Oral health status of children in a Paediatric Intensive Care Unit

Objective: The aim of the present study was to examine the dental status of critically ill children in a Paediatric Intensive Care Unit (PICU) and determine the efficacy of the mouth care received. Design: Prospective nonrandomized study. Setting: The study was carried out in the PICU at Great Ormond Street Hospital for Children. Patients and paiticipants: All children admitted to the PICU during the period of the study were eligible for inclusion. A total of 54 children completed the study. Measurements and results: Children were examined for dental caries, plaque accumulation, gingival inflammation and gingival bleeding on admission to the PICU. The examination was repeated on discharge from the Unit. The levels of dental caries found on examination were compared with results from the most recent national surveys carried out in the United Kingdom, and analysed using the one sample t-test. The levels of plaque accumulation, gingival inflammation and gingival bleeding on admission were compared to those on discharge and analysed using the paired sample t-test. Results revealed a very highly significant increase in plaque accumulation (p = 0.001), and a highly significant increase in gingival inflammation (p = 0.006) between admission to the PICU and discharge. Conclusions: Results indicate that the present mouth care regimen is not effective in preventing the build up of plaque or maintaining gingival health. These children may therefore be at unnecessary risk from local or systemic spread of oral microorganisms.