Oral care practices in ICUs are not consistent or standardized. A recent survey of oral care practices in 59 European ICUs documented that oral care practices were carried out once daily in 20%, twice daily in 31%, and three times daily in 37% of patients. Oral care consisted primarily of mouth washes (55%) performed with chlorhexidine (61%). In contrast, only 41% used manual toothbrushes for oral care, and electric toothbrushes were never used.(5) A survey of oral care practices in U.S. ICUs had similar findings.(6) The frequency of oral hygiene for intubated patients is controversial.