Inclusion Criteria:• Patients on mechanical ventilator who have been in intensive care for at least 48 hours  Male and female patients over the age of 18 Patients without thrombocytopenia, leukopenia and oral stomatitis, aphthae, candiasis, gingivitis Patients whose respiratory support is provided by a mechanical ventilator Patients who are considered to be able to provide mechanical ventilator support for 7 days Patients without any respiratory-related infectious pathogens Obtaining informed consent from the patient if he/she can give consent or from his/her guardian if he/she is unable to give consent. It was determined as patients who did not undergo any intraoral surgical intervention.  Exclusion Criteria: patients with pneumonia Patients younger than 18 years  -