Background: Poor dental health occurs in patients with chronic obstructive pulmonary disease (COPD); some evidence suggests that it may correlate with lower forced expiratory volume in 1 second (FEV1) and 6-minute walk distance, and an increased rate of exacerbations. However, there is no data that examines how dental health may impact the daily respiratory symptoms that COPD patients experience. We prospectively studied indices of dental health and hygiene in patients with COPD and determined their impact on daily respiratory symptoms. Methods: A total of 20 individuals with COPD (median [interquartile range (IQR)] % FEV1 37 [29-43]) and 10 healthy control individuals with no lung disease were recruited. Dental questionnaires, spirometry, and a dental examination were administered on their initial visit. COPD participants were given an electronic COPD daily diary to document peak expiratory flow and the presence and magnitude of daily breathlessness, cough, sputum production, and wheeze. Results: Compared to healthy controls, COPD participants had less teeth (median 16.5 versus 28, p=0.0001), a trend to a higher plaque index (median 2.2 versus 1.7, p=0.15), and worse oral health-related quality of life (median Oral Health Impact Profile score 12.0 versus 4.5, p=0.02). A greater number of teeth correlated with higher percentage of days with cough (r=0.48, p < 0.05) and wheeze (r=0.47, p < 0.05). Conclusion: Individuals with severe COPD have poor oral hygiene and oral health-related quality of life. In the setting of poor dentition, a greater number of teeth correlates with more daily respiratory symptoms. More teeth may create a larger reservoir for inflammatory proteins and pathogenic bacteria to be aspirated into the airways.
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Abbreviations: chronic obstructive pulmonary disease, COPD; forced expiratory volume in 1 second, FEV1; interquartile range, IQR; National Health and Nutrition Survey, NHANES; plaque index, PI; forced vital capacity, FVC; oral health impact profile, OHIP; oral health impact profile summative score, OHIP-S; oral health impact profile weighted score, OHIP-W Funding Support: This work was funded by a grant from AVISA Pharma, Inc. Date of Acceptance: November 8, 2017 Citation: Gaeckle NT, Heyman B, Criner AJ, Criner GJ. Markers of dental health correlate with daily respiratory symptoms in COPD. Chronic Obstr Pulm Dis. 2018;5(2):97-105. doi: https://doi.org/10.15326/jcopdf.5.2.2017.0159
GJC reports grants from the National Institutes of Health and the Department of Defense, consulting from AstraZeneca, Boehringer Ingelheim, Holaira, Mereo, Third Pole, PneumRX, Pulmonx, Pearl, Amirall, CSA Medical, Broncus, AVISA Pharma, Inc, Lungpacer and GlaxoSmithKline; and contracted clinical trials from AstraZeneca, AVISA Pharma, Inc, Mereo, Boehringer Ingelheim, Broncus, GlaxoSmithKline, Lungpacer, Novartis, Pulmonx, PneumRx/BTG, and Yungjin. NTG, BH, and AJC report no conflicts of interest.
- Chronic obstructive pulmonary disease
- Oral health
- Plaque index
- Respiratory symptoms