Association Between Pneumonia and Oral Care in Nursing Home Residents

Abstract

Pneumonia remains the leading cause of death in nursing home residents. The accumulation of dental plaque and colonization of oral surfaces and dentures with respiratory pathogens serves as a reservoir for recurrent lower respiratory tract infections. Control of gingivitis and dental plaques has been effective in reducing the rate of pneumonia but the provision of dental care for institutionalized elderly is inadequate, with treatment often sought only when patients experience pain or denture problems. Direct mechanical cleaning is thwarted by the lack of adequate training of nursing staff and residents' uncooperativeness. Chlorhexidine-based interventions are advocated as alternative methods for managing the oral health of frail older people; however, efficacy is yet to be demonstrated in randomized controlled trials. Development and maintenance of an oral hygiene program is a critical step in the prevention of pneumonia. While resources may be limited in long-term-care facilities, incorporating oral care in daily routine practice helps to reduce systemic diseases and to promote overall quality of life in nursing home residents.

An analysis of the biofilms adhered to framework alloys using in vitro denture plaque models

“…Aspiration pneumonia is also caused by denture plaque 5,6,9) that contains the same anaerobic bacteria, such as Prevotella and Fusobacterium 9) . Oral care, with a focus on oral hygiene to reduce the dental plaque, can help decrease the incidence of pneumonia 10,11) . Among the microorganisms present in denture plaques, Candida albicans (C. albicans) and Streptococcus mutans (S. mutans) are well known as pathogens causing oral infections 2,[12][13][14][15][16] .…”

The role of the local microbial ecosystem in respiratory health and disease

“…We postulate that an imbalanced oral microbiome might also have an effect on respiratory health through physiological episodes of micro-aspiration [66]. Compelling evidence for the importance of oral health and micro-aspiration is generated by a study in residents of nursing homes, showing that neglect of oral health measures leads to a dramatic increase in incidence of and mortality by pneumonia [120].…”

Understanding Between Medical and Dental Professionals.

“…Paediatricians and doctors should have a good understanding of this important epidemic, give appropriate health advice, and make appropriate early referrals to dentists [11]. The importance of maintaining good oral hygiene and oral health in the prevention of pneumonia among nursing home residents [12], as well as in the management of patients with diabetes [7], cardiovascular diseases [13], and chronic kidney disease [14] have been amply reported.…”