Effect of Mouthwash with Boswellia Extract on the Prevention of Dental Plaque Formation in Patients under Mechanical Ventilation

Document Type : Original Article


Background: Oral hygiene is a crucial nursing care in the intensive care unit (ICU) that can prevent ventilator‑associated pneumonia. Objectives: This study compares the effect of mouthwash with Boswellia extract and chlorhexidine on the prevention of dental plaque formation in ICU patients having an endotracheal tube. Methods: A clinical trial was performed on 90 patients under mechanical ventilation in the ICU of Ayatollah Kashani Hospital in Isfahan, Iran, in 2018. The study data were collected using a demographic information form, a checklist, and the O’Leary dental plaque index (ODPI). The patients were randomly divided into two groups to receive mouthwash using solutions containing Boswellia or chlorhexidine. Data were analyzed using the Kolmogorov–Smirnov test, analysis of variance, independent samples, and paired t‑tests. Results: Most of the patients were male (76.67%), with a smoking background (60%) and in the age range of 18–38  years. The two groups did not significantly differ in terms of demographic characteristics (P > 0.05). The mean ODPI was 0.89 ± 0.07 at baseline in the Boswellia group and changed to 0.67 ± 0.05 after the intervention (P < 0.001). Furthermore, the mean ODPI was 0.93 ± 0.03 in the chlorhexidine group and change to 0.77 ± 0.09 after the intervention (P < 0.001). Conclusions: Both Boswellia and chlorhexidine mouthwashes were effective in the prevention of dental plaque in patients under mechanical ventilation.