Scannapieco F A, Papandonatos G D, Dunford R G
Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, USA.
Ann Periodontol. 1998 Jul;3(1):251-6. doi: 10.1902/annals.1998.3.1.251.
Respiratory infectious diseases such as bacterial pneumonia and bronchitis are common and costly, especially in institutionalized and elderly inpatients. Respiratory infection is thought to rely in part on the aspiration of oropharyngeal flora into the lower respiratory tract and failure of host defense mechanisms to eliminate the contaminating bacteria, which then multiply to cause infection. It has been suggested that dental plaque may act as a reservoir of respiratory pathogens, especially in patients with periodontal disease. However, the impact of poor oral health on oral respiratory pathogen colonization and lung infection is uncertain, especially in ambulatory, non-institutionalized populations. To begin to assess potential associations between respiratory diseases and oral health, data from the National Health and Nutrition Examination Survey I (NHANES I) were analyzed. This database contains information on the general health status of 23,808 individual Of these, 386 individuals reported a suspected respiratory condition that was further assessed by a physician. These subjects were categorized as having a confirmed chronic respiratory disease (chronic bronchitis or emphysema) or an acute respiratory disease (influenza, pneumonia, acute bronchitis). They were compared to those not having a respiratory disease. Initial non-parametric analysis noted that individuals with a confirmed chronic respiratory disease (n = 41) had significantly greater oral hygiene index scores than subjects without respiratory disease (n = 193; P = 0.0441). Logistic regression analysis of data from these subjects, which considered age, race, gender, smoking status, and simplified oral hygiene index (OHI), suggested that subjects having the median OHI value were 1.3 times more likely to have a chronic respiratory disease relative to those with and OHI of O. Similarly, subjects with the maximum OHI value were 4.5 times more likely to have a chronic respiratory disease than those with an OHI of O. No evidence was found to support an association between the periodontal index and any respiratory disease. These results suggest OHI to have a residual effect on chronic respiratory disease of both practical and statistical significance.
诸如细菌性肺炎和支气管炎等呼吸道传染病很常见且代价高昂，在机构化照料的患者和老年住院患者中尤其如此。呼吸道感染被认为部分依赖于口咽菌群吸入下呼吸道以及宿主防御机制未能清除污染细菌，这些细菌随后繁殖并导致感染。有人提出牙菌斑可能是呼吸道病原体的储存库，尤其是在患有牙周病的患者中。然而，口腔健康状况不佳对口腔呼吸道病原体定植和肺部感染的影响尚不确定，尤其是在非机构化照料的门诊人群中。为了开始评估呼吸道疾病与口腔健康之间的潜在关联，对第一次全国健康和营养检查调查（NHANES I）的数据进行了分析。该数据库包含23,808个人的总体健康状况信息。其中，386人报告了疑似呼吸道疾病，医生对其进行了进一步评估。这些受试者被分类为患有确诊的慢性呼吸道疾病（慢性支气管炎或肺气肿）或急性呼吸道疾病（流感、肺炎、急性支气管炎）。将他们与没有呼吸道疾病的人进行比较。初步的非参数分析指出，患有确诊慢性呼吸道疾病的个体（n = 41）的口腔卫生指数得分显著高于没有呼吸道疾病的受试者（n = 193；P = 0.0441）。对这些受试者的数据进行逻辑回归分析，该分析考虑了年龄、种族、性别、吸烟状况和简化口腔卫生指数（OHI），结果表明，OHI值处于中位数的受试者患慢性呼吸道疾病的可能性是OHI为0的受试者的1.3倍。同样，OHI值最高的受试者患慢性呼吸道疾病的可能性是OHI为0的受试者的4.5倍。没有发现证据支持牙周指数与任何呼吸道疾病之间存在关联。这些结果表明，OHI对慢性呼吸道疾病具有实际和统计学意义的残留影响。
