Periodontitis as a Risk Factor for Respiratory Disease
and hospital-acquired pneumonia
1. Pneumonia is a serious inflammation of one or both lungs. This is caused by the inhalation of microorganisms and may range in severity from mild to life threatening. There are two types of pneumonia: community-acquired and nosocomial.
2. Community-acquired pneumonia, pneumonia contracted outside a hospital setting.
a. In most cases of community-acquired bacterial pneumonia caused by aspiration of oropharyngeal organisms such as Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae .
B. Community-acquired bacterial pneumonia usually responds well to treatment. There is no evidence that periodontal diseases of oral hygiene or modifies the risk of community-acquired pneumonia.
3. Hospital-acquired pneumonia is an infection of the lungs became infected during your stay in hospital or long-term care.
a. Hospital-acquired pneumonia is not caused by the same organisms that cause pneumonia.
1) hospital-acquired pneumonia, as a rule, leads organisms called potential respiratory pathogens (Prp), which are commonly found in the intestinal tract, but can be transferred in oropharynx through the gastro-esophageal reflux.
2) Gastroesophageal reflux disease (GERD) is a return backing up of stomach contents into the esophagus. It reflux often causes heartburn due to irritation of the esophagus from stomach acid.
B. Hospital-acquired pneumonia, as a rule, more serious, because the patient's defense mechanisms against infection are often the violations during your stay in hospital or long-term care.
c. Oral colonization with potential respiratory pathogens (Prp) increases in hospitalization, and the longer the patient is hospitalized, the more their prevalence [84-86].
1) bacterial plaque biofilm can serve as reservoirs for Prp, especially with prolonged hospitalization .
2) a patient with Prp colonization of the mouth and oropharynx is an increased risk of developing pneumonia.
B. summary of research
1. Data show that in certain at-risk individuals, periodontitis, and poor oral hygiene can be associated with hospital-acquired pneumonia.
2. Several early studies provide evidence that periodontal intervention might be useful in reducing the incidence of nosocomial pneumonia [88-90].
C. periodontal disease and chronic Obstructive pulmonary disease (COPD)
1. COPD is a group of lung diseases, mainly, emphysema and chronic bronchitis, characterized by obstruction of air during exhalation.
2. Several investigators have suggested that periodontal infection can increase the risk of developing COPD.
3. Two recent systematic review of all available data, however, indicate that currently there is not sufficient evidence of a relationship between periodontal disease and COPD [91,92].
D. Possible Biological Explanation. As Periodontits associated with respiratory disease? Bacterial respiratory infections are believed to be purchased through aspiration (inhalation) small drops in the mouth and throat, lungs. These drops contain bacteria that can grow and multiply in the lungs to cause harm.
E. implications for dental hygiene. Poor oral hygiene is common in hospitals or long-term care facilities, especially in patients who pretty bad [86,93]. Dental doctors should promote programs that promote access institutionalized elders of dental services and to train health workers health, providing daily for the oral cavity.
1. Studies show that improving oral hygiene measures can reduce the incidence of nosocomial pneumonia .
2. Applications for 0,2% solution of chlorhexidine gel for teeth, gums, and other surfaces of the mucous membrane of the mouth, as was shown to significantly reduce the risk of pneumonia, especially in patients that are on artificial lung ventilation [88,89].