MedicalResearch.com Interview with:
Michelle E. Doll, M.D., M.P.H.
Associate Hospital Epidemiologist
Department of Internal Medicine
Division of Infectious Diseases
Richmond, VA 23298-0019
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There are many studies that show that poor oral health is associated with systemic conditions including bacterial pneumonias. Many find this link surprising, but considering that the airways are a direct conduit between the oral cavity and the lungs, saliva containing oral bacteria is able to track down into the lungs via aspiration. Previous studies have found that good oral health seems to prevent pneumonias in people susceptible to lung infections, possibly because the types and quantities of bacteria residing in the mouth are different in people with healthy versus unhealthy teeth.
In my infectious disease clinical practice, I am often frustrated by my inability to assist patients with dental problems. Many of my patients are immunosuppressed, and when they have tooth decay for which they are unable to get timely dental care, I worry about consequences of untreated dental disease; lack of access to dental care is common in the United States. For these reasons, we decided to use data from the Medical Expenditure Panel Survey (MEPS) to determine whether dental care is preventive for bacterial pneumonia. The MEPS database is a large, nationwide survey administered by the Agency for Healthcare Research and Quality (AHRQ), with comprehensive insurance data including dental insurance and access. We found that those who never see the dentist were 86% more likely to get pneumonia in a year, compared to those who visit the dentist for routine check-ups twice a year or more. Furthermore, even those who visit the dentist less than once yearly were at smaller but still significantly increased risk of pneumonia compared to those who see the dentist more frequently.
MedicalResearch.com: What should readers take away from your report?
Response: Don’t neglect the teeth; oral health is increasingly shown to be important in disease prevention. The results of our study suggest that dental preventive care may be an important part of one’s overall healthcare.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: While we controlled for socioeconomic and co-morbid factors in our analysis, it is difficult to know whether frequent dental visits are driving the reduced risk or if they are surrogates for other healthy behaviors such as routine flossing or even exercise. Future studies could confirm that dental care can help prevent pneumonia by exploring other healthy behaviors that may be hidden confounders. It is also important to understand barriers to care even among those with dental benefits, because the presence of dental insurance alone was not enough to protect against pneumonia in the study.
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Citation: ID Week 2016 Abstract
Access to Dental Care and Risk of Pneumonia: the Importance of Healthy Teeth
Access to Dental Care and Risk of Pneumonia: The Importance of Healthy Teeth Michelle Doll MD, MPH1 , Kristen Kelly MSc 2 , Scott Ratliff MS 2 , Norman V. Carroll PhD3
Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.
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