Comparison of honey and chlorhexidine for oral hygiene and oral health improvement
DOI: https://doi.org/10.56922/msc.v6i1.2997
Chlorhexidine ICU Honey Oral Hygiene Oral Health
Abstract
Background: Patients admitted to the Intensive Care Unit (ICU) are at high risk of oral health impairment due to decreased levels of consciousness, the use of mechanical ventilation, and limited self-care ability. Poor oral health conditions can serve as a source of microbial colonization and increase the risk of infection, including ventilator-associated pneumonia. Therefore, effective oral hygiene measures constitute an important component of nursing care for critically ill patients.
Purpose: To compare the effectiveness of honey and Chlorhexidine in oral hygiene procedures on the oral health status of ICU patients.
Method: A quasi-experimental design using a two-group pretest–posttest approach. Sampling was conducted using accidental sampling of ICU patients at Sari Asih Serang Hospital who met the inclusion and exclusion criteria. Oral health status was assessed using the Oral Assessment Guide (OAG) instrument. Data analysis was performed using the Wilcoxon test to assess pre- and post-intervention changes, and the Mann–Whitney test to compare the effectiveness between the two groups.
Results: The study findings demonstrated that oral hygiene procedures using both honey and Chlorhexidine significantly improved the oral health status of ICU patients. However, no statistically significant difference was found between the use of honey and Chlorhexidine in improving patients’ oral health status.
Conclusion: Honey demonstrates potential as an effective and safe alternative oral hygiene agent for ICU patients. Its use may be considered as part of evidence-based nursing interventions to maintain oral health and prevent infectious complications in critically ill patients.
Downloads
References
Abid, M., Rauf, R., Siddiq, A., Mazhar, S., Zaidi, H. A., & Zafar, U. (2025). Comparison of the side effects of chlorhexidine and honey mouthwash among dental patients: A randomized controlled trial: side effects of chlorhexidine and honey. Pakistan Journal of Health Sciences, 75-79.
Abuelgasim, H., Albury, C., & Lee, J. (2021). Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis. BMJ evidence-based medicine, 26(2), 57-64.
Adini, S., Santoso, B., Sarkum, S., & Sudirman, S. (2018). The comparison of the effect of honey and chlorhexidine in preventing ventilator associated pneumonia in patients on mechanical ventilaton. Belitung Nursing Journal, 4(2), 161-167.
Carranza, F. A., Newman, M. G., Takei, H. H., & Klokkevold, P. R. (2019). Newman and carranza's clinical periodontology. (No Title).
da Silva, S. E. M., Fernandes, R. R., da Silva, M. E. M., Duarte, H. O., da Câmara, R. O., de Sousa Lopes, M. L. D., ... & Da Silveira, É. J. D. (2025). Factors associated with oral candidosis and hyposalivation in intensive care unit patients: a prospective cohort study. Clinical Oral Investigations, 29(8), 392.
Damasnyah, H., Yunus, P., Monoarfa, S., & Taliki, V. (2024). Pengaruh VAP bundle intervention dalam pencegahan VAP pada pasien terpasang ventilator mekanik di ruangan ICU RSUD Prof. Dr. H. Aloei Saboe Kota Gorontalo. Jurnal Keperawatan Muhammadiyah, 9(3).
Eilers, J. U. N. E. (1988). Development, testing, and application of the oral assessment guide. In Oncology nursing forum (Vol. 15, No. 3, pp. 325-330).
Molan, P. C. (1999). The role of honey in the management of wounds. Journal of wound care, 8(8), 415-418.
Musdalipah, M. (2022). Efek Salvadora Persica Sebagai Bahan Oral Hygiene Terhadap Penurunan Kolonisasi Pathogen Oral Pada Pasien Ventilasi Mekanik; A Systematic Review= The effects of Salvadora Persica as an Oral Hygiene Agent On The Decrease of Oral Pathogens Colonization In Mechanically Ventilated Patients; A Systematic Review.
Nurjannah, S. D., & Syafriati, A. (2023). Pengaruh Penggunaan Madu Dalam Oral Hygiene Terhadap Status Kesehatan Mulut Pada Pasien Pneumonia Yang Terintubasi. J Kesehat dan Pembang, 13(26), 99-109.
Nursalam, N. I. D. N. (2016). Metodologi penelitian ilmu keperawatan.
Putri, N. A. E., Wulandari, D. A., & Widada, W. (2024). Manfaat madu terhadap imunitas tubuh dalam perspektif pengobatan Islam. Scientific Proceedings of Islamic and Complementary Medicine, 2(1), 35-43.
Potter, P. A., Perry, A. G., Stockert, P. A., Hall, A., & Ostendorf, W. R. (2025). Fundamentals of Nursing-E-Book: Fundamentals of Nursing-E-Book. Elsevier health sciences.
Reddy, S. (2017). Essentials of clinical periodontology & periodontics. JP Medical Ltd.
Sharma, S., & Singh, J. (2025). Rare but real: Unusual side effects of chlorhexidine mouthwash–A case-based perspective. Journal of Indian Society of Periodontology, 29(4), 437-441.
Shidiq, N. R. A., Awaludin, S., & Kurniawan, A. (2021). Implementasi Oral Care Hygiene untuk Mengurangi Risiko Ventilator Associated Pneumonia (VAP) di Ruang Intensive Care Unit (ICU) Rumah Sakit Prof. Dr. Margono Soekarjo: Case Study. Journal of Bionursing, 3(2), 113-121.
Shi, Z., Xie, H., Wang, P., Wu, Y., Chen, E., Ng, L., & Needleman, I. (2010). Oral hygiene care for critically ill patients to prevent ventilator associated pneumonia [Intervention Protocol]. Cochrane Database of Systematic Reviews, (2), 1-14.
Untari, D., made Kariasa, I., & Adam, M. (2019). Efektivitas Perawatan Mulut Menggunakan Madu Terhadap Risiko Pneumonia Aspirasi Pada Pasien Stroke Yang Mengalami Penurunan Kesadaran Dan Disfagia. Journal Educational of Nursing (JEN) Vol, 2(2), 24.
Wanderley, M. I. A., Rodrigues-Oliveira, L., Nascimento, T. C. D. C., Cardoso, L. F., Brandão, T. B., Santos-Silva, A. R., & Prado-Ribeiro, A. C. (2025). Oral Manifestations, Dental Interventions, and Clinical Outcomes in Hospitalized COVID-19 Patients: A Two-Year Cohort Study in São Paulo, Brazil. Dentistry Journal, 13(8), 362.
World Health Organization. (2022). Global oral health status report: Towards universal health coverage for oral health by 2030. Retrieved from : https://www.who.int/publications/i/item/9789240061484
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Adriyani, Moh. Arifin Noor
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
