Aspiration pneumonia: dental and oral risk factors in an older veteran population

J Am Geriatr Soc. 2001 May;49(5):557-63. doi: 10.1046/j.1532-5415.2001.49113.x.

Abstract

Objectives: To investigate the importance of medical and dental factors in aspiration pneumonia in an older veteran population.

Design: Prospective enrollment of subjects with retrospective analysis of data.

Setting: Department of Veterans Affairs outpatient clinic, inpatient ward, and nursing home.

Participants: 358 veterans age 55 and older; 50 subjects with aspiration pneumonia.

Measurements: Demographic and medical data; functional status; health-related behaviors; dental care utilization; personal oral hygiene; comprehensive dental examination; salivary assays including IgA antibodies; and cultures of saliva, throat, and dental plaques.

Results: Two logistic regression models produced estimates of significant risk factors. One model using dentate patients included: requiring help with feeding (odds ratio (OR) = 13.9), chronic obstructive pulmonary disease (COPD) (OR = 4.7), diabetes mellitus (OR = 3.5), number of decayed teeth (OR = 1.2), number of functional dental units (OR = 1.2), presence of important organisms for decay, Streptococcus sobrinus in saliva (OR = 6.2), and periodontal disease, Porphyromonous gingivalis in dental plaque (OR = 4.2), and Staphylococcus aureus presence in saliva (OR = 7.4). The second model, containing both dentate and edentulous patients included: requiring help with feeding (OR = 4.7), COPD (OR = 2.5), diabetes mellitus (OR = 1.7), and presence of S. aureus in saliva (OR = 8.3).

Conclusion: This study supports the significance of oral and dental factors while controlling for established medical risk factors in aspiration pneumonia incidence.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Activities of Daily Living
  • Age Distribution
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Dental Caries / complications*
  • Dental Caries / microbiology
  • Dental Plaque / complications*
  • Dental Plaque / microbiology
  • Diabetes Complications
  • Geriatric Assessment
  • Humans
  • Incidence
  • Logistic Models
  • Lung Diseases, Obstructive / complications
  • Michigan / epidemiology
  • Mouth, Edentulous / complications*
  • Oral Health*
  • Pneumonia, Aspiration / epidemiology
  • Pneumonia, Aspiration / etiology*
  • Risk Factors
  • Saliva / microbiology*
  • Staphylococcal Infections / complications*
  • Staphylococcal Infections / microbiology
  • Staphylococcus aureus*
  • Streptococcal Infections / complications*
  • Streptococcal Infections / microbiology
  • Streptococcus sobrinus*
  • Stroke / complications
  • Veterans / statistics & numerical data*