Human medicine

Pneumology

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Who we are

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How healthy are your patients with lung diseases?

(Lung) health starts in the mouth

Lung and respiratory diseases lead to the most hospital admissions and are among the top ten causes of death worldwide. An American study has shown that patients with chronic respiratory diseases have poorer oral hygiene, more tartar and more diseased teeth than patients without respiratory diseases. Conversely, people with above-average early tooth loss also appear to be more likely to develop COPD. Whether a causal relationship actually exists is the subject of controversial debate; however, smoking is a common risk factor for both periodontal and respiratory diseases.

Possible complications

Is there a need for action?

Yes, on the one hand for patients at risk of pneumonia, because ...

  • The link between oral plaque and the risk of developing pneumonia is considered established. In cross-sectional studies, a 4.5-fold increase in the relative risk of pneumonia was found in patients with poor oral hygiene.
  • the mortality risk for pneumonia in a Japanese study with approx. 700 patients was increased around 3.9-fold if ten or more teeth had pocket depths of more than 4 mm compared to a healthy mouth control group.

On the other hand, in patients with COPD, because ...

  • A meta-analysis of almost 4,000 COPD patients shows an increased risk of COPD in the presence of periodontitis (Hobbins 2017).
  • Scientists at the University of New York showed in a study with almost 14,000 participants that the periodontium of patients with COPD shows deficits earlier than in healthy people.

aMMP-8

Expanding prevention diagnostics with aMMP-8

Clinical studies provide initial indications that the frequency of exacerbations in COPD can be significantly reduced through good oral hygiene and professional dental cleaning. Pulmonologists from the German Society for Pneumology and Respiratory Medicine (DGP) advise patients with chronic obstructive pulmonary disease (COPD) in particular to pay attention to good dental hygiene. People in need of care, the immunocompromised and the elderly, especially in care institutions, benefit considerably from simple strategies to reduce dental plaque and prevent and treat periodontitis.

With the PerioSafe DR test, pulmonologists can now easily test their patients in the office for hidden active oral collagen degradation. As a check-up to identify patients at risk of periodontitis, PerioSafe DR is an addition to internal medicine practice prevention programs.

With PerioSafe

Advanced diagnostics with PerioSafe

  • With PerioSafe DR, clinicians can detect active oral collagen degradation at a reversible stage, i.e. before the gums appear clinically conspicuous
  • PerioSafe DR is particularly suitable for patients with type 1 and 2 diabetes and an increased risk of diabetes
  • PerioSafe DR is easy to use chairside in the internal medicine practice (saliva sample)

Oral health is particularly important for:

  • Patients with an increased risk of pneumonia, e.g. those in need of care, immunocompromised and elderly people
  • Patients with COPD
  • Patients with cardiovascular risks
  • All patients who want to do more for their (oral) health as a preventive measure

What to do if the value is high?

In the event of a finding, a referral to a periodontist or specialist dentist for periodontology is advisable as part of an interdisciplinary collaboration. Patients should be informed about the risks of a possibly incipient or manifest chronic periodontal inflammation in connection with their individual health situation.

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Dirk-Rolf Gieselmann

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