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Regular dental checkups appear to cut the risk of bacterial pneumonia, a research said.
Data from a national survey suggest that people who never get a checkup have almost twice the risk of bacterial pneumonia as those who see their dentists twice a year, according to Michelle Doll, MD, of Virginia Commonwealth University in Richmond.
The finding builds on previous research showing a link between dental care and pneumonia in critically ill patients, Doll told reporters at the annual IDWeek meeting. The meeting brings together four organizations that focus on infectious disease — the Infectious Diseases Society of America (IDSA), the Society for Healthcare Epidemiology of America (SHEA), the HIV Medicine Association (HIVMA), and the Pediatric Infectious Diseases Society (PIDS).
But the analysis extends that research to a more general population, in which bacterial pneumonia is much less common, Doll said.
She added that the clinical message for physicians is to stress the need for good dental care during medical checkups, even though there is little they can do directly.
“What can you do today? Probably not a lot,” she said. “But I think it would be good not to forget the teeth as part of the whole body and general wellness.”
The study reinforces the need for comprehensive wellness care, commented Thomas File Jr., MD, chief of the Infectious Disease Service at Summa Health System in Akron, Ohio, who was not part of the study but moderated a media briefing at which some details were discussed.
Bacterial pneumonia is a serious illness “associated with significant morbidity and mortality,” he said, adding, “Anything we can do to reduce the burden of disease is important.”
Doll said the link between bacteria in the mouth and pneumonia is fairly straightforward. After all, she said, there’s a direct conduit between the mouth and the lungs, and it is easy to aspirate bacterial species that can cause disease.
To investigate the issue, she and her colleagues turned to the Medical Expenditure Panel Survey (MEPS), “a set of large-scale surveys of families and individuals, their medical providers, and employers across the U.S.,” according to the Agency for Healthcare Research and Quality, which runs them.
With MEPS data from 2013, the researchers were able to assess participants’ access to dental care — the number of dental visits in 2013, the frequency of having dental checkups, and the presence of dental insurance — and used ICD-9 codes to look for bacterial pneumonia in the previous year.
All told, the survey had data on 26,687 people, including 4410 who had an episode of bacterial pneumonia.
The two groups had some significant differences, the analysis showed. Those who got pneumonia were:
Importantly, just 34.2% of those who developed pneumonia reported having at least two dental checkups a year, compared with 45.9% of those who did not, Doll and colleagues found. Conversely, 29.4% of the pneumonia patients said they never got dental checkups, compared with 16.2% of the other participants.
Multivariate analysis showed that white race, increasing age, comorbidities, and worse perceived health status were associated with an increased risk of pneumonia. But the only dental variable associated with disease was the reported frequency of checkups, Doll said.
The analysis showed that those who reported never having checkups had an odds ratio for pneumonia of 1.86 compared with those who reported two or more checkups a year. Similarly, those who had some checkups but less often than once a year had an odds ratio for disease of 1.49.
Both findings were significant, with 95% confidence intervals of 1.30 to 2.65 and 1.02 to 2.16, respectively, Doll and colleagues reported.
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