[Dysphagia] Dental Plaque Linked to Pneumonia

[bonnieh4455 at sbcglobal.net (Bonnie Heintskill)]

http://story.news.yahoo.com/news?tmpl=story&cid=541&ncid=751&e=10&u=/ap/2004
1202/ap_on_he_me/plaque_pneumonia


Dental Plaque Linked to Pneumonia

Thu Dec 2, 5:11 AM ET

 Health - AP

By CAROLYN THOMPSON, Associated Press Writer

BUFFALO, N.Y. - Better oral hygiene, including good regular toothbrushing,
may lessen nursing home residents' chances of developing pneumonia,
according to a study which traced germs from dental plaque to the lungs of
patients with the potentially fatal illness.

Dr. Ali El-Solh, lead author of the study published in the November issue of
the journal Chest, said the findings "indicate that dental plaque is a
reservoir of respiratory pathogens" that can be inhaled into the lungs and
lead to pneumonia.

The University at Buffalo researcher stopped short of saying that brushing
or rinsing patients' teeth or dentures is enough to destroy the germs and
prevent pneumonia, citing the need for more research. But the study makes a
strong case for improving dental care for nursing home residents, he and
others said.

Institutionalized and critically ill elderly people, who are often frail
with weakened immune systems, are particularly susceptible to pneumonia, and
poor dental hygiene has been suspect for several years.

"They tend to have no oral hygiene at all so there's a lot of bacteria
growing in the front part of the respiratory tract, the mouth," said Dr.
Jack Caton, past president of the American Academy of Periodontology, "so
it's not surprising that these bacteria can then be somehow inhaled and
establish in the lungs and produce pneumonia."

Caton said other preliminary studies have indicated that cleaning the mouths
of patients, either chemically or with toothbrushes or sponges, reduces the
incidence of pneumonia, further strengthening the oral health-pneumonia
link.

Previous researchers have suggested that oral bacteria contribute to
ailments ranging from heart disease to premature births.

The study, funded by a grant from the American Lung Association, followed 49
nursing home patients admitted to the intensive care unit of a Buffalo
hospital. The patients' plaque was tested upon admission and the patients
were watched for signs of pneumonia.

Fourteen of the patients developed pneumonia while in the hospital. Genetic
testing found that the bacteria in the lung fluid of those patients matched
the bacteria found in their dental plaque when they were admitted.

"This was a unique study in that they looked at the bacteria before they
ever got pneumonia," said Dr. Mark Rosen, president-designate of the
American College of Chest Physicians.

"This really made the case that the bacteria in the mouth precede those that
you see when the pneumonia sets in ... making the case this is how people
get pneumonia," said Rosen, chief of the Division of Pulmonary and Critical
Care Medicine at New York's Beth Israel Medical Center.

The problem will only get worse as the population ages, he said.

"Now the question is, what do you need to do to get rid of the plaque?"
Rosen said. "Is brushing teeth enough? Probably not."

He said a combination of brushing, flossing and regular dental visits < the
same oral hygiene formula recommended for the general population < would
likely be most effective.
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On the net: Chest: http://www.chestjournal.org