Mouth the mirror of lungs: where does the connection lie?

Abstract

Periodontitis is the chronic destructive disease of the periodontium (Gums) caused by host bacterial interactions. The effect of such host bacterial interactions in oral cavity also evokes a systemic response. Numerous studies have found common mechanisms of destruction for periodontal diseases and other chronic diseases like diabetes mellitus, atherosclerosis, respiratory diseases, and adverse pregnancy outcomes. Oral colonization by respiratory pathogens appears to be a risk factor for development of respiratory diseases and oral interventions aimed at reducing oral bacterial count have resulted in reduced incidence of these reparatory illness. This reflects the importance of oral hygiene among patients with respiratory illness. This review highlights the association between periodontal diseases and respiratory diseases.

Keywords

periodontitis / respiratory diseases / acute pneumonia / COPD

References

[1] Reddy MS. Reaching a better understanding of non-oral disease and the implication of periodontal infections. Periodontol 2000 2007; 44(1): 9–14

[2] American Academy of Periodontology. Oral Health Information for the Public: Mouth Body Connection. Accessed <Date>January 16</Date> 2008)

[3] Page RC. The pathobiology of periodontal diseases may affect systemic diseases: inversion of a paradigm. Ann Periodontol 1998; 3(1): 108–120

[4] Verghese A, Berk SL. Bacterial pneumonia in the elderly. Medicine (Baltimore) 1983; 62(5): 271–285

[5] Scannapieco FA, Stewart EM, Mylotte JM. Colonization of dental plaque by respiratory pathogens in medical intensive care patients. Crit Care Med 1992; 20(6): 740–745

[6] No author listed. Centers for Disease Control and Prevention (CDC). Morb Mortal Wkly Rep. 1997; 46(RR-1): 1–79

[7] Scannapieco FA, Stewart EM, Mylotte JM. Colonization of dental plaque by respiratory pathogens in medical intensive care patients. Crit Care Med 1992; 20(6): 740–745

[8] Sumi Y, Miura H, Sunakawa M, Michiwaki Y, Sakagami N. Colonization of denture plaque by respiratory pathogens in dependent elderly. Gerodontology 2002; 19(1): 25–29

[9] Sumi Y, Kagami H, Ohtsuka Y, Kakinoki Y, Haruguchi Y, Miyamoto H. High correlation between the bacterial species in denture plaque and pharyngeal microflora. Gerodontology 2003; 20(2): 84–87

[10] Tablan OC, Anderson LJ, Besser R, Bridges C, Hajjeh R; CDC; Healthcare Infection Control Practices Advisory Committee. Guidelines for preventing health-care—associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR Recomm Rep 2004; 53(RR-3): 1–36

[11] Fourrier F, Duvivier B, Boutigny H, Roussel-Delvallez M, Chopin C. Colonization of dental plaque: a source of nosocomial infections in intensive care unit patients. Crit Care Med 1998; 26(2): 301–308

[12] Didilescu AC, Skaug N, Marica C, Didilescu C. Respiratory pathogens in dental plaque of hospitalized patients with chronic lung diseases. Clin Oral Investig 2005; 9(3): 141–147

[13] Abe S, Ishihara K, Adachi M, Okuda K. Oral hygiene evaluation for effective oral care in preventing pneumonia in dentate elderly. Arch Gerontol Geriatr 2006; 43(1): 53–64

[14] Russell SL, Boylan RJ, Kaslick RS, Scannapieco FA, Katz RV. Respiratory pathogen colonization of the dental plaque of institutionalized elders. Spec Care Dentist 1999; 19(3): 128–134

[15] Joshi N, O’Bryan T, Appelbaum PC. Pleuropulmonary infections caused by Eikenella corrodens. Rev Infect Dis 1991; 13(6): 1207–1212

[16] Zijlstra EE, Swart GR, Godfroy FJM, Degener JE. Pericarditis, pneumonia and brain abscess due to a combined Actinomyces—Actinobacillus actinomycetemcomitans infection. J Infect 1992; 25(1): 83–87

[17] Scannapieco FA, Wang B, Shiau HJ. Oral bacteria and respiratory infection: effects on respiratory pathogen adhesion and epithelial cell proinflammatory cytokine production. Ann Periodontol 2001; 6(1): 78–86

[18] Langmore SE, Terpenning MS, Schork A, Chen Y, Murray JT, Lopatin D, Loesche WJ. Predictors of aspiration pneumonia: how important is dysphagia? Dysphagia 1998; 13(2): 69–81

[19] Robert R, Grollier G, Frat JP, Godet C, Adoun M, Fauchère JL, Doré P. Colonization of lower respiratory tract with anaerobic bacteria in mechanically ventilated patients. Intensive Care Med 2003; 29(7): 1062–1068

[20] Gibbons RJ, Hay DI, Childs WC 3rd, Davis G. Role of cryptic receptors (cryptitopes) in bacterial adhesion to oral surfaces. Arch Oral Biol 1990; 35(Suppl): 107S–114S

[21] Barbara R. chronic obstructive pulmonary disease. Soc Work Health Care 1991; 16: 4–10

[22] No author listed. GOLD—The Global Initiative for Chronic Obstructive Lung Disease. Available at

[23] Deo V, Bhongade ML, Ansari S, Chavan RS. Periodontitis as a potential risk factor for chronic obstructive pulmonary disease: a retrospective study. Indian J Dent Res 2009; 20(4): 466–470

[24] Hyman JJ, Reid BC. Cigarette smoking, periodontal disease, and chronic obstructive pulmonary disease. J Periodontol 2004; 75(1): 9–15

[25] Mannino DM, Davis KJ. Lung function decline and outcomes in an elderly population. Thorax 2006; 61(6): 472–477

[26] Bolin A, Eklund G, Frithiof L, Lavstedt S. The effect of changed smoking habits on marginal alveolar bone loss. A longitudinal study. Swed Dent J 1993; 17(5): 211–216

[27] Burt BA, Ismail AI, Morrison EC, Beltran ED. Risk factors for tooth loss over a 28-year period. J Dent Res 1990; 69(5): 1126–1130

[28] Hayes C, Sparrow D, Cohen M, Vokonas PS, Garcia RI. The association between alveolar bone loss and pulmonary function: the VA Dental Longitudinal Study. Ann Periodontol 1998; 3(1): 257–261

[29] Scannapieco FA, Genco RJ. Association of periodontal infections with atherosclerotic and pulmonary diseases. J Periodontal Res 1999; 34(7): 340–345

[30] Scannapieco FA, Ho AW. Association of periodontal disease & chronic lung diseases. Analysis of NHANES III. J Periodontol 1999; 78: 1777–1782

[31] Scannapieco FA, Ho AW. Potential association between chronic respiratory disease and periodontal diseases: analysis of National Health and Nutrition Examination Survey III. J Periodontol 2001; 72: 50–56

[32] Prasanna SJ. Causal relationship between periodontitis and chronic obstructive pulmonary disease. J Indian Soc Periodontol 2011; 15(4): 359–365

[33] Scannapieco FA, Mylotte JM. Relationship between periodontal disease and bacterial pneumonia. J periodontal 1996; 67: 1114–1122

[34] Scannapeico FA, Bush RB, Paju S. Association between periodontal disease and risk for nosocomial bacterial pneumonia —a systematic review. Ann Periodontol 2003; 8: 54–69

[35] Pugin J, Auckenthaler R, Lew DP, Suter PM. Oropharyngeal decontamination decreases incidence of ventilator-associated pneumonia. A randomized, placebo-controlled, double-blind clinical trial. JAMA 1991; 265(20): 2704–2710

[36] Stoutenbeek CP, van Saene HK, Miranda DR, Zandstra DF, Langrehr D. The effect of oropharyngeal decontamination using topical nonabsorbable antibiotics on the incidence of nosocomial respiratory tract infections in multiple trauma patients. J Trauma 1987; 27(4): 357–364

[37] Yoneyama T, Yoshida M, Ohrui T, Mukaiyama H, Okamoto H, Hoshiba K, Ihara S, Yanagisawa S, Ariumi S, Morita T, Mizuno Y, Ohsawa T, Akagawa Y, Hashimoto K, Sasaki H; Oral Care Working Group. Oral care reduces pneumonia in older patients in nursing homes. J Am Geriatr Soc 2002; 50(3): 430–433

[38] Yoshida M, Yoneyama T, Akagawa Y. Oral care reduces pneumonia of elderly patients in nursing homes, irrespective of dentate or edentate status. Nippon Ronen Igakkai Zasshi 2001; 38(4): 481–483 (in Japanese)

[39] Ishikawa A, Yoneyama T, Hirota K, Miyake Y, Miyatake K. Professional oral health care reduces the number of oropharyngeal bacteria. J Dent Res 2008; 87(6): 594–598

[40] Bassim CW, Gibson G, Ward T, Paphides BM, Denucci DJ. Modification of the risk of mortality from pneumonia with oral hygiene care. J Am Geriatr Soc 2008; 56(9): 1601–1607

[41] Treppening M. Geriatric oral health & pneumonia risk. Clin Infect Dis  2005;  40:1807–1810

[42] Prevention of Ventilator Associated Pneumonia: Institute for Clinical Systems I<?Pub Caret?>mprovement. 5th ed. Bloomington. 2011.

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