AIMThe oral cavity is normally colonized by microorganisms that adapts to the environment in which they are, but sometimes this balance is altered resulting in the formation of tooth decay and periodontal disease. The environment where this balance is altered are intensive care units, such as anesthesia and burn centers, as patients hospitalized for long periods are not able to carry out the activities of daily hygiene and have their immune defenses compromised. This obviously implies a predisposition to those infections that develop in colonized environments, just like the oral cavity.

The aim of the present work is to investigate and detect the presence of bacterial colonies in the oral cavity and implement the most appropriate prophylaxis against them.

This work focuses on two patients admitted to an intensive care unit with third-degree burn on 40-45% of the body, caused by the explosion of a flammable liquid. After a physical examination of the oral cavity and an evaluation of the periodontal history, the following procedures were carried out: bacteriological swab, washing with saline, mechanical cleansing with chlorhexidine gel, rinsing with saline, cleansing with dental floss, massage of the oral mucosa with adjuvant gel and finally another bacteriological swab.

The protocol we used had a good outcome while respecting the needs of patients, clinicians and nurses and we managed to achieve that goal: that oral hygiene can and must improve the life of patients during their long hospital stay.

In conclusion, we can say that carrying out periodic treatments of oral hygiene (not only debridement) allows the not self-sufficient patient to maintain a state of optimal health of the oral cavity and to control localized and systemic superinfections, which may be very dangerous in some particular cases.
Last but not least, the chance for the patient to have a clean and fresh mouth which, as we could establish, helps to increase his/her self-esteem.

Authors: INCHINGOLO Francesco, PUGLIESE Adalisa, MARRELLI Massimo, TATULLO Marco, INCHINGOLO Angelo Michele, POLI Gaetano, INCHINGOLO Alessio Danilo, MARINELLI Grazia, SCHINCO Fabio, PIGNATARO Chiara, BALICE Pierluigi, MARASCO Silvia, PADUANELLI Gregorio, DIPALMA Gianna.