title: Tongue-coating as risk indicator for aspiration pneumonia in edentate elderly.
abstract: Silent aspiration of oral microorganisms is a major cause of aspiration pneumonia. To establish oral hygiene criteria for the prevention of aspiration pneumonia in edentulous elderly persons, we investigated the relationship between presence of tongue-coating and number of oral bacteria in saliva and episodes of pneumonia. A total of 71 edentulous Japanese people aged 65 years or older living in nursing homes were enrolled in the study. A tongue plaque index (TPI) was used to evaluate quantity of tongue-coating, with TPI0 signifying no tongue-coating and TPI1 signifying presence of tongue-coating. Edentate elderly with TPI1 demonstrated significantly higher salivary bacterial counts than those with TPI0 (p<0.05). The number of elderly patients developing aspiration pneumonia was larger (p<0.005) in patients with TPI-based poor scores (average TPI>0.5) than in those with TPI-based good scores. The relative risk of developing pneumonia in the good tongue hygiene group compared with in the poor tongue hygiene group was 0.12, 95% confidence interval (CI): 0.02-0.9. The results demonstrate that tongue-coating is associated with number of viable salivary bacterial cells and development of aspiration pneumonia, suggesting that tongue-coating is a risk indicator of aspiration pneumonia in edentate subjects.
authors.affiliation: Department of Microbiology, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba 261-8502, Japan.
authors.forename: Shu
authors.initials: S
authors.lastname: Abe
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Ishihara
authors.forename: Mieko
authors.initials: M
authors.lastname: Adachi
authors.forename: Katsuji
authors.initials: K
authors.lastname: Okuda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D006801:Humans; D009066:Mouth, Edentulous / Q000150:complications* / Q000382:microbiology; D009910:Oral Hygiene; D011015:Pneumonia, Aspiration / Q000209:etiology*; D012306:Risk; D012463:Saliva / Q000382:microbiology; D014059:Tongue / Q000382:microbiology*