A critical review of the literature available on the subject helps to formulate evidence-based best practice for the frequency of oral care interventions, tools used, cleaning agents, and innovative techniques suitable for intubated patients.The benefit of change management in oral care using the transformational leadership style and based on Roger’s (1983) Diffusion of Innovations Theory is discussed. Improving oral care through recommendations for practice take into account the importance of strategy to overcome barriers to change and professional issues such as ethical considerations in critical care nursing. Areas for essential future research are identified.The provision of oral hygiene to orally intubated patients in intensive care is an area that has not received much attention as a part of nursing care of critically ill patients. Oral hygiene is a crucial nursing skill that needs to be practised, for the patient’s comfort as well as for the prevention of serious health complications such as pneumonia. Even in Intensive Treatment Units where it is practised, it is not always provided using research-based evidence.It is important that fundamental nursing skills should be developed from research-based evidence, which should form the foundation for advanced nursing practice used in the critical care of patients in intensive care units of hospitals, states McNeill (2000). Government policy has outlined that qualified nurses will have a basic knowledge of the importance of oral health and disease. The outcome would be to maintain oral health of patients, enhance oral comfort, prevent oral disease and handicap: The British Society for Disability and Oral Health (2000). The requirement of oral care in the Intensive Care Unit is to be taken into account:1.1 The Importance of Oral Care: The maintenance of oral health and hygiene is normally a part of the care of personal hygiene. Though not the most urgent care needs in the critically ill, it should never be overlooked, according to the white paper Fundamentals of Care (2003).