Periodontal Pathogens and Respiratory Diseases— Evaluating Their Potential Association: A Clinical and Microbiological Study

BackgroundPeriodontal disease is more prevalent and more severe among men and women suffering from chronic obstructive pulmonary disease (COPD) compared with healthy adults. The objectives of this paper were to assess the association between periodontal disease and COPD, controlling the effect of sociodemographic characteristics, oral health status, lifestyle variables, and comorbidities. Second, we identified which of the variables analyzed were independently associated with periodontal disease among COPD sufferers.MethodsThis descriptive study was done with data from the National/European Health Interview Surveys, conducted in years 2006, 2011/12, and 2014 in Spain. We included subjects ≥40 years of age. COPD status was self-reported. One non-COPD patient was matched by age, gender, and the year of survey for each COPD case. The presence of periodontal disease was defined using the answers “my teeth bleed spontaneously or while brushing” or/and “my teeth move” to the question: “Do you suffer of any of these dental and oral disorders or diseases?” Independent variables included demographic, socioeconomic, and health care-related variables, oral health status, and presence of comorbidities.ResultsThe prevalence of periodontal disease was higher among COPD patients than their matched non-COPD controls (26.5% vs 22.2%; P<0.001). Adjusted odds ratio (AOR) of periodontal disease for subjects with COPD was 1.21 (95% CI: 1.12–1.30). Suffering mental disorders (AOR: 1.61; 95% CI: 1.32–1.97) was positively associated with higher risk of periodontal disease. Older age, having a private dental health insurance, and university education were variables associated with lower rates of periodontal disease.ConclusionPrevalence of periodontal disease was higher among those with COPD compared to non-COPD controls. Dentists and physicians should increase their awareness with their COPD patients, especially those who are younger, with lower education, and suffer depression and/or anxiety.

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“… 27 , 34 , 35 Studies on nonsmoker COPD patients have also found an association of periodontal disease with COPD. 12 , 36 …”

Section: Discussionmentioning

confidence: 99%

Is COPD associated with periodontal disease? A population-based study in Spain

López‐de‐Andrés¹,

Vázquez-Vázquez²,

Martínez-Huedo³

et al. 2018

COPD

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“…Aspiration of oral pathogens into the lower respiratory tract was one of these hypotheses. 31 Periodontal disease-associated enzymes in saliva may also change respiratory environmental conditions, permitting mucosal colonization and infection by respiratory pathogens. 15 , 28 , 31 In addition, the association between poor oral health and respiratory disease was suggested to be mediated through systemic inflammatory responses.…”

Section: Discussionmentioning

confidence: 99%

“… 31 Periodontal disease-associated enzymes in saliva may also change respiratory environmental conditions, permitting mucosal colonization and infection by respiratory pathogens. 15 , 28 , 31 In addition, the association between poor oral health and respiratory disease was suggested to be mediated through systemic inflammatory responses. 9 , 32 Inflammatory cytokines, such as interleukin (IL)-6 or IL-8, from periodontal tissues may alter the respiratory epithelium to promote infection by respiratory pathogens.…”

Section: Discussionmentioning

confidence: 99%

The relationship between the number of natural teeth and airflow obstruction: a cross-sectional study using data from the Korean National Health and Nutrition Examination Survey

Kim¹,

Han²,

Kim³

et al. 2015

COPD

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BackgroundPotential associations between oral health and respiratory disease, including chronic obstructive pulmonary disease (COPD), have been suggested in several studies. Among the indicators reflecting oral health, the number of natural teeth is an integrated and simple index to assess in the clinic. In this study, we examined the relationship between the number of natural teeth and airflow obstruction, which is a central feature of COPD.MethodsA total of 3,089 participants over 40 years, who underwent reliable spirometry and oral health assessments were selected from the Korean National Health and Nutrition Examination Survey 2012, a cross-sectional and nationally representative survey. Spirometry results were classified as normal, restrictive, or obstructive pattern. Total number and pairs of natural teeth were counted after excluding third molars.ResultsAfter adjusting for other variables, such as age, body mass index, socioeconomic factors, and oral health factors, the group with airflow obstruction showed significantly fewer natural teeth than the other groups in males (P=0.014 and 0.008 for total number and total pairs of natural teeth, respectively). Compared with participants with full dentition, the adjusted odds ratio for airflow obstruction in males with fewer than 20 natural teeth was 4.18 (95% confidence interval: 2.06–8.49) and with fewer than 10 pairs of natural teeth was 4.74 (95% confidence interval: 2.34–9.62). However, there was no significant association between the total number or pairs of natural teeth and airflow obstruction after adjustment in females.ConclusionsLoss of natural teeth was significantly associated with the presence of airflow obstruction in males. Our finding suggests that the number of natural teeth could be one of the available indices for obstructive lung diseases, including COPD.

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“…The course of the pulmonary diseases can be affected by both infectious and inflammatory process, such as periodontitis (Azarpazhooh & Leake, 2006;Vadiraj, Nayak, Choudhary, Kudyar, & Spoorthi, 2013). The microorganisms present in the periodontal pocket, specially anaerobic bacteria, can be aspirated into the lower airway (Bansal, Khatri, & Taneja, 2013).…”

Section: Introductionmentioning

confidence: 99%

Periodontitis and respiratory diseases: A systematic review with meta‐analysis

et al. 2019

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Objective To conduct a systematic review and meta‐analysis to evaluate the recent scientific literature addressing the association between periodontitis and asthma, chronic obstructive pulmonary disease (COPD), and pneumonia. Materials and Methods The search for studies was carried out using MEDLINE/PubMed, EMBASE, Lilacs, Web of Science, Scopus, and SciELO databases, including the gray literature (ProQuest). Reference lists of selected articles were also searched. Studies having varying epidemiological designs assessing the association between periodontitis and respiratory diseases in human subjects were eligible for inclusion. Three independent reviewers performed the selection of articles and data extraction. Fixed and random effects meta‐analysis were performed for the calculation of the association measurements (Odds Ratio—OR) and 95% confidence intervals (95% CI). Results A total of 3,234 records were identified in the database search, with only 13 studies meeting the eligibility criteria and 10 studies contributed data for meta‐analysis. Using a random effects models periodontitis was associated with asthma: ORadjusted: 3.54 (95% CI: 2.47–5.07), I2 = 0%; with COPD: OR adjusted: 1.78 (95% CI: 1.04–3.05), I2 = 37.9%; and with pneumonia: OR adjusted: 3.21 (95% CI: 1.997–5.17), I2 = 0%. Conclusions The main findings of this systematic review validated an association between periodontitis and asthma, COPD and pneumonia.

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Periodontal Pathogens and Respiratory Diseases— Evaluating Their Potential Association: A Clinical and Microbiological Study

Abstract: It is conceivable that oral interventions that improve oral health status may prove to lower the severity of lung infection in susceptible populations.

Cited by 18 publications

References 15 publications

Is COPD associated with periodontal disease? A population-based study in Spain

Is COPD associated with periodontal disease? A population-based study in Spain

The relationship between the number of natural teeth and airflow obstruction: a cross-sectional study using data from the Korean National Health and Nutrition Examination Survey

Periodontitis and respiratory diseases: A systematic review with meta‐analysis

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