Table 2.

Systematic reviews about the association between oral care and reduction in pneumonia or respiratory tract infection

Author, journal, date	Type of studies included	Population	Type of intervention	Major conclusion
Azarpazhooh A. et al., J Periodontol, 2006 [37]	Systematic Review (7 RCT, 3 control trials)	Elderly adults living in nursing homes, ICU patients and patients from a general hospital	Professional dental care, mouthrinse with 0.12 % CHX, application of 0.2% CHX gel, 1% PVI scrubbing of pharynx, topical application of a non-absorbable antibiotic solution and topical antimicrobial prophylaxis	Oral care reduces incidence of pneumonia
Sjorgen P. et al., J Am Geriatr Soc, 2008 [36]	Systematic Review (5 RCT, 1 systematic review, 3 case–control trials, 5 cross-sectional trials, 1 retrospective trial)	Dependent elderly people	0.12% CHX oral rinse, tooth-brushing, 1% PVI scrubbing of pharynx or professional mechanical oral health care weekly	Oral care prevents pneumonia, respiratory tract infection and death from pneumonia
Kaneoka A. et al., Infect Control Hosp Epidemiol, 2015 [34]	Systematic Review (4 RCT) and Meta-analysis (5 RCT)	Hospitalized non-ventilated patients and patients living in nursing homes	0.2% CHX application, 0.12% CHX gargle, tooth brushing performed by dental professionals, ± 1% PVI scrubbing of pharynx	Oral care prevents pneumonia and fatal pneumonia in non-ventilated patients
El-Rabbany M. et al., Int J Nurs Stud, 2015 [35]	Systematic Review (28 RCT)	Elderly adults living in nursing homes and ICU patients	Professional dental care, sodium bicarbonate mouthrinse, toothbrushing, 0.12% and 0.2% CHX, topical application of a non-absorbable antibiotic solution and PVI swab	Oral care was suggested to be associated with a reduction in the risk for HAP and VAP in high-risk patients

CHX chlorhexidine, HAP hospital-acquired pneumonia, ICU Intensive Care Unit, PVI povidone-iodine, RCT Randomized Control Trials, VAP ventilator-associated pneumonia