Effect Estimates in RCTs
In the parallel-group RCT publications (n54), two of
which covered the same trial (i.e., duplicate publications),
sufficient primary data were given for secondary analyses.
Four different endpoints were analyzed (Table 3). All of
these RCTs revealed positive preventive effects of oral care
on pneumonia or respiratory tract infection in nursing
home residents15,19,23,24 or hospitalized elderly patients.14
The ARRs ranged from 6.6% to 11.7%, and the NNTs
ranged from 8.6 to 15.3 individuals (Table 3). One of the
RCTs studying the preventive effect for death from pneumonia
on nursing home residents, with tooth brushing after
every meal, alone or in combination with daily 1% povidone
iodine scrubbing of the pharynx, had 95% CIs for
ARR and NNT values that were solely positive, indicating
strong evidence of a clinically relevant effect (Table 3).
Moreover, data from one RCT indicated that preoperative
0.12% chlorhexidine gluconate oral rinse may reduce
the incidence of respiratory tract infection in hospitalized
elderly patients undergoing heart surgery (Table 3).