Periodontal status and oral health behavior in hospitalized patients with chronic obstructive pulmonary disease

Abstract

Aim:We evaluated the periodontal health status and oral health behavior among hospitalized patients with chronic obstructive pulmonary disease (COPD) to assess the association of COPD with dental health.Materials and Methods:A group of 100 hospitalized patients with COPD and a group of 100 age, sex, and race-matched control patients were included in this study. Detailed case histories along with standardized measures of oral health including gingival index, plaque index (PI), and simplified oral hygiene index (OHI) were estimated and compared. Probing depths and clinical attachment levels (CALs) were recorded at four sites per tooth. C-reactive protein (CRP) levels in saliva and serum were also measured.Results:The study subjects had similar demographics and distribution in either group. Patients with COPD had significantly lower brushing frequency, poor periodontal health (OHI and PI), greater gingival inflammation, and deeper pockets/CALs compared to controls. Further COPD patients had significantly higher serum and salivary CRP levels compared to control groups.Conclusions:Lower brushing frequency, poor oral health, and presence of destructive periodontal disease were observed among patients with COPD, which warrants promoting dental care and oral health knowledge as an integrated approach to treating COPD patients.

Is periodontitis a comorbidity of COPD or can associations be explained by shared risk factors/behaviors?

“…In support of this, Bhavsar et al found patients in the COPD group, as a whole, had significantly reduced brushing frequency compared with a non-COPD group (independent of periodontal status) 95. Similarly, Liu et al found that a higher proportion of patients with frequent COPD exacerbations brushed their teeth less than once per day and had higher PI scores after adjusting for other confounding factors 104.…”

“…Most studies investigating associations between COPD and periodontitis base the diagnosis of COPD on post- bronchodilator spirometry and GOLD staging 95,96,100,102,103,106. However, some authors used pre-bronchodilator spirometry,107 which could lead to an overestimation of the prevalence of COPD, others report lung function measurements but not whether pre- or post-bronchodilation,40,98 and one study failed to mention how COPD was confirmed 99.…”

Patients with Chronic Obstructive Pulmonary Disease Suffer from Worse Periodontal Health—Evidence from a Meta-Analysis

“…And 171 records which are irrelevant or duplicate were excluded first after the titles and abstracts were screened, leaving 49 articles for a further full-text review. Eventually, 35 studies were excluded and 14 studies (Hayes et al, 1998 ; Scannapieco and Ho, 2001 ; Deo et al, 2009 ; Wang et al, 2009 ; Prasanna, 2011 ; Si et al, 2012 ; Ledić et al, 2013 ; Peter et al, 2013 ; Vadiraj et al, 2013 ; Yildirim et al, 2013 ; Öztekin et al, 2014 ; Bhavsar et al, 2015 ; Chung et al, 2016 ; Terashima et al, 2016 ) were eligible for inclusion in this analysis to perform the comparison of periodontal status between COPD and non-COPD subjects. The selection procedure is shown in Figure 1 .…”

“…The publication dates of the 14 included studies ranged from 1998 to 2016. Among the 14 studies, 12 (Hayes et al, 1998 ; Deo et al, 2009 ; Wang et al, 2009 ; Prasanna, 2011 ; Si et al, 2012 ; Ledić et al, 2013 ; Peter et al, 2013 ; Vadiraj et al, 2013 ; Yildirim et al, 2013 ; Öztekin et al, 2014 ; Bhavsar et al, 2015 ; Terashima et al, 2016 ) are case-control study (one of which is nested case-control study) and 2 are cross-sectional studies (Scannapieco and Ho, 2001 ; Chung et al, 2016 ). Totally 3348 COPD patients and 20612 non-COPD controls were studied.…”

“…Methodological quality assessments of the included studies are also shown in Table 1 . Among the 14 studies, 3 studies (Wang et al, 2009 ; Yildirim et al, 2013 ; Öztekin et al, 2014 ) scoring 7 points were considered to be of high quality and 11 studies (Hayes et al, 1998 ; Scannapieco and Ho, 2001 ; Deo et al, 2009 ; Prasanna, 2011 ; Si et al, 2012 ; Ledić et al, 2013 ; Peter et al, 2013 ; Vadiraj et al, 2013 ; Bhavsar et al, 2015 ; Chung et al, 2016 ; Terashima et al, 2016 ) were considered to be of moderate quality because their score ranged from 4 to 6 points. While the Kappa value for the article screening and quality assessment were 0.892 and 0.811, respectively, which mean an excellent agreement between the authors.…”