December 2, 2004
BUFFALO, N.Y. (AP) -- 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.
Copyright 2004 The Associated Press. All rights
reserved.
