Jan. 31, 2001 BUFFALO, N.Y. -- Chronic lung-disease sufferers should be especially fastidious about brushing and flossing their teeth. That is the message delivered in a study just published in the Journal of Periodontology conducted by oral biologists from the University at Buffalo.
The researchers found an association between chronic respiratory disease and periodontal disease in an analysis of data from a large national database, the Third National Health and Nutrition Examination Survey, known as NHANES III.
The results add to a growing body of evidence that poor oral health is linked to a number of chronic diseases.
Frank Scannapieco, D.M.D., Ph.D., associate professor of oral biology in UB's School of Dental Medicine and lead author of the study, said the mechanism linking oral health and lung disease isn't clear, but that bacteria in the mouth likely are to blame.
"Accumulation of disease-causing organisms associated with gum disease may increase the risk for serious lower-respiratory-tract infection in susceptible subjects," said Scannapieco.
"It is possible that bacteria that normally stick to the teeth are sloughed into the saliva and may be breathed into the upper airways, changing that environment and paving the way for other germs to infect the lower airways. Oral conditions likely work together with other factors, such as smoking, environmental pollutants, allergies and genetics to make existing lung problems worse."
Scannapieco's earlier work with pneumonia in hospitalized patients suggested a potential association between respiratory diseases and poor oral health, and led him to investigate whether such a relationship exists in the general population. For the analysis, he used data from 13,792 participants in NHANES III who were at least 20 years old and had at least six natural teeth.
Questionnaires completed by participants included items about their history of respiratory disease. The physical examination measured each person's forced expiratory volume (FEV1), or how much air a person can blow out in one second, a measure of lung health and function.
A dental examination assessed the loss of gum attachment supporting the teeth, amount of gum bleeding, number of cavities and number of teeth.
Analyzing these two sets of data for a relationship, the researchers found that lung function appeared to diminish as the amount of gum-attachment loss increased. Results also showed a decline in respiratory function as oral health worsened.
"We aren't saying that if you don't brush, you'll develop lung disease," said Scannapieco. "We're saying that if you already have lung disease, taking care of your teeth and gums is especially important. It's possible that improved oral health is one factor that may help prevent progression of this disease, which is responsible for 2.2 million deaths a year worldwide."
Alex W. Ho, M.S., oral-biology statistician, was the co-author of the study.
The work was supported in part by grants from the U.S. Health Service and the National Institute of Dental and Craniofacial Research.
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