Journal of the American Geriatrics Society

Volume 49, Issue 5 p. 557-563

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

Margaret S. Terpenning MD,

Margaret S. Terpenning MD

Department of Internal Medicine, University of Michigan Medical School;

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George W. Taylor DMD, MPH, DrPH,

George W. Taylor DMD, MPH, DrPH

Department of Cardiology, Restorative Sciences, and Endodontics and

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Dennis E. Lopatin PhD,

Dennis E. Lopatin PhD

Department Biologic and Materials Sciences, University of Michigan School of Dentistry; and

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Connie Kinder Kerr RN, MS,

Connie Kinder Kerr RN, MS

University of Michigan School of Nursing, Ann Arbor, Michigan.

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B. Liza Dominguez DMD, MS,

B. Liza Dominguez DMD, MS

Department Biologic and Materials Sciences, University of Michigan School of Dentistry; and

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Walter J. Loesche DMD, PhD,

Walter J. Loesche DMD, PhD

Department Biologic and Materials Sciences, University of Michigan School of Dentistry; and

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Margaret S. Terpenning MD,

Margaret S. Terpenning MD

Department of Internal Medicine, University of Michigan Medical School;

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George W. Taylor DMD, MPH, DrPH,

George W. Taylor DMD, MPH, DrPH

Department of Cardiology, Restorative Sciences, and Endodontics and

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Dennis E. Lopatin PhD,

Dennis E. Lopatin PhD

Department Biologic and Materials Sciences, University of Michigan School of Dentistry; and

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Connie Kinder Kerr RN, MS,

Connie Kinder Kerr RN, MS

University of Michigan School of Nursing, Ann Arbor, Michigan.

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B. Liza Dominguez DMD, MS,

B. Liza Dominguez DMD, MS

Department Biologic and Materials Sciences, University of Michigan School of Dentistry; and

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Walter J. Loesche DMD, PhD,

Walter J. Loesche DMD, PhD

Department Biologic and Materials Sciences, University of Michigan School of Dentistry; and

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First published: 21 December 2001

https://doi.org/10.1046/j.1532-5415.2001.49113.x

Citations: 260

Address correspondence to Margaret S. Terpenning, MD, VA Medical Center, GRECC (11G), 2215 Fuller Road, Ann Arbor, MI 48105.

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Abstract

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.

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Volume49, Issue5

MAY 2001

Pages 557-563

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

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

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