Dental plaques linked with pneumonia in elderly

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Bacteria in dental plaque can cause hospital-acquired pneumonia in elderly nursing home residents, according to a report in the medical journal Chest.

“The available evidence suggests that poor oral health, characterized by inadequate hygiene results in the formation of extensive (plaques), promotes oral colonization by potential respiratory (microbes) and increases the risk for serious lower respiratory tract infections in institutionalized subjects,” co-author Dr. Ali A. El-Solh told AMN Health.

Dr. El-Solh from University of Buffalo, New York, and colleagues investigated the rate of plaque contamination by disease-causing microbes in institutionalized elderly patients. In addition, the researchers sought to determine whether these bugs were related to those recovered from patients who developed pneumonia.

Fourteen of 49 patients (29 percent) who needed mechanical assistance to breathe had evidence of hospital-acquired pneumonia about 12 days after assisted respiration began, the authors report.

Oral hygiene was poor in patients who did and those who did not develop pneumonia, the report indicates.

Patients with bacteria in their dental plaques were at increased risk for developing pneumonia and had a poorer functional status than their peers without bacteria.

All nine microbes isolated from eight patients with pneumonia matched those recovered from their dental plaque, the investigators note.

“The lack of adequate oral hygiene in nursing homes results in an increase in the mass and complexity of dental plaques, which fosters an environment that promotes colonization by” pneumonia-causing microbes, El-Solh told Reuters Health.

“The avoidable, yet undeniable, status quo of poor oral hygiene in institutionalized elderly will remain unchanged until those who control distribution of health care resources realize that the added expense of daily oral care is lower than the cost of ignoring it,” El-Solh added.

SOURCE: Chest, November 2004. 

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