Pros and Cons
Topics in Geriatric Rehabilitation Vol. 23, No. 3, pp. 280–288 Copyright c 2007 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Oral Care Imperative
The Link Between Oral Hygiene and Aspiration Pneumonia
Minn N. Yoon, BSc; Catriona M. Steele, PhD
Oral health has increasingly become a priority issue for healthcare agencies in North America and worldwide. This review article attempts to (1) inform various healthcare providers of the risk factors that can arise from poor oral hygiene, specifically aspiration pneumonia; (2) report the mechanisms of bacterial colonization that are responsible for the development of aspiration pneumonia and the factors that can influence these mechanisms; and (3) propose an interdisciplinary approach to enhance oral care delivery that is imperative to limiting the risks of developing systemic diseases such as aspiration pneumonia. Key words: aged, aspiration, dysphagia, health promotion, long-term care, oral hygiene, pneumonia, risk factors
T
HE links between oral health, general health, and systemic disease in institutionalized elderly populations have been established in the literature.1,2 As a result, major health organizations, both within North America and worldwide, have increasingly mandated oral health as a priority.3–5 As a result of dramatic improvements in general dental health in the western world during the latter half of the 20th century, people are increasingly reaching old age with intact dentition.6 Although this trend indicates improvements in the delivery of dental services, it brings with it an imperative to promote proper oral care delivery to seniors and persons with disability to limit the oralhealth–related risk of systemic diseases such as pneumonia. Pneumonia is the leading cause of acute care hospitalization and the primary cause of death in many diseases found among longterm care (LTC) residents.7 The reported in-
cidence of pneumonia in LTC ranges from 0.1 to 2.4 per 1000 patient
The Oral Care Imperative
The Link Between Oral Hygiene and Aspiration Pneumonia
Minn N. Yoon, BSc; Catriona M. Steele, PhD
Oral health has increasingly become a priority issue for healthcare agencies in North America and worldwide. This review article attempts to (1) inform various healthcare providers of the risk factors that can arise from poor oral hygiene, specifically aspiration pneumonia; (2) report the mechanisms of bacterial colonization that are responsible for the development of aspiration pneumonia and the factors that can influence these mechanisms; and (3) propose an interdisciplinary approach to enhance oral care delivery that is imperative to limiting the risks of developing systemic diseases such as aspiration pneumonia. Key words: aged, aspiration, dysphagia, health promotion, long-term care, oral hygiene, pneumonia, risk factors
T
HE links between oral health, general health, and systemic disease in institutionalized elderly populations have been established in the literature.1,2 As a result, major health organizations, both within North America and worldwide, have increasingly mandated oral health as a priority.3–5 As a result of dramatic improvements in general dental health in the western world during the latter half of the 20th century, people are increasingly reaching old age with intact dentition.6 Although this trend indicates improvements in the delivery of dental services, it brings with it an imperative to promote proper oral care delivery to seniors and persons with disability to limit the oralhealth–related risk of systemic diseases such as pneumonia. Pneumonia is the leading cause of acute care hospitalization and the primary cause of death in many diseases found among longterm care (LTC) residents.7 The reported in-
cidence of pneumonia in LTC ranges from 0.1 to 2.4 per 1000 patient