title: Respiratory pathogen colonization of the dental plaque of institutionalized elders.
abstract: Although it has been established that aspiration of pharyngeal bacteria is the major route of infection in the development of nosocomial pneumonia, colonization of the pharyngeal mucosa by respiratory pathogens has been shown to be a transient phenomenon. It has been suggested that the dental plaque may constitute an additional, possibly more stable, reservoir of respiratory pathogens. The purpose of this study was to assess the prevalence of oral colonization by potential respiratory pathogens in a group of elderly (mean age = 75.9 yrs) chronic-care-facility residents (n = 28) and a group of age-, gender-, and race-matched outpatient control subjects (n = 30), with specific attention to plaque present on tooth, denture, and oral mucosal surfaces. Plaque scores on teeth and dentures were significantly higher in the chronic-care-facility (CCF) subjects than in the dental outpatient control (DOC) subjects (PII 2.3 vs. 1.2 and denture plaque 1.4 vs. 0.3). While no subjects in the DOC group were found to be colonized with respiratory pathogens (> 1.0% of the cultivable aerobic flora), 14.3% (4/28) of the CCF subjects were found to be colonized. Oral colonization with respiratory pathogens in CCF subjects was associated with the presence of chronic obstructive pulmonary disease (COPD) and higher plaque scores. These results suggest that deficient dental plaque control and the presence of COPD may be related to respiratory pathogen colonization of dental plaque in chronic-care-facility residents.
authors.affiliation: Department of Periodontics, New York University College of Dentistry, NY 10010-4086, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Russell
authors.forename: R J
authors.initials: RJ
authors.lastname: Boylan
authors.forename: R S
authors.initials: RS
authors.lastname: Kaslick
authors.forename: F A
authors.initials: FA
authors.lastname: Scannapieco
authors.forename: R V
authors.initials: RV
authors.lastname: Katz
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D002908:Chronic Disease; D015169:Colony Count, Microbial; D016321:Dental Care for Aged / Q000706:statistics & numerical data; D017742:Dental Care for Chronically Ill / Q000706:statistics & numerical data; D003753:Dental Health Surveys; D003773:Dental Plaque / Q000150:complications / Q000453:epidemiology / Q000382:microbiology*; D003824:Denture, Complete / Q000382:microbiology; D004926:Escherichia coli / Q000302:isolation & purification; D005006:Ethnicity; D005260:Female; D006193:Haemophilus influenzae / Q000302:isolation & purification; D006801:Humans; D007326:Institutionalization; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D008134:Long-Term Care; D008173:Lung Diseases, Obstructive / Q000150:complications / Q000382:microbiology; D008297:Male; D009061:Mouth Mucosa / Q000382:microbiology; D009519:New York City / Q000453:epidemiology; D009735:Nursing Homes; D010614:Pharynx / Q000382:microbiology; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D015995:Prevalence; D011513:Proteus mirabilis / Q000302:isolation & purification; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012706:Serratia marcescens / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000302:isolation & purification