Oral Health and Respiratory Disease- A Review-Juniper publishers
JUNIPER PUBLISHERS-OPEN ACCESS INTERNATIONAL JOURNAL OF PULMONARY & RESPIRATORY SCIENCES
Introductionn
In 2001, following a nine year study of 358 veterans,
dental decay and the presence of cariogenic bacteria and periodontal
pathogens were shown to be significant aspiration pneumonia risk factors
[1]. Another study observed 189 elderly persons over a four year period
and confirmed an association between pneumonia and decayed teeth. In
this study dependence on caregivers was also linked to Pneumonia [2]. A
third study linked higher plaque scores with a previous history of
respiratory tract infections [3].
Pneumonia is defined as an inflammatory condition of
the lung caused by bacterial, viral, fungal or parasitic infections [4].
The risk of pneumonia is, in part, determined by the specific bacteria
inhaled and the body’s ability to eliminate the bacteria from the airway
mucosa. To eliminate aspirated bacteria from the lower airway, multiple
defense mechanisms must function properly. Poor oral hygiene and the
presence of periodontal disease may foster oropharyngeal colonization of
respiratory pathogens which increase the probability of aspiration
pneumonia, especially in high‐risk patients [5]. The effectiveness of
these mechanisms may also be further impaired by a variety of life
conditions such as advanced age, residing in a nursing home or hospital
and debilitated persons [5].
Asthma Implications for Dentistry
Recognition and Understanding of Asthma
In the dental office, the understanding of asthma is
very essential. A patient with asthma symptoms may present with a need
for emergency treatment. Additionally, there may be a needto use rescue
medication for the patients during treatment in the dental office. It is
essential to determine in advance that the rescue inhaler should always
be present and easily available to the patient. The treatment side
effects and symptoms of asthma should be recognized and managed
appropriately. For example, side effects of asthma controller
medications include oral fungal overgrowth and throat irritation.
Rinsing with water should be advised to patients after each inhalation
to minimize this side effect.
Additionally, there is a frequent history of asthma
reported by grown-up dental patients. In children, it is more prevalent.
An acute episode of asthma in the dental office may be precipitated by
extrinsic factors such as inhaled allergens, as well as various
intrinsic factors such as anxiety or fear. An episode of asthma should
be regarded as a medical emergency and must be treated promptly by
inhalation of a bronchodilating agent. The dentist should be alert with
an asthma history of the dental patient and implement strategies that
may prevent an acute attack and to be prepared to manage this
potentially life-threatening medical emergency properly. The chronic use
of glucocorticoids and/ or bronchodilating inhalers for the management
of asthma can increase the likelihood of oral candidiasis, particularly
in patients having other risk factors such as the use of xerostomic
medications, denture use, or smoking [6].
The management of patient with respiratory disease in
dental office is very important. Thorough diagnosis for any systemic
diseases should be done for preventing any systemiccomplications during
dental treatment. Various emergency
drugs required in treatment of respiratory diseases should be
kept in the dental office.
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