The company began sending the kits, which include oral hygiene products and a get-well note, to its members in January 2019 as part of its Rush to Brush pilot program. To date, about 8,000 patients have received the packages. Aetna anticipates that 36,000 packages will be sent by the end of 2019.

The number of kits is an estimate because the figures are based on the number of precertified elective surgeries the previous year, explained Mary Lee Conicella, DMD, Aetna's chief dental officer.

"It was a perfect opportunity to say that your oral care regimen is important," she said during an August 26 media presentation at the Johnson & Johnson (J&J) consumer products headquarters in Skillman, NJ.

The program grew from the evidence that performing basic oral care during hospital stays can help prevent the spread of pneumonia, Dr. Conicella said.

She noted that one Sacramento, CA, hospital reduced its nonventilator cases of hospital-acquired pneumonia by about 70% by promoting good oral care during stays.

Since Aetna requires members to obtain precertification for most elective surgeries, such as hip and knee replacements and musculoskeletal procedures, Dr. Conicella thought it was a good idea to start with these patients.

After procedures are approved, the packages are sent to members about two weeks before they are scheduled for hospital admissions. Three months after surgery, the patients are sent a survey to complete that details their oral health regimen while in the hospital.

Each kit includes the following:

• Listerine mouthwash (J&J)
• Colgate toothpaste (Colgate-Palmolive)
• Manual toothbrush
• Toothbrush shield

The items, as well as oral care tips, are delivered in a clear plastic pouch.

If the results show that sending the packages are effective, Dr. Conicella said the next focus may be working with oncology departments, as patients must get dental checkups prior to receiving cancer treatment.

As hospital-acquired pneumonia is the No. 1 acquired infection in the U.S., it is important to take steps to reduce the risk of infection, according to Dr. Conicella.

Over the next five years, she suggested two actions that will move things in the right direction: improved access to dental benefits in government-funded programs and making good hygiene a priority at health organizations.

Patients who have regular dental care have fewer bacteria in their mouths, so making sure everyone knows about it should be a primary concern, Dr. Conicella noted.

"To reduce risk of nosocomial infections such as pneumonia and to fight antibiotic resistance, encourage hospitals and inpatient facilities to prioritize oral health," she said.

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