title: Association between dental caries and pneumonia in patients with systemic lupus erythematosus.
abstract: OBJECTIVE
  To establish the association between oral pathology and pneumonia in patients with systemic lupus erythematosus (SLE).
  
  
  METHODS
  Thirty women with SLE, consecutively admitted for hospitalization because of pneumonia, and 60 noninfected controls with SLE (30 hospitalized and 30 ambulatory), matched by age, sex, and date of hospitalization to the cases, were enrolled. At entry, information about sociodemographic variables, traditional infection risk factors, SLE characteristics, treatment, and comorbidity was gathered by medical chart review. In every patient, one rheumatologist performed a complete physical examination, and assessed disease activity and chronic damage using validated indices; and one periodontist performed a standardized oral health evaluation including the use of 6 international oral health indices.
  
  
  RESULTS
  Twenty-eight patients with community-acquired and 2 patients with nosocomial pneumonias were included. Age of the total study population was 38.8 +/- 14.6 years, mean number of SLE criteria 6.3 +/-1.95, and disease duration 6.6 +/- 7.2 years, with no differences among the 3 groups. Cases had greater disease activity and damage, and were taking higher doses of prednisone than ambulatory controls (p <or= 0.03). Cases accrued more traditional infection risk factors than ambulatory controls and had lower levels of serum albumin than both control groups (p <or= 0.04). Oral health was worse among the cases, including more periapical lesions, cervical and third-grade caries, and a higher mean number of caries/patient than controls (p <or= 0.05). In the multivariate analysis, third-grade caries (odds ratio 7.5, 95% CI 2.05-27.3, p = 0.002) was strongly associated with pneumonia.
  
  
  CONCLUSIONS
  Poor oral hygiene and third-grade caries are common in patients with SLE who develop pneumonia.
authors.affiliation: Department of Immunology and Rheumatology and the Dentistry Service, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico.
authors.forename: Virginia
authors.initials: V
authors.lastname: Pascual-Ramos
authors.forename: Carlos
authors.initials: C
authors.lastname: Hernández-Hernández
authors.forename: Armando E
authors.initials: AE
authors.lastname: Soto-Rojas
authors.forename: Erika
authors.initials: E
authors.lastname: Celis-Aguilar
authors.forename: Jorge
authors.initials: J
authors.lastname: Sánchez-Guerrero
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D003731:Dental Caries / Q000209:etiology*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy; D008875:Middle Aged; D015999:Multivariate Analysis; D009910:Oral Hygiene / Q000009:adverse effects; D011014:Pneumonia / Q000209:etiology*; D011241:Prednisone / Q000627:therapeutic use; D012307:Risk Factors
chemical_list: D000893:Anti-Inflammatory Agents; D011241:Prednisone