Posted by: The Probe 7th February 2020
Author: Kate Scheer Marketing Executive W&H (UK) Ltd
Each year in the UK, between 0.5% to 1% of adults contract pneumonia. For many, the illness passes without incident, but for some – particularly those most at risk – it can result in serious and potentially fatal complications that may require hospitalisation.[i] While pneumonia is associated with deprivation, it can strike anyone – billionaire Oprah Winfrey recently joined a long list of celebrities to have contracted the illness.[ii], [iii]
For many elderly people, aspiration pneumonia can lead to a spiral of worsening health with lethal consequences if left untreated. Numerous studies have established that maintaining oral hygiene and regular dental care is associated with a reduced risk of aspiration pneumonia.[iv], [v], [vi], [vii] Dental plaque acts as a reservoir from which bacteria, such as Staphylococcus aureus, can subsequently infect other tissues, including the respiratory tract.[viii], [ix], [x], [xi], [xii]
Dental clinicians have a role to play in helping patients avoid infection from pneumonia-causing bacteria and other harmful pathogens. Dental plaque is already universally recognised as a threat to patients’ teeth and gums, but it also represents a potential threat to patients’ general health too. Therefore, helping a patient maintain their oral health reduces the chances of them developing pneumonia.[xiii], [xiv]
Some elderly patients sleep with their dentures in their mouth. This not only increases denture plaque and gum inflammation, but also more than doubles the risk of developing pneumonia.[xv] It is, therefore, important that patients with dentures are made aware of the risk that leaving their dentures in overnight poses.
While oral health care has the potential to help patients’ general health, care must be taken to avoid exposing people to harmful microbes. Improperly sterilized instruments can transfer pathogens between patients, giving dangerous microorganisms the chance to infect deeper tissues. Dental professionals have a responsibility to educate patients on how to minimise this risk. It is also critical that instruments are thoroughly decontaminated and sterilized in order to prevent cross-contamination and surgical site infections.
With fully featured traceability options providing excellent documentation and security, W&H’s new Lisa type B vacuum sterilizer can process and dry a 2kg load in just 30 minutes. The Lisa Mobile App also ensures ultimate ease-of-use, an additional means of backing up data, and real-time cycle monitoring.
With oral health being intimately linked to general health, prevention is always better than treatment. Dental clinicians can prevent infections by ensuring the safety of their instruments and helping their patients maintain good oral hygiene.
[ii] Chalmers J., Campling J., Ellsbury G., Hawkey P., Madhava H., Slack M. Community-acquired pneumonia in the United Kingdom: a call to action. Pneumonia. 2017; 9: 15. https://www.ncbi.nlm.nih.gov/pubmed/29043150 September 26, 2019.
[iii] Young S. Oprah Winfrey opens up about ‘very serious’ battle she had with pneumonia. The Independent. 2019. https://www.independent.co.uk/life-style/health-and-families/oprah-winfrey-pneumonia-ellen-degeneres-show-health-symptoms-a9117771.html September 26, 2019.
[iv] Garcia R., Jendresky L., Colbert L., Bailey A., Zaman M., Majumder M. Reducing ventilator-associated pneumonia through advanced oral-dental care: a 48-month study. American Journal of Critical Care. 2009; 18(6): 523-532. http://ajcc.aacnjournals.org/content/18/6/523.full September 26, 2019.
[v] Terpenning M., Taylor G., Lopatin D., Kerr C., Dominguez L., Loesche W. Aspiration pneumonia: dental and oral risk factors in an older veteran population. Journal of the American Geriatrics Society. 2001; 49(5): 557-563. https://doi.org/10.1046/j.1532-5415.2001.49113.x September 26, 2019.
[vi] Bassim C., Gibson G., Ward T., Paphides B., DeNucci D. Modification of the risk of mortality from pneumonia with oral hygiene care. Journal of the American Geriatrics Society. 2008; 56(9): 1601-1607. https://doi.org/10.1111/j.1532-5415.2008.01825.x September 26, 2019.
[vii] Van der Maarel-Wierink C., Vanobbergen J., Bronkhorst E., Schols J., de Baat C. Oral health care and aspiration pneumonia in frail older people: a systematic literature review. Gerodontology. 2012; 30(1): 3-9. https://doi.org/10.1111/j.1741-2358.2012.00637.x September 26, 2019.
[viii] Garcia R., Jendresky L., Colbert L., Bailey A., Zaman M., Majumder M. Reducing ventilator-associated pneumonia through advanced oral-dental care: a 48-month study. American Journal of Critical Care. 2009; 18(6): 523-532. http://ajcc.aacnjournals.org/content/18/6/523.full September 26, 2019.
[ix] El-Solh A., Pietrantoni C., Bhat A., Okada M., Zambon J., Aquilina A., Berbary E. Colonization of dental plaques: a reservoir of respiratory pathogens for hospital-acquired pneumonia in institutionalized elders. Chest. 2004; 126(5): 1575-1582. https://doi.org/10.1016/S0012-3692(15)31374-X September 26, 2019.
[x] Somal J., Darby J. Gingival and plaque decontamination: can we take a bite out of VAP? Critical Care. 2006; 10(4): 312. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1751021/ September 26, 2019.
[xi] Nishizawa T., Niikura Y., Akasaka K., Watanabe M., Kurai D., Amano M., Ishii H., Matsushima H., Yamashita N., Takizawa H. Pilot study for risk assessment of aspiration pneumonia based on oral bacteria levels and serum biomarkers. BMC Infectious Diseases. 2019; 19: 761. https://doi.org/10.1186/s12879-019-4327-2 October 3, 2019.
[xii] Sumi Y., Miura H., Michiwaki Y., Nagaosa S., Nagaya M. Colonization of dental plaque by respiratory pathogens in dependent elderly. Archives of Gerontology and Geriatrics. 2007; 44(2): 119-124. https://www.ncbi.nlm.nih.gov/pubmed/16723159 October 3, 2019.
[xiii] Huang S., Chiou C., Liu H. Risk factors of aspiration related to improper oral hygiene behaviour in community dysphagia persons with nasogastric tube feeding. Journal of Dental Sciences. 2017; 12(4): 375-381. https://doi.org/10.1016/j.jds.2017.06.001 October 3, 2019.
[xv] Iinumma T., Arai Y., Abe Y., Takayama M., Fukumoto M., Fukui Y., Iwase T., Takebayashi T., Hirose N., Gionhaku N., Komiyama K. Denture wearing during sleep doubles the risk of pneumonia in the very elderly. Journal of Dental Research. 2015; 94(3): S28-36. https://doi.org/10.1177%2F0022034514552493 October 3, 2019.
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