Impact of oral diseases on systemic health in the elderly: Diabetes mellitus and aspiration pneumonia

Evidence is increasing that oral health has important impacts on systemic h ealth. This paper presents data from the third National Health and Nutritio n Examination Survey (NHANES III) describing the prevalence of dental carie s and periodontal diseases in the older adult population. It then evaluates published reports and presents data from clinical and epidemiologic studie s on relationships among oral health status, chronic oral infections (of wh ich caries and periodontitis predominate), and certain systemic diseases, s pecifically focusing on type 2 diabetes and aspiration pneumonia. Both of t hese diseases increase in occurrence and impact in older age groups. The NH ANES iii data demonstrate that dental caries and periodontal diseases occur with substantial frequency and represent a burden of unmet treatment need in older adults. Our review found clinical and epidemiologic evidence to su pport considering periodontal infection a risk factor for poor glycemic con trol in type 2 diabetes; however, there is limited representation of older adults in reports of this relationship. For aspiration pneumonia, several l ines of evidence support oral health status as an important etiologic facto r. Additional clinical studies designed specifically to evaluate the effect s of treating periodontal infection on glycemic control and improving oral health status in reducing the risk of aspiration pneumonia are warranted. A lthough further establishing causal relationships among a set of increasing ly more frequently demonstrated associations is indicated, there is evidenc e to support recommending oral care regimens in protocols for managing type 2 diabetes and preventing aspiration pneumonia.