Dental Status and 30-Day Postoperative Pneumonia in Burn Surgery Patients

Background and Objectives: Major burn injury causes systemic immune dysregulation and increases susceptibility to infectious complications. While poor oral health is a potential reservoir for respiratory pathogens, its impact on burn patients—who often require repeated airway manipulation—is not well-defined. This study investigated the association between preoperative dental status and postoperative pneumonia in patients undergoing burn surgery. Materials and Methods: We conducted a retrospective cohort study of 894 adult patients (≥19 years) admitted to a burn intensive care unit (ICU) between 2015 and 2024. Preoperative dental status was categorized as favorable or unfavorable (≥2 missing teeth, loose teeth, or fractured teeth). The primary outcome was 30-day postoperative pneumonia. Secondary outcomes included 90-day hospital-free days and ICU-free days. Results: Postoperative pneumonia occurred in 294 patients (32.9%). The incidence of postoperative pneumonia was 47.7% among patients with unfavorable preoperative dental status, compared with 31.2% among those with favorable preoperative dental status (p < 0.001). In multivariable analysis, unfavorable dental status was an independent predictor of 30-day pneumonia (odds ratio, 1.681; 95% confidence interval, 1.084–2.599; p = 0.018). Patients with unfavorable status also had significantly fewer 90-day hospital-free days (9 vs. 22 days, p = 0.034) and ICU-free days (65 vs. 68 days, p = 0.012). Conclusions: Unfavorable preoperative dental status is independently associated with an increased risk of postoperative pneumonia and poorer clinical recovery in burn patients. Routine dental assessment may serve as a simple tool for perioperative risk stratification in patients undergoing burn surgery.