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Published on: February 23, 2014
Aspiration pneumonia: dental and oral risk factors in an older veteran population
M S Terpenning1, G W Taylor, D E Lopatin
1Department of Internal Medicine, University of Michigan Medical School, Ann Arbor 48105, USA.
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.
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