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Ishikawa A, Yoneyama T et al. J Dent Res 2008; 87: 594–598

The aspiration of oropharyngeal bacteria, particularly by those with cerebrovascular disease and/or cognitive impairment, may cause pneumonia. In this study, groups comprising of about 70 residents in each of three care-homes in Japan, received different oral care regimens over a 5 month period, some delivered by dental hygienists. Twenty percent of subjects did not complete the study. Weekly professional debridement was more effective at removing oropharyngeal bacteria than daily gargling with 0.35% povidone iodine. Although the levels of certain microbial species decreased or disappeared during the study, this was not reflected consistently by the debris scores, nor the number of febrile days that the subjects experienced. The latter measurement was an implied marker for aspiration pneumonia. In the discussion, the authors assert the importance of professional oral care in comparison with the use of chemical disinfection by this mouthwash.