Mind, Body, Mouth, it’s all connected. Dental Health Week 2023 – Lungs 

Evidence is emerging for oral bacteria being a risk factor for aspiration pneumonia.

Some studies have found a link between the oral microbiome (the collection of all microbes, such as bacteria, fungi, viruses, and their genes), and respiratory diseases. Bacteria from the oral cavity are known to add to the population of the lung microbiome. There is growing evidence that microbial misbalance, such as in periodontitis, contributes to respiratory diseases.

Both periodontitis and respiratory illness are common diseases with COPD amongst the top 10 diseases inducing long term disability. In 2020, COPD was the fifth underlying cause of death in Australia.

Here is a scary number- periodontitis affects 45-50% of the global adult population.

Other factors that can lead to oral microbial imbalance that then affects lungs include tobacco use,diabetes and medicaments shown to decrease saliva flow.

Possible links between periodontitis and respiratory illness:

1. Aspiration of oral bacteria exacerbating inflammation in the lungs and vascular cell dysfunction
2. Indirect low-grade inflammation generated by periodontitis can lead to cytokines (small proteins that are crucial in controlling the growth and activity of other immune system cells and blood cells) impacting pulmonary epithelium.

Specific to COVID-19, studies have determined that the oral epithelium is highly susceptible to viral infection. High salivary viral loads, has been considered to lead to poor outcomes.

Aspiration pneumonia is common in patients with oral dysphagia (impaired swallowing which misdirects regurgitated gastric contents or mouth/back of throat secretions to the lungs. Studies have found increased levels of pathogenic bacteria in the mouth will increase the risk of transfer in susceptible individuals to the respiratory tract and cause aspiration pneumonia.

There is sufficient evidence to indicate that maintenance of oral hygiene will reduce the impact on aspiration of oral pathogens to respiratory tissue.