Oral hygiene is a basic task of nurses who caring for ICU patients . So, critical care nurses must be aware of the best method of oral care for the critically ill patient. There are many questions about oral care that need to be explored further. These include the best option for care, brushing versus swabbing. Hence, the present study aim to compare between tooth brushes and cotton swabs in their ability to remove dental plaque among patients receiving mechanical ventilation. Quasi-experimental research design was used to conduct this research .This study was carried out at the general intensive care unit in Assiut University Hospitals . A Convenient sample of sixty adults patients receiving mechanical ventilation constituted the study sample. They were divided into two equal groups 30 for each . group G1who received oral care by using tooth brush, Group G2 who received oral care by using the cotton swab
.TOOLS, Two tools were used to collect the data in this study ,tool one "Patient’s assessment sheet ". Tool two: " evaluation sheet" . Results : finding of the current study revealed that The percent of Oral assessment guide score increase with belonged day until reached on the seventh day 93.33% of (G1) had mild compromise score (7-12 score) While, 80.00% of (G2) had compromise score (13-18 score) with highly statistical significant difference between two groups. the percent of Oral Hygiene Index score increase with belonged day until reached on the seventh day 46.67% of (G1) had score (1) While 93.33% of (G2) had score 3 , with highly statistical significant difference between two groups , regarding the result of oropharyngeal swab on the seventh day, it was noticed that 46.67% of (G1) had growth swab. While 100% of the control group (G2) had growth swab. Conclusion ,the current study concluded that the toothbrushes are more effective in plaque removal than cotton swabs. Recommendations:based on the current study finding it can be recommended the use of a soft pediatric brush to remove debris and subsequent plaque to assist in decreasing microbial colonization. Moreover, training program should be established to update critical care nurses' knowledge and skills about oral hygienic care .