Hospital of St. Paul dental implants to reduce mortality in ICU

Nosocomial pneumonia is the second leading cause of infections in hospital ICUs in the world. In Brazil, it increases the incidence of death in 25% and generates an increase of on average 13 days in the stay of the patient, also increasing the costs of hospitalization. Thinking to avoid this condition, the Hospital Santa Isabel (HSI) in São Paulo, is implementing the protocol for prevention of dental diseases in the ICU with the clinical staff of dentists credentialed, which provides medical care for patients already admitted to the unit.

Patient safety is our focus. In this sense, we are taking another step with the creation of the manual of oral health, explains the medical director of the unit Carbone Frederick Son. The matter was also the theme of the 14th Scientific Day of the HSI this month, and the doctor said, is so important that it is a vote in Congress a bill that requires the presence of a dentist in the hospital ICU. We decided in advance, since this is a public health issue, he says.

In the nosocomial pneumonia (lower respiratory tract infection), the main diseases associated with poor oral hygiene are or infectious endocarditis and dental caries. Preventing dental reduces up to 65% cases of nosocomial pneumonia, dental surgeon reveals the USP-SP and speaker, Sandra Oyama. She notes that the costs of preventive protocols can reach 10% of the cost of treatment of pneumonia diagnosed, ie, besides improving the chances of patient survival, prevention also generates significant savings for the hospital.

<b> Treatment </ b>

The cleaning can be performed by the nurse, by brushing the teeth every 12 hours, cleaning of the tongue coating, aspiration of secretions and use of chlorhexidine 0.12%, a mouthwash which reduces the number of bacteria in the mouth. Another important procedure, which is even recommended by ANVISA, is to keep the patient in the 30 to 45 degrees, to prevent it broncoaspire his own saliva that contains many bacteria, says Sandra.

In the case of endocarditis, evaluation of the framework is done by a cardiologist and a dentist. It is important to assess the oral health of the patient and high risk of developing endocarditis. There are recommendations from the American Heart Association, but prevention is always the best choice, says the surgeon dentist.

Since the decay is very common in cancer patients. In some people, radiation therapy destroys tooth enamel and exposed dentin causes what we call radiation caries. The assessment in these cases should be very specific and treatment also explains Sandra.

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