Oral care methods to reduce salivary bacteria in infants undergoing cardiac surgery: A randomized controlled trial

Background/purpose: Complications, such as postoperative pneumonia, can occur after pediatric cardiac surgery; however, studies on related changes in perioperative oral bacterial counts are scarce. Herein, we investigated the changes in oral bacterial counts before and after surgery in infants who underwent cardiac surgery, as well as after oral care using an antiseptic mouthwash. Materials and methods: A total of 102 infants who underwent congenital heart disease surgery were enrolled in this study. Preoperative oral care was provided using water and a sponge brush. Bacterial cultures were used to determine salivary bacterial counts before and after oral care. Postoperatively, the infants were randomized into a water group (WA group), benzethonium chloride mouthwash group (BZ group), or povidone-iodine mouthwash group (PV -I group), and their salivary bacterial counts, before and after oral care, were measured. Results: The preoperative salivary bacterial colony counts did not change after oral care; however, the postoperative bacterial counts were significantly lower, possibly because of the use of systemic antibiotics. Bacterial counts before and after oral care were not significantly different between the WA and BZ groups; however, bacterial counts were significantly decreased in the PV-I group after oral care. Conclusion: Overall, the results of this study show that systemic administration of antibiotics reduces postoperative salivary bacterial counts in infants undergoing cardiac surgery, and oral care with PV-I can further reduce bacterial counts. (c) 2025 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons. org/licenses/by-nc-nd/4.0/).