A Japanese study suggests that one of the most important ways to reduce post-operative risk is also the easiest – by practicing good dental hygiene. While research has previously linked coronary artery disease (CAD) with dental plaque and chronic gum inflammation – two articles by Akutsu et. al (2010) in Japan have shown a reduction in post-operative pneumonia in esophageal cancer patients through the use of dental hygiene regimens.
The first of these articles in an overview of several factors to reduce post-operative risk, and was previously mentioned in another post:
Akutsu, Y. & Matsubara, H. (2009) Perioperative Management for the Prevention of Postoperative Pneumonia with Esophageal Surgery. Ann Thorac Cardiovasc Surg. 2009 Oct;15(5):280-5. (free full text). This is a well written report by Japanese surgeons on several techniques to reduce post-operative pneumonia. Several of these items can be directly implemented by patients – such as pre-operative smoking cessation, pulmonary rehabilitation and good dental hygiene.
The second article, “Pre-operative dental brushing can reduce the risk of post-operative pneumonia in esophageal cancer patients” was published in Surgery (2010, Apr; 147(4) 497-502.) The authors conducted an investigational study using 86 thoracic surgery patients scheduled to undergo esophagectomy. A control group of 41 patients and the dental hygiene (treatment) group consisting of 45 patients.
The dental hygiene group underwent no special dental procedures or cleanings but were instructed to brush their teeth five times a day.
The results showed a dramatic decrease in the incidence of post-operative pneumonia in the treatment group. 32% of the control group developed pneumonia post-operatively compared to only 9% of the toothbrushing group. 12% of the patients in the control group required tracheostomy due to the development of pneumonia (and prolonged respiratory support). No members of the treatment group required tracheostomy.
While the study size is relatively small – the results show an impressive reduction in post-operative pneumonia for a fairly small investment (increased tooth brushing/ dental hygiene.)
Thoracic Surgery 