Pneumonia

Pulmonary Disease Q & A
-Dr. Lisa Marie Samaha, DDS,  Perio Arts Institute, April 2011

Individuals with periodontal disease have been shown to have a 4.5 increase in Chronic Obstructive Pulmonary Disease (COPD), by definition, a “progressive development of airflow restriction not fully reversible.” We also see periodontal disease linked to upper and lower respiratory infections, as well as aspiration pneumonia and hospital-acquired pneumonia.  35 million Americans suffer from some sort of respiratory disease and it accounts for at least 1 in 6 deaths in the US, establishing pulmonary disease as the third most common cause of death among Americans. (There is no association between periodontal disease and community acquired pneumonia, however.)

Despite the overwhelming connection noted in various pieces of literature, some would still caution us not to use the term “cause.” We can certainly say periodontal disease is a significant confounding issue. Naturally, anyone with pulmonary destruction has a high level of inflammation in their body. Since periodontal disease is also an inflammatory as well as a bacterial disease, we have two things going on in someone with COPD, in addition to a depressed immune system.

Additionally, it is known that 50% of the population aspirate the contents of their saliva during their sleep. I believe these estimates to be conservative, especially w the statistics on upper respiratory allergies and sleep apnea growing. Lung abscesses have been found to be contaminated with specific, dangerous periodontal bacteria, namely p. gingivalis and t. denticola. A periodontal infection can deeply compromise the individual with COPD and even be fatal.

Furthermore, when inflammation is high and immune function is low, an individual becomes highly susceptible to the direct and indirect invasion of bacterial infection.

In looking at nursing home individuals, we see a 60% increase in pneumonia if there is no daily oral health care present. It is further estimated that 1 in 10 deaths from pneumonia in nursing home residents may be prevented by improving oral hygiene, resulting in a decrease from 9% to 1% of nursing home residents contracting a respiratory infection.

It is also important to note that a 70% increase in lung cancer mortality has been noted in individuals with periodontal disease, above and beyond adjustments for known risk factors for lung cancer, such as smoking, socioeconomics, alcohol consumption and the like.

It certainly behooves every one of us to maintain optimum dental/periodontal health for a multitude of general health reasons. For those susceptible to lung disease of any kind, it is critical.