The interest in research on oral care in intensive care unit (ICU) patients has emerged largely from the 2000s onward after years of being a rather ignored topic in health science. Since, the focus has been on its potential contribution to preventing pneumonia by eliminating contaminated oral pathogens that might invade the lower respiratory tract. Accumulating evidence of the effectiveness of oral care with chlorhexidine gluconate (CHG) in preventing ventilator-associated pneumonia (VAP) or postoperative pneumonia 1, 2 has led to adopting CHG oral care as the gold standard for intubated patients. Recently, however, potential adverse effects of CHG on the oral mucosa 3 and reduced bacterial susceptibility 4 have been reported, as well as an even more alarming potential association of CHG oral care with an increased risk of mortality 5–8. Although the latter association results from retrospective studies or meta-analyses, righteous calls for caution and for a thorough re-evaluation of the established gold standard have been launched 9, 10.