We are grateful to Wise et al1 for their interest in our study recently published in CHEST (May 2009).2 We offer the following responses: Colonization of the dental plaque and oral mucosa has consistently been shown to be a reservoir for nosocomial pneumonia. An earlier investigation by Fourrier et al3 showed that decontamination with 0.2% chlorhexidine decreased the incidence of bacterial colonization of the dental plaque. The use of chlorhexidine oral rinse has also been shown to have a residual activity, preventing the accumulation of dental plaque even after 4 days of discontinuation of oral hygiene.4 In our study,2 all patients admitted to the ICU underwent oral cleansing within 6 h of admission. Hence, plaque formation and colonization should have been reduced as early as the first day in the ICU. Although the oral cleansing procedure in our study did not include brushing teeth, it included swabbing the oral, buccal, and posterior pharyngeal mucosa, which would possibly have an additional effect on a bacterial colonization of the pharynx.