According to recent guidelines, what strategy is recommended for preventing ventilator-associated events (VAEs)?

• A. Regular toothbrushing
• B. Daily antibiotic therapy
• C. Frequent mouthwash with alcohol
• D. Increase moisture in the ventilator tubing

Answer: (A)

Maintaining good oral hygiene reduces the amount of bacteria in the mouth that can be aspirated into the lungs. Regular toothbrushing physically removes dental plaque and lowers the oropharyngeal bacterial load, which in turn decreases the risk that bacteria will reach the lower airways when a patient is intubated or coughing. That direct, mechanical reduction of the microbial burden is why brushing teeth is the best-fitting strategy for preventing ventilator-associated events.

Daily antibiotic therapy isn’t used for prevention because it promotes antibiotic resistance and disrupts the normal microbiome without reliably preventing VAEs. A mouthwash with alcohol isn’t favored here, as it can irritate mucosa and isn’t as effective at reducing pathogenic load as routine mechanical cleaning; antiseptic mouthwashes such as chlorhexidine are more commonly considered, but the core protective action remains removing biofilm through brushing. Merely increasing moisture in the ventilator tubing doesn’t address the bacterial colonization that contributes to VAEs and can introduce other issues.