Frequency of Oral Care to Address Thirst: A Practice in Search of Evidence

The use of oral chlorhexidine gluconate twice a day in intubated patients is a well-established practice for reducing the risk of ventilator-associated events and is based on a strong foundation of research (level A, AACN levels of evidence). Because of that research, we know that oral care reduces the dental plaque that contributes to infection and development of ventilator-associated events. However, the same is not true of frequency of oral care for patient comfort, specifically for the mitigation of thirst and dry mouth (level E, AACN levels of evidence). No clinical studies support the practice of oral moisturizing every 2 to 4 hours.VonStein et al attempt to address the lack of research to support frequency of oral care in their study “Effect of a Scheduled Nurse Intervention on Thirst and Dry Mouth in Intensive Care Patients.” Ice-cold-water oral swabs and oral moisturizer were applied to the oral mucosa every hour as part of hourly rounding instead of the standard 2 to 4 hours. Thirst intensity decreased significantly in the patients receiving hourly oral care. The study was small and was limited to 1 type of intensive care unit, but the results are promising. More research is needed to determine how often oral care for comfort should be provided.