 319-28. DOI: 10.4037/ajcc2009121
10- Munro CL, Grap MJ, Jones DJ, McClish DK, Sessler CN. Chlorhexidine, toothbrushing, and preventing ventilator-associated pneumonia in critically ill adults. Am J Crit Care 2009; 18(5): 428-37. DOI: 10.4037/ajcc2009792
11- Firouzian A, Darvishi-Khezri H. Comparison of the antibacterial effects of Persica, Matrica and chlorhexidine gluconate mouthwashes and normal saline in mechanically ventilated ICU patients: A clinical trial. Feyz. 2016; 19(6): 486-94. Link
12- Maghareh Abed A, Yaghini J, Fallah A. Comparison of the Side Effects Of Two Common Iranian-made Chlorhexidine Mouthwashes. J Isfahan Dent Sch. 2011; 458-63. Link
13- Lindhe J, Lang NP, Karring T. Clinical periodontology and implant dentistry. 5th ed. Oxford: Blackwell Munksgaard; 2003.
14- Genuit T, Bochicchio G, Napolitano LM, McCarter RJ, Roghman MC. Prophylactic chlorhexidine oral rinse decreases ventilator-associated pneumonia in surgical ICU patients. Surg Infect (Larchmt). 2001; 2(1): 5-18. DOI: 10.1089/109629601750185316.
15- Hirata K, Kurokawa A. Chlorhexidine gluconate ingestion resulting in fatal respiratory distress syndrome. Vet Hum Toxicol 2002; 44(2): 89-91. Link
16- Baharvand M, Sarrafi M, Alavi K, Jalali Moghaddam E. Efficacy of topical phenytoin on chemotherapy-induced oral mucositis; a pilot study. DARU.. 2010; 18(1): 46-50. Link
17- Mazokopakis EE, Vrentzos GE, Papadakis JA, Babalis DE, Ganotakis ES. Wild chamomile (Matricaria recutita L.) mouthwashes in methotrexate-induced oral mucositis. Phytomedicine. 2005; 12(1-2): 25-7. DOI: 10.1016/j.phymed.2003.11.003.
18- Southern EN, McCombs GB, Tolle SL, Marinak K. The comparative effects of 0.12% chlorhexidine and herbal oral rinse on dental plaque-induced gingivitis. J Dent Hyg. 2006; 80(1): 12. Link
19- Atai Z, Abdollahi H, Naderipour S, Mohammadi S. [Comparison of antifungal and antibacterial effects of Persica Matrica and Iralwex with Chlorhexidine mouthwashes (An in vitro study)]. J Dent Sch Shahid Beheshti Univ Med Sci. 2007; 25(1): 585-592. [Persian] Link
20- Safarabadi M, Rezaei K, Ghaznavi-Rad E. Comparing the effect of Echinacea and chlorhexidine mouthwash on oral health in patients hospitalized in intensive care units.Complement Med J. 2012; 2 (3): 222-34. [Persian] Link
21- Silness P, Löe H. Periodontal disease in pregnancy, II: correlation between oral hygiene and periodontal condition. Acta Odentol Scand. 1964; 22(1): 121–135. DOI: 10.3109/00016356408993968
22- Henriksen BM, Ambjornsen E, Axell TE. Evaluation of a mucosal-plaque index (MPS) designed to assess oral care in groups of elderly. Spec Care Dentist. 1999; 19(4): 154–157. [PubMed:10765880] DOI: 10.1111/j.1754-4505.1999.tb01378.x.
23- Mojtahedzade F, Moslemi N, Sodagar A, Kiaee G, Kiaee B. The effects of herbal mouthwashes on periodontal parameters of patients undergoing fixed orthodontic treatment compared to chlorhexidine 0.2%. Dent Med. 2017; 30(1): 18-26. [Persian] Link
24- Rabienejad N, Karami V, Torkzaban P, Dastan D. Effect of Green Tea Mouthwash on Gingival Indices in Gingivitis Patients. Avicenna J Clin Med. 2018; 86 (24): 285-90. [Persian] DOI: 10.21859/ajcm.24.4.285.
25- Sofrata A, Brito F, Al-Otaibi M, Gustafsson A. Short term clinical effect of active and inactive Salvadora persica miswak on dental plaque and gingivitis. J Ethnopharmacol. 2011; 137(3): 1130-4. DOI: 10.1016/j.jep.2011.07.034.
26- Berry AM, Davidson PM, Masters J, Rolls K, Ollerton R. Effects of three approaches to standardized oral hygiene to reduce bacterial colonization and ventilator associated pneumonia in mechanically ventilated patients: a randomised control trial. Int J Nurs Stud. 2011; 48 (6): 681-8. DOI: 10.1016/j.ijnurstu.2010.11.004.
27- Moin Taghavi A, Ebrahim Nezhad Z. Clinical comparison of the effects of persica and chlorhexidne 0.2% on the dental plaque and gingival inflammation. J Dent Sch Shahid Beheshti Univ Med Sci. 2003; 20(3): 370-8.
27- Mojtahedzade F, Moslemi N, Sodagar A, Kiaee G. The effects of herbal mouthwashes on periodontal parameters of patients undergoing fixed orthodontic treatment compared to chlorhexidine 0.2%. Dent Med. 2017; 30 (1) :18-26. [Persian] Link
28- Estaji Z, Rad M, Rakhshani MH, Nejad-Moghadam MA. The comparison between chlorhexidine solution and toothbrush in preventing oral lesions in patients hospitalized in intensive care unit. J Sabzevar Uni Med Sci. 2014; 20(5): 747-56. [Persian] Link
29- Halm MA, Armola R. Effect of Oral Care on Bacterial Colonization and Ventilator- Associated Pneumonia. Am J Crit Care. 2009; 18(3): 275-8.
Type of Study: Original Article |
Subject:
Nursing
Received: 2020/03/15 | Accepted: 2020/05/31 | ePublished ahead of print: 2021/02/14 | ePublished: 2021/06/20
Received: 2020/03/15 | Accepted: 2020/05/31 | ePublished ahead of print: 2021/02/14 | ePublished: 2021/06/20
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Attribution-NoneCommercial CC BY-NC