Preoperative Professional Tooth Cleaning as a Preventive Measure for Postoperative Pneumonia in OSCC Patients: A Retrospective Study

Abstract

Background: Professional tooth cleaning is a simple, low-cost preoperative oral intervention. Its role in reducing postoperative complications in oral squamous cell carcinoma (OSCC) remains unclear. Methods: This retrospective cohort study included 415 OSCC patients undergoing radical resection with free flap reconstruction. After propensity score matching, 174 well-matched pairs were analyzed. Patients were divided into a tooth cleaning group (n = 174) and a control group (n = 174). Outcomes included postoperative pneumonia (PP), surgical site infection (SSI), fever, length of stay, and unplanned reoperation were recorded. Results: Preoperative tooth cleaning was significantly associated with lower PP risk (OR = 0.30). Significant independent risk factors for PP included tumor location at the floor of the mouth (OR = 4.70), hypertension (OR = 2.93), and longer operative duration (OR = 1.33 per hour). The radiographic severity of periodontitis was not a significant risk factor for PP. No associations were found between tooth cleaning and other outcomes. Stratified analyses showed significant protective effects in patients aged > 60 years (OR = 0.19), with hypertension (OR = 0.08), periodontitis (OR = 0.07), or surgeries > 5 h (OR = 0.18). Conclusion: Preoperative professional tooth cleaning one day before surgery is associated with a reduced risk of PP in OSCC patients.