Severe gum disease is associated with impaired lung function

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gum disease and lung function
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Lung function declines with increasingly severe gum disease, according to research from Norway presented at the recent EuroPerio10, a world congress in periodontology and implant dentistry organised by the European Federation of Periodontology.

Previous research has found that dental cleaning including plaque removal is associated with a reduction in symptom flare-ups in patients with chronic obstructive pulmonary disease. 

This study by a team at the University of Bergen, Norway, investigated the association between lung function and periodontitis in the community-based Malmö Offspring Dental Study.

The study included 1021 participants, of which 513 were men and 508 were women. The average age was 44.5 years. A dental check-up was performed, and the severity of periodontitis was assessed.

Moderate periodontitis was diagnosed in 28 per cent of participants and seven per cent had severe periodontitis. The remaining 65 per cent were classified as having no periodontitis or mild periodontitis and acted as a comparison group. The average age of those with severe periodontitis was 55 years and 59 per cent were men. Smoking was significantly more common in people with moderate or severe periodontitis compared with the healthy/mild group.

Lung function was assessed using spirometry, which measures the volume of air exhaled from the lungs and the flow rate of air. The researchers measured forced expiratory volume (FEV1) which is the volume of air (in litres) an individual can exhale during one second after maximal inspiration. 

They also measured forced vital capacity (FVC) which is the amount of air (in litres) forcibly exhaled after taking the deepest breath possible. Both FEV1 and FVC were expressed as a percentage of the predicted value for healthy people. The researchers also calculated the ratio of FEV1/FVC (%).

The investigators found that FEV1 and FVC (both expressed as a per cent of the predicted value) and FEV1/FVC declined with increasing severity of periodontitis. In analyses adjusted for age, sex, smoking, body mass index, diabetes, and educational level, significant inverse associations were observed between lung function and severe periodontitis: compared to the healthy/mild group, those with severe periodontitis had 3.6 per cent lower FEV1 and 2.2 lower FEV1/FVC.

“All measures of lung function deteriorated as gum disease worsened,” study author Dr Anders Røsland said.

“In addition, as gum inflammation became more widespread throughout the mouth, some of the respiratory values tended to worsen. 

“A decline in lung function may indicate airway inflammation, possibly originating from inflamed gums and the inhalation of dental plaque, which contains bacteria. 

“If this link between gum disease and lung function is confirmed, this could provide the rationale for periodontal treatment and oral hygiene programs to improve oral and respiratory health.”

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