The effect of periodontal diseases on chronic obstructive pulmonary disease (COPD)

Periodontal disease and poor oral health can be the cause of the higher concentration of oral pathogens in saliva. These pathogens can be aspirated into the upper airway, they can be attached to the lung and airway epithelium and induce directly inflammatory response. From aspirated upper airway contents induced inflammation may play a causal role in the progression and severity of COPD exacerbation. The aim of our study was to determine the potential relationship between acute exacerbation of COPD and periodontitis by microbiologically analyses of Aggregatibacter actinomycetemcomitans, Prevotella intermedia and Porphyromonas gingivalis levels in microbial dental plaque (MDP), bronchoalveolar lavage (BAL) and saliva samples in COPD patients with mild acute exacerbation. Ninety-one patients were recruited and divided into 6 subgroups of COPD(+)PER(+)Cigarette(+), COPD(+)PER(-) Cigarette(+), COPD(-)PER(+)Cigarette(+), COPD(-)PER(-)Cigarette(+), COPD(-)PER(-)Cigarette(-), COPD(-)PER(+)Cigarette(-). A complete periodontal and airflow limitation measures was performed and MDP, BAL and saliva samples were collected. Bacteria levels were detected by Real- time PCR. The statistical analysis was performed by Varience Analysis, Student?s t test, Mann Whitney U and Spearman?s Correlation tests. All clinical parameters were higher in COPD(+)PER(+)Cigarette(+) group than COPD(+)PER(-) Cigarette(+) group, however this alteration was found statistically insignificant (p>0.05), except PD (p<0.001), CAL (p<0.001) ve BOP (p=0.003) levels. We detected P.intermedia ve P.gingivalis colonization in BAL samples. Subjects wtih higher plaque index (PI) scores had significantly higher risk of severe COPD than subjects with lower PI scores. Aspiration of periodontal pathogens, fostered by poor oral hygiene and periodontitis, appeares to be associated with acute exacerbations of COPD.