Chronic obstructive pulmonary disease exacerbations and periodontitis: a possible association

Hesham A Abdelhalim,Heba H Aboelnaga,Reham L Aggour

doi:10.4103/ejb.ejb_12_18

Abstract

BackgroundThere is an increasing interest concerning the potential link between both chronic obstructive pulmonary disease (COPD) and chronic periodontitis; therefore the association became the research focus.ObjectiveThis study intended to evaluate the potential association between the frequency of COPD exacerbations and chronic periodontitis.Patients and methodsA total of 250 male patients with COPD were included in the study and were categorized into two groups according to the frequency of exacerbations per year: group 1 had patients with frequent exacerbations (having ≥2 exacerbations in last year) and group 2 had patients with infrequent exacerbations (having <2 exacerbations in last year). They were compared regarding age, smoking history, education background, information of their oral hygiene behaviors, calculated modified Medical Research Council dyspnea scale, calculated COPD assessment test, the number of exacerbations and hospitalizations in the past year, prebronchodilator and postbronchodilator spirometry, calculated plaque index, bleeding index, probing pocket depth, clinical attachment level, and measured high-sensitivity C-reactive protein. Correlations between variables were examined. Logistic regression test was performed to explore the concurrent influences of periodontal health variables on the frequency of exacerbations.ResultsThis study evidenced that all periodontal health variables were significantly correlated with smoking status, modified Medical Research Council dyspnea scale, COPD assessment test, number of exacerbations and hospitalizations per year, and C-reactive protein level. Simplified oral hygiene index, plaque index, bleeding index, gingival index, probing pocket depth, and clinical attachment level were significantly correlated with most of the spirometry data.ConclusionPeriodontal health variables were considerably associated with the frequency of COPD exacerbations.

Highlights

The possible relationship between both chronic obstructive pulmonary disease (COPD) and ‘chronic periodontitis’ has become an increasing focal point of research [1]
This study evidenced that all periodontal health variables were significantly correlated with smoking status, modified Medical Research Council dyspnea scale, COPD assessment test, number of exacerbations and hospitalizations per year, and C-reactive protein level
Exacerbating COPD group rather than in nonexacerbators. Adding to this is the positive correlation of C-reactive protein (CRP) with all periodontal health variables, which supports confirmation of current systemic inflammation.As this study proved that periodontal health variables were worse in patients with frequent COPD exacerbation than infrequent exacerbation, it is deduced that better oral hygiene and frequent expert oral health care may be a potential protective measure against COPD exacerbations as it was applied previously in another study [31]

Summary

Introduction

The possible relationship between both chronic obstructive pulmonary disease (COPD) and ‘chronic periodontitis’ has become an increasing focal point of research [1]. Cytokines and other mediators or substances like oxygen-free radicals that may be released by polymorphs at distant sites have an essential role [2]. This was proved in previous studies that evidenced an association of chronic periodontitis with additional chronic diseases such as chronic renal disease and renal dysfunction [4]; another study proved as well the association of COPD with concealed renal impairment [5]. There is an increasing interest concerning the potential link between both chronic obstructive pulmonary disease (COPD) and chronic periodontitis; the association became the research focus

Methods

Results

Discussion

Conclusion