Efficacy of artificial saliva in preventing oral changes in patients admitted to the ICU: a controlled clinical trial

OBJECTIVE: To evaluate the effect of prophylactic artificial saliva application on the prevention of oral changes in patients admitted to the Intensive Care Unit (ICU). MATERIALS AND METHODS: This controlled clinical trial was conducted in an ICU between October 2024 and May 2025. Patients were assigned to an Experimental Group (EG), which received topical artificial saliva after standard oral hygiene, and a Control Group (CG), which underwent oral hygiene only. Statistical analyses were performed using Jamovi, SPSS, and Stata. Fisher’s exact test, Kaplan–Meier survival analysis with log-rank test, and Poisson regression were applied, adopting a significance level of p < 0.05. RESULTS: Among the 46 patients analyzed (21 in EG and 25 in CG), oral changes occurred in 61% during hospitalization. The Control Group developed significantly more lesions than the Experimental Group (p = 0.023), showing a 29% higher occurrence of changes. Oral candidiasis (24.1%) and dry mouth (20.2%) were more frequent in the CG, whereas traumatic ulceration predominated in the EG (51.6%). CONCLUSION: The prophylactic use of artificial saliva was associated with a lower occurrence of oral changes in critically ill patients and may represent a simple and potentially cost-effective supportive intervention in the ICU setting. CLINICAL RELEVANCE: The findings suggest that prophylactic use of artificial saliva may contribute to reducing oral complications in critically ill patients. As a simple and low-cost intervention, it has the potential to support oral care strategies in ICU settings; however, further studies are needed to confirm its effectiveness and inform clinical protocols.