Dental Visits May Prevent Pneumonia

Several sources are reporting on a paper presented at IDWeek that showed people with a regular dental checkup had half the incidence of bacterial pneumonia (1). Michelle Doll and colleagues used the Medical Expenditure Panel Survey (MEPS) data from 2013. The researchers were able to assess participants' access to dental care and used ICD-9 codes to look for bacterial pneumonia in the previous year. The survey had data on 26,687 people, including 441 who had an episode of bacterial pneumonia. Thirty-four percent of those who developed pneumonia reported having at least two dental checkups a year, compared with 46% of those who did not. It is important to point out that this is an observational study and there were significant differences between those who developed and did not develop bacterial pneumonia. Those who got pneumonia were: more likely to be white and older, with an average age of 47 versus 40; more likely to have comorbidities and cognitive limitations; and less likely to have dental insurance.

Nevertheless, the data is consistent with the hypothesis that microaspiration is a frequent cause of bacterial pneumonia. Previous data has shown oral chlorhexidine reduces ventilator-associated pneumonia in the ICU (2). Although a large randomized study is needed, the data suggests that dental care may be another community-acquired pneumonia preventative in addition to conjugated pneumococcal vaccine (3).

Richard A. Robbins, MD

Editor, SWJPCC

References

1. Smith M. Regular checkups linked to protection against bacterial disease. Medscape. October 28, 2016. Available at: http://www.medpagetoday.com/MeetingCoverage/IDWeek/61071 (accessed 10/28/16). 
2. Hua F, Xie H, Worthington HV, Furness S, Zhang Q, Li C. Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia. Cochrane Database Syst Rev. 2016 Oct 25;10:CD008367. [CrossRef] [PubMed]
3. Bonten MJ, Huijts SM, Bolkenbaas M, et al. Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults. N Engl J Med. 2015 Mar 19;372(12):1114-25. [CrossRef] [PubMed]

Cite as: Robbins RA. Dental visits may prevent penumonia. Southwest J Pulm Crit Care. 2016;13(4):186. doi: http://dx.doi.org/10.13175/swjpcc105-16 PDF