Preoperative Professional Tooth Cleaning as a Preventive Measure for Postoperative Pneumonia in OSCC Patients: A Retrospective Study

ABSTRACT Background Professional tooth cleaning is a simple, low‐cost preoperative oral intervention. Its role in reducing postoperative complications in oral squamous cell carcinoma (OSCC) remains unclear. Methods This retrospective cohort study included 415 OSCC patients undergoing radical resection with free flap reconstruction. After propensity score matching, 174 well‐matched pairs were analyzed. Patients were divided into a tooth cleaning group ( n = 174) and a control group ( n = 174). Outcomes included postoperative pneumonia (PP), surgical site infection (SSI), fever, length of stay, and unplanned reoperation were recorded. Results Preoperative tooth cleaning was significantly associated with lower PP risk (OR = 0.30). Significant independent risk factors for PP included tumor location at the floor of the mouth (OR = 4.70), hypertension (OR = 2.93), and longer operative duration (OR = 1.33 per hour). The radiographic severity of periodontitis was not a significant risk factor for PP. No associations were found between tooth cleaning and other outcomes. Stratified analyses showed significant protective effects in patients aged > 60 years (OR = 0.19), with hypertension (OR = 0.08), periodontitis (OR = 0.07), or surgeries > 5 h (OR = 0.18). Conclusion Preoperative professional tooth cleaning one day before surgery is associated with a reduced risk of PP in OSCC patients.