Smart Tips #4: Repiratory Disease And Oral Health

Importance:

Residents of long-term care facilities are often at a greater risk of developing respiratory diseases, such as pneumonia. Poor oral hygiene may be one reason for this development because the bacteria that cause respiratory disease may be present in dental plaque. Previous studies have demonstrated a reduced incidence of respiratory disease development in patients who received daily oral hygiene care while in long-term care facilities. A recent study(1) examined the levels of respiratory pathogens present in the dental plaque of patients in a long-term care facility. The investigators found that dental plaque can be a source of respiratory pathogens, and suggest that oral hygiene protocols be instituted to help reduce the development of respiratory disease in this population of patients.

Patient Management:

Ongoing research in this area suggests that poor oral hygiene on the part of institutionalized patients may contribute to increased risk of contracting respiratory disease. Although most dental hygienists in private practice will not treat these patients in the dental operatory, many hygienists are seeking employment outside of the traditional dental office. Long-term care facilities need dental hygienists to provide preventive care to residents. As part of a multidisciplinary team, the dental hygienist will play a critical role in the care and well-being of institutionalized patients.

Long-term care facilities need to implement comprehensive oral care programs for their residents. Daily oral care regimens must be adhered to if this potential cause of respiratory disease is to be reduced. Many aspects of a patient's health should be considered when assessing periodontal status and developing comprehensive treatment plans. Emphasis should be placed on the reduction of the bacteria and of the biofilm, both supragingivally and subgingivally. In the long-term care facility, this can be accomplished, depending on the resident, with traditional scaling and root planing in addition to excellent oral hygiene. Others who can't undergo traditional treatment should have the oral cavity swabbed daily with an antimicrobial solution. Residents who can manage their own daily oral care should have oral hygiene instructions provided. And, because we know that bacterial challenge is a risk factor for gingivitis among even healthy patients, residents who are capable should be encouraged to floss regularly and brush twice daily with a dentifrice that offers antibacterial protection and anti-inflammatory benefits.

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Reference