Aspiration Pneumonia: Dental and Oral Risk Factors in an Older Veteran Population

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 49; no. 5; pp. 557 - 563
• Main Authors: Terpenning, Margaret S., Taylor, George W., Lopatin, Dennis E., Kerr, Connie Kinder, Dominguez, B. Liza, Loesche, Walter J.
• Format: Journal Article
• Language: English
• Published: Boston, MA, USA Blackwell Science Inc 01.05.2001; Blackwell; Wiley Subscription Services, Inc
• Subjects: Activities of Daily Living; Age Distribution; Age Factors; Aged; Aged, 80 and over; aspiration pneumonia; Biological and medical sciences; Clinical trials; Dental Caries - complications; Dental Caries - microbiology; Dental health; Dental Plaque - complications; Dental Plaque - microbiology; dental risk factors; Diabetes Complications; Elderly people; Geriatric Assessment; Health risk assessment; Humans; Incidence; Logistic Models; Lung Diseases, Obstructive - complications; Medical sciences; Michigan - epidemiology; Mouth, Edentulous - complications; Older people; older veterans; Oral Health; Pneumology; Pneumonia; Pneumonia, Aspiration - epidemiology; Pneumonia, Aspiration - etiology; Respiratory system : syndromes and miscellaneous diseases; Risk Factors; Saliva - microbiology; Staphylococcal Infections - complications; Staphylococcal Infections - microbiology; Staphylococcus aureus; Streptococcal Infections - complications; Streptococcal Infections - microbiology; Streptococcus sobrinus; Stroke - complications; USA; Veterans; Veterans - statistics & numerical data; United States; North America; America; Michigan; Human; Lung disease; Respiratory disease; Aspiration pneumonia; Dental disease; Risk factor; Veteran; Epidemiology; Elderly; Trauma; Public health
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1046/j.1532-5415.2001.49113.x

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.