The clinical and inflammatory relationships between periodontitis and chronic obstructive pulmonary disease

Abstract

AimTo investigate associations between periodontitis and chronic obstructive pulmonary disease (COPD) with and without alpha‐1 antitrypsin deficiency (AATD), including neutrophil functions implicated in tissue damage.MethodsThe presence and severity of periodontitis (using two international criteria) and lung disease were assessed in 156 COPD patients with and without AATD accounting for common confounding factors. Saliva and systemic inflammatory markers were measured by ELISA together with neutrophil migration.ResultsCOPD and AATD patients exhibited higher prevalence of periodontitis (COPD 95%; AATD 88%) than reported in unselected community‐dwelling populations even when risk factors (age, smoking history, socio‐economic status and dental habits) were considered. Periodontitis severity associated with lung disease severity (AATD, periodontitis versus no periodontitis; FEV1 = 56% versus 99% predicted; TLCO = 59% versus 81% predicted, p < .0001 for both). Neutrophil migratory accuracy declined in stage II–IV periodontitis patients with COPD or AATD compared to COPD or AATD with no or stage I periodontitis. Improved dental habits appeared to be associated with a reduction in exacerbation frequency in COPD.ConclusionThe results support shared pathophysiology between periodontitis and COPD, especially when associated with AATD. This may reflect an amplification of neutrophilic inflammation and altered neutrophil functions, already described in periodontitis, COPD and AATD.

Periodontal Health and Chronic Obstructive Pulmonary Disease (COPD) Exacerbations: A Systematic Review

“…The ndings are in agreement with previous studies which highlighted a potential relationship between periodontitis and respiratory function [12][3] [2]. COPD and periodontitis are believed to have similar pathophysiology, as both diseases are characterised by chronic in ammation and shared risk factors [40]. Given the previously demonstrated role for oral bacteria in lung infections and pneumonia [22][7], it is reasonable to suggest that improved oral health will have a positive impact on COPD patients.…”

Periodontitis and Systemic Disorder—An Overview of Relation and Novel Treatment Modalities

“…By aspiration of oropharyngeal secretions, oral pathogens may enter the lungs. However, in a healthy individual, the immunological and defense mechanism acts as a barrier for oral pathogens to reach the lower respiratory tract; to cause an infection, the pathogen must be virulent and the defense mechanism must be compromised [ 35 ].…”

“…To explain the role of oral bacterial pathogens in the etiology of respiratory disorders, the following mechanism has been proposed [ 35 , 36 , 37 ].…”

Dental Biofilm and Saliva Microbiome and Its Interplay with Pediatric Allergies

“…An overgrowth by, e.g., periopathogenic species mostly in subgingival biofilm can provoke periodontal diseases like gingivitis and periodontitis, which are marked by chronic inflammation of the tooth-supporting structures with progressive alveolar bone loss [ 15 ]. As a consequence, clinical and inflammatory relationships between chronic periodontitis and other chronic metabolic, inflammatory, and vascular diseases, such as diabetes [ 16 ], cardiovascular diseases [ 17 ], chronic obstruction pulmonary disease (COPD) [ 18 ], metabolic syndrome, and obesity [ 19 , 20 ] were found, which is triggered not only by swallowed bacteria but rather by metabolic products of dental biofilms. In this context, the microbial community of dental biofilms has an important impact on the overall biology of humans.…”