Dentures are a Reservoir for Respiratory Pathogens

Abstract

Purpose Recent studies have established a relationship between dental plaque and pulmonary infection, particularly in elderly individuals. Given that approximately one in five adults in the UK currently wears a denture, there remains a gap in our understanding of the direct implications of denture plaque on systemic health. The aim of this study was to undertake a comprehensive evaluation of putative respiratory pathogens residing upon dentures using a targeted quantitative molecular approach. Materials and Methods One hundred and thirty patients’ dentures were sonicated to remove denture plaque biofilm from the surface. DNA was extracted from the samples and was assessed for the presence of respiratory pathogens by qunatitative polymerase chain reaction (qPCR). Ct values were then used to approximate the number of corresponding colony forming equivalents (CFEs) based on standard curves. Results Of the dentures, 64.6% were colonized by known respiratory pathogens. Six species were identified: Streptococcus aureus, Streptococcus pneumoniae, Pseudomonas aeruginosa, Haemophilus influenzae B, Streptococcus pyogenes, and Moraxella catarrhalis. P. aeruginosa was the most abundant species followed by S. pneumoniae and S. aureus in terms of average CFE and overall proportion of denture plaque. Of the participants, 37% suffered from denture stomatitis; however, there were no significant differences in the prevalence of respiratory pathogens on dentures between healthy and inflamed mouths. Conclusions Our findings indicate that dentures can act as a reservoir for potential respiratory pathogens in the oral cavity, thus increasing the theoretical risk of developing aspiration pneumonia. Implementation of routine denture hygiene practices could help to reduce the risk of respiratory infection among the elderly population.

Occurrence and antimicrobial susceptibility of enteric rods and pseudomonads isolated from the dental prostheses biofilm

“…In this study we also found a slightly higher prevalence (27.5%) of Enterobacteriaceae species with decreased susceptibility to cefotaxime (MIC 90 ≥2 μg/mL) than the data previously reported of 22.5% 21 , and these isolates were considered potential ESBL (Extended Spectrum Beta-Lactamases) producers according to the limits established by the CLSI 6,7 . Resistance to β-lactam antimicrobials in Enterobacteriaceae has been largely due to the presence of β-lactamase enzymes.…”

“…By wearing dental prostheses, individuals are at a higher risk of aspirating such pathogens from the denture biofilm due to the close proximity of this oral appliance and lungs, being reported a high prevalence of respiratory pathogens on the denture biofilm of hospitalized adults 21 . Furthermore, not only are such pathogens involved in the development of aspiration pneumonia, but also they have been directly associated with bacterial endocarditis, gastrointestinal infection, and chronic obstructive pulmonary disease.…”

Oral health for an ageing population: the importance of a natural dentition in older adults

“…In particular, fixed and removable implant restorations can present a challenge in dependent elders, both with regard to the handling of the prosthesis as well as to its cleaning by both patients and caregivers 16 . A special threat is posed by the accumulation of an oral biofilm on natural tooth surfaces, dental prostheses, or the tongue 17 . In the case of dysphagia, an illness frequently encountered in old age, oral bacteria are often carried into the bronchoalveolar system 18,19 .…”

The Denture-Associated Oral Microbiome in Health and Stomatitis

“…Denture wearing has been associated with a number of microbial diseases, including denture-related mucosal tissue inflammation (denture stomatitis) (20) and malodor (21). Dentures are also suspected to serve as a reservoir for respiratory pathogens (3, 13) and thus lead to an increased risk of pulmonary infections (22). Despite the fact that microorganisms are the obvious suspects for most of the above denture-related diseases, little is known about their etiology.…”