Skip to main content
Top
Published in: BMC Pulmonary Medicine 1/2019

Open Access 01-12-2019 | Community-Acquired Pneumonia | Research article

Chronic periodontitis and community-acquired pneumonia: a population-based cohort study

Authors: Seon-Jip Kim, Kyuwoong Kim, Seulggie Choi, Jooyoung Chang, Sung Min Kim, Sang Min Park, Hyun-Jae Cho

Published in: BMC Pulmonary Medicine | Issue 1/2019

Login to get access

Abstract

Background

This study aimed to determine the association between chronic periodontitis (CP) and community-acquired pneumonia (CAP) according to CP severity in the Korean population based on the National Health Insurance Service database.

Methods

Data from the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS), conducted from 2002 to 2013, were analyzed. A total of 363,541 participants were enrolled in this retrospective cohort study. Data on socio-demographic characteristics and CAP-related variables were collected. Participants were divided into 4 groups according to CP severity. Cox proportional hazards regression was performed after adjusting for sociodemographic and related covariates.

Results

A total of 363,541 participants were included in the analysis. The number of CAP cases in the index period was 14,838 (4.1%). Among the 4 groups, the mean age was significantly higher in the severe CP group. The incidence rates of severe and non-severe CP were 5.68 and 4.99, respectively (per 103 person-years). The hazard ratio for CAP was not significant in any of the models regardless of the presence or absence of CP. On stratification analysis by sex, smoking and Charlson comorbidity index, there were no significant differences between CAP and CP in any of the models.

Conclusion

The results of this study show that CP may not be a potential risk factor for CAP.
Literature
1.
go back to reference Nazir MA. Prevalence of periodontal disease, its association with systemic diseases and prevention. Int J Health Sci (Qassim). 2017;11(2):72–80. Nazir MA. Prevalence of periodontal disease, its association with systemic diseases and prevention. Int J Health Sci (Qassim). 2017;11(2):72–80.
2.
go back to reference Abusleme L, Dupuy AK, Dutzan N, et al. The subgingival microbiome in health and periodontitis and its relationship with community biomass and inflammation. Isme j. 2013;7(5):1016–25.PubMedPubMedCentralCrossRef Abusleme L, Dupuy AK, Dutzan N, et al. The subgingival microbiome in health and periodontitis and its relationship with community biomass and inflammation. Isme j. 2013;7(5):1016–25.PubMedPubMedCentralCrossRef
3.
go back to reference Haffajee AD, Socransky SS. Microbial etiological agents of destructive periodontal diseases. Periodontol 2000. 1994;5:78–111.PubMedCrossRef Haffajee AD, Socransky SS. Microbial etiological agents of destructive periodontal diseases. Periodontol 2000. 1994;5:78–111.PubMedCrossRef
4.
go back to reference Gendron R, Grenier D, Maheu-Robert L. The oral cavity as a reservoir of bacterial pathogens for focal infections. Microbes Infect. 2000;2(8):897–906.PubMedCrossRef Gendron R, Grenier D, Maheu-Robert L. The oral cavity as a reservoir of bacterial pathogens for focal infections. Microbes Infect. 2000;2(8):897–906.PubMedCrossRef
5.
go back to reference Cullinan MP, Ford PJ, Seymour GJ. Periodontal disease and systemic health: current status. Aust Dent J. 2009;54(Suppl 1):S62–9.PubMedCrossRef Cullinan MP, Ford PJ, Seymour GJ. Periodontal disease and systemic health: current status. Aust Dent J. 2009;54(Suppl 1):S62–9.PubMedCrossRef
6.
go back to reference Garcia RI, Krall EA, Vokonas PS. Periodontal disease and mortality from all causes in the VA dental longitudinal study. Ann Periodontol. 1998;3(1):339–49.PubMedCrossRef Garcia RI, Krall EA, Vokonas PS. Periodontal disease and mortality from all causes in the VA dental longitudinal study. Ann Periodontol. 1998;3(1):339–49.PubMedCrossRef
7.
8.
go back to reference Sopena N, Heras E, Casas I, et al. Risk factors for hospital-acquired pneumonia outside the intensive care unit: a case-control study. Am J Infect Control. 2014;42(1):38–42.PubMedCrossRef Sopena N, Heras E, Casas I, et al. Risk factors for hospital-acquired pneumonia outside the intensive care unit: a case-control study. Am J Infect Control. 2014;42(1):38–42.PubMedCrossRef
9.
11.
go back to reference Azarpazhooh A, Leake JL. Systematic review of the association between respiratory diseases and oral health. J Periodontol. 2006;77(9):1465–82.PubMedCrossRef Azarpazhooh A, Leake JL. Systematic review of the association between respiratory diseases and oral health. J Periodontol. 2006;77(9):1465–82.PubMedCrossRef
12.
go back to reference Scannapieco FA, Bush RB, Paju S. Associations between periodontal disease and risk for nosocomial bacterial pneumonia and chronic obstructive pulmonary disease. A systematic review. Ann Periodontol. 2003;8(1):54–69.PubMedCrossRef Scannapieco FA, Bush RB, Paju S. Associations between periodontal disease and risk for nosocomial bacterial pneumonia and chronic obstructive pulmonary disease. A systematic review. Ann Periodontol. 2003;8(1):54–69.PubMedCrossRef
13.
go back to reference Scannapieco FA, Shay K. Oral health disparities in older adults: oral bacteria, inflammation, and aspiration pneumonia. Dent Clin N Am. 2014;58(4):771–82.PubMedCrossRef Scannapieco FA, Shay K. Oral health disparities in older adults: oral bacteria, inflammation, and aspiration pneumonia. Dent Clin N Am. 2014;58(4):771–82.PubMedCrossRef
15.
go back to reference van der Maarel-Wierink CD, Vanobbergen JN, Bronkhorst EM, et al. Oral health care and aspiration pneumonia in frail older people: a systematic literature review. Gerodontology. 2013;30(1):3–9.PubMedCrossRef van der Maarel-Wierink CD, Vanobbergen JN, Bronkhorst EM, et al. Oral health care and aspiration pneumonia in frail older people: a systematic literature review. Gerodontology. 2013;30(1):3–9.PubMedCrossRef
16.
go back to reference Kwon S. Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage. Health Policy Plan. 2009;24(1):63–71.PubMedCrossRef Kwon S. Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage. Health Policy Plan. 2009;24(1):63–71.PubMedCrossRef
17.
go back to reference Seong SC, Kim YY, Park SK, et al. Cohort profile: the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) in Korea. BMJ Open. 2017;7(9):e016640.PubMedPubMedCentralCrossRef Seong SC, Kim YY, Park SK, et al. Cohort profile: the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) in Korea. BMJ Open. 2017;7(9):e016640.PubMedPubMedCentralCrossRef
18.
go back to reference Hofmann JN, Torner A, Chow WH, et al. Risk of kidney cancer and chronic kidney disease in relation to hepatitis C virus infection: a nationwide register-based cohort study in Sweden. Eur J Cancer Prev. 2011;20(4):326–30.PubMedPubMedCentralCrossRef Hofmann JN, Torner A, Chow WH, et al. Risk of kidney cancer and chronic kidney disease in relation to hepatitis C virus infection: a nationwide register-based cohort study in Sweden. Eur J Cancer Prev. 2011;20(4):326–30.PubMedPubMedCentralCrossRef
19.
go back to reference Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–83.PubMedCrossRef Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–83.PubMedCrossRef
20.
21.
go back to reference Bergmans DC, Bonten MJ, Gaillard CA, et al. Prevention of ventilator-associated pneumonia by oral decontamination: a prospective, randomized, double-blind, placebo-controlled study. Am J Respir Crit Care Med. 2001;164(3):382–8.PubMedCrossRef Bergmans DC, Bonten MJ, Gaillard CA, et al. Prevention of ventilator-associated pneumonia by oral decontamination: a prospective, randomized, double-blind, placebo-controlled study. Am J Respir Crit Care Med. 2001;164(3):382–8.PubMedCrossRef
22.
go back to reference El-Rabbany M, Zaghlol N, Bhandari M, et al. Prophylactic oral health procedures to prevent hospital-acquired and ventilator-associated pneumonia: a systematic review. Int J Nurs Stud. 2015;52(1):452–64.PubMedCrossRef El-Rabbany M, Zaghlol N, Bhandari M, et al. Prophylactic oral health procedures to prevent hospital-acquired and ventilator-associated pneumonia: a systematic review. Int J Nurs Stud. 2015;52(1):452–64.PubMedCrossRef
23.
go back to reference Fourrier F, Cau-Pottier E, Boutigny H, et al. Effects of dental plaque antiseptic decontamination on bacterial colonization and nosocomial infections in critically ill patients. Intensive Care Med. 2000;26(9):1239–47.PubMedCrossRef Fourrier F, Cau-Pottier E, Boutigny H, et al. Effects of dental plaque antiseptic decontamination on bacterial colonization and nosocomial infections in critically ill patients. Intensive Care Med. 2000;26(9):1239–47.PubMedCrossRef
24.
go back to reference Fourrier F, Dubois D, Pronnier P, et al. Effect of gingival and dental plaque antiseptic decontamination on nosocomial infections acquired in the intensive care unit: a double-blind placebo-controlled multicenter study. Crit Care Med. 2005;33(8):1728–35.PubMedCrossRef Fourrier F, Dubois D, Pronnier P, et al. Effect of gingival and dental plaque antiseptic decontamination on nosocomial infections acquired in the intensive care unit: a double-blind placebo-controlled multicenter study. Crit Care Med. 2005;33(8):1728–35.PubMedCrossRef
25.
go back to reference Tada A, Miura H. Prevention of aspiration pneumonia (AP) with oral care. Arch Gerontol Geriatr. 2012;55(1):16–21.PubMedCrossRef Tada A, Miura H. Prevention of aspiration pneumonia (AP) with oral care. Arch Gerontol Geriatr. 2012;55(1):16–21.PubMedCrossRef
26.
go back to reference Yoneyama T, Hashimoto K, Fukuda H, et al. Oral hygiene reduces respiratory infections in elderly bed-bound nursing home patients. Arch Gerontol Geriatr. 1996;22(1):11–9.PubMedCrossRef Yoneyama T, Hashimoto K, Fukuda H, et al. Oral hygiene reduces respiratory infections in elderly bed-bound nursing home patients. Arch Gerontol Geriatr. 1996;22(1):11–9.PubMedCrossRef
27.
go back to reference Almirall J, Bolibar I, Serra-Prat M, et al. New evidence of risk factors for community-acquired pneumonia: a population-based study. Eur Respir J. 2008;31(6):1274–84.PubMedCrossRef Almirall J, Bolibar I, Serra-Prat M, et al. New evidence of risk factors for community-acquired pneumonia: a population-based study. Eur Respir J. 2008;31(6):1274–84.PubMedCrossRef
28.
go back to reference Almirall J, Serra-Prat M, Bolibar I, et al. Risk factors for community-acquired pneumonia in adults: a systematic review of observational studies. Respiration. 2017;94(3):299–311.PubMedCrossRef Almirall J, Serra-Prat M, Bolibar I, et al. Risk factors for community-acquired pneumonia in adults: a systematic review of observational studies. Respiration. 2017;94(3):299–311.PubMedCrossRef
29.
go back to reference Scannapieco FA. Role of oral bacteria in respiratory infection. J Periodontol. 1999;70(7):793–802.PubMedCrossRef Scannapieco FA. Role of oral bacteria in respiratory infection. J Periodontol. 1999;70(7):793–802.PubMedCrossRef
30.
go back to reference de Melo Neto JP, Melo MS, dos Santos-Pereira SA, et al. Periodontal infections and community-acquired pneumonia: a case-control study. Eur J Clin Microbiol Infect Dis. 2013;32(1):27–32.PubMedCrossRef de Melo Neto JP, Melo MS, dos Santos-Pereira SA, et al. Periodontal infections and community-acquired pneumonia: a case-control study. Eur J Clin Microbiol Infect Dis. 2013;32(1):27–32.PubMedCrossRef
31.
go back to reference Diaz PI. Microbial diversity and interactions in subgingival biofilm communities. Front Oral Biol. 2012;15:17–40.PubMedCrossRef Diaz PI. Microbial diversity and interactions in subgingival biofilm communities. Front Oral Biol. 2012;15:17–40.PubMedCrossRef
32.
go back to reference Socransky SS, Haffajee AD, Cugini MA, et al. Microbial complexes in subgingival plaque. J Clin Periodontol. 1998;25(2):134–44.PubMedCrossRef Socransky SS, Haffajee AD, Cugini MA, et al. Microbial complexes in subgingival plaque. J Clin Periodontol. 1998;25(2):134–44.PubMedCrossRef
33.
go back to reference Didilescu AC, Skaug N, Marica C, et al. Respiratory pathogens in dental plaque of hospitalized patients with chronic lung diseases. Clin Oral Investig. 2005;9(3):141–7.PubMedCrossRef Didilescu AC, Skaug N, Marica C, et al. Respiratory pathogens in dental plaque of hospitalized patients with chronic lung diseases. Clin Oral Investig. 2005;9(3):141–7.PubMedCrossRef
34.
go back to reference Linden GJ, Lyons A, Scannapieco FA. Periodontal systemic associations: review of the evidence. J Clin Periodontol. 2013;40(Suppl 14):S8–19.PubMed Linden GJ, Lyons A, Scannapieco FA. Periodontal systemic associations: review of the evidence. J Clin Periodontol. 2013;40(Suppl 14):S8–19.PubMed
35.
go back to reference Scannapieco FA, Mylotte JM. Relationships between periodontal disease and bacterial pneumonia. J Periodontol. 1996;67(Suppl 10S):1114–22.PubMedCrossRef Scannapieco FA, Mylotte JM. Relationships between periodontal disease and bacterial pneumonia. J Periodontol. 1996;67(Suppl 10S):1114–22.PubMedCrossRef
36.
go back to reference Terpenning MS. The relationship between infections and chronic respiratory diseases: an overview. Ann Periodontol. 2001;6(1):66–70.PubMedCrossRef Terpenning MS. The relationship between infections and chronic respiratory diseases: an overview. Ann Periodontol. 2001;6(1):66–70.PubMedCrossRef
37.
go back to reference Okuda K, Kimizuka R, Abe S, et al. Involvement of periodontopathic anaerobes in aspiration pneumonia. J Periodontol. 2005;76(Suppl 11S):2154–60.PubMedCrossRef Okuda K, Kimizuka R, Abe S, et al. Involvement of periodontopathic anaerobes in aspiration pneumonia. J Periodontol. 2005;76(Suppl 11S):2154–60.PubMedCrossRef
38.
go back to reference Scannapieco FA, Genco RJ. Association of periodontal infections with atherosclerotic and pulmonary diseases. J Periodontal Res. 1999;34(7):340–5.PubMedCrossRef Scannapieco FA, Genco RJ. Association of periodontal infections with atherosclerotic and pulmonary diseases. J Periodontal Res. 1999;34(7):340–5.PubMedCrossRef
39.
go back to reference Cilloniz C, Ewig S, Polverino E, et al. Microbial aetiology of community-acquired pneumonia and its relation to severity. Thorax. 2011;66(4):340–6.PubMedCrossRef Cilloniz C, Ewig S, Polverino E, et al. Microbial aetiology of community-acquired pneumonia and its relation to severity. Thorax. 2011;66(4):340–6.PubMedCrossRef
40.
go back to reference Musher DM, Roig IL, Cazares G, et al. Can an etiologic agent be identified in adults who are hospitalized for community-acquired pneumonia: results of a one-year study. J Inf Secur. 2013;67(1):11–8. Musher DM, Roig IL, Cazares G, et al. Can an etiologic agent be identified in adults who are hospitalized for community-acquired pneumonia: results of a one-year study. J Inf Secur. 2013;67(1):11–8.
41.
go back to reference Peto L, Nadjm B, Horby P, et al. The bacterial aetiology of adult community-acquired pneumonia in Asia: a systematic review. Trans R Soc Trop Med Hyg. 2014;108(6):326–37.PubMedPubMedCentralCrossRef Peto L, Nadjm B, Horby P, et al. The bacterial aetiology of adult community-acquired pneumonia in Asia: a systematic review. Trans R Soc Trop Med Hyg. 2014;108(6):326–37.PubMedPubMedCentralCrossRef
42.
44.
go back to reference van der Maarel-Wierink CD, Vanobbergen JN, Bronkhorst EM, et al. Risk factors for aspiration pneumonia in frail older people: a systematic literature review. J Am Med Dir Assoc. 2011;12(5):344–54.PubMedCrossRef van der Maarel-Wierink CD, Vanobbergen JN, Bronkhorst EM, et al. Risk factors for aspiration pneumonia in frail older people: a systematic literature review. J Am Med Dir Assoc. 2011;12(5):344–54.PubMedCrossRef
45.
go back to reference Marik PE, Kaplan D. Aspiration pneumonia and dysphagia in the elderly. Chest. 2003;124(1):328–36.PubMedCrossRef Marik PE, Kaplan D. Aspiration pneumonia and dysphagia in the elderly. Chest. 2003;124(1):328–36.PubMedCrossRef
46.
go back to reference Huang YF, Chang CT, Liu SP, et al. The impact of Oral hygiene maintenance on the association between periodontitis and osteoporosis: a Nationwide population-based cross sectional study. Medicine (Baltimore). 2016;95(6):e2348.PubMedCentralCrossRef Huang YF, Chang CT, Liu SP, et al. The impact of Oral hygiene maintenance on the association between periodontitis and osteoporosis: a Nationwide population-based cross sectional study. Medicine (Baltimore). 2016;95(6):e2348.PubMedCentralCrossRef
47.
go back to reference Kalil AC, Metersky ML, Klompas M, et al. Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016;63(5):e61–e111.PubMedPubMedCentralCrossRef Kalil AC, Metersky ML, Klompas M, et al. Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016;63(5):e61–e111.PubMedPubMedCentralCrossRef
48.
go back to reference Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: framework and proposal of a new classification and case definition. J Periodontol. 2018;89(Suppl 1):S159–s72.PubMedCrossRef Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: framework and proposal of a new classification and case definition. J Periodontol. 2018;89(Suppl 1):S159–s72.PubMedCrossRef
Metadata
Title
Chronic periodontitis and community-acquired pneumonia: a population-based cohort study
Authors
Seon-Jip Kim
Kyuwoong Kim
Seulggie Choi
Jooyoung Chang
Sung Min Kim
Sang Min Park
Hyun-Jae Cho
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2019
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-019-1017-1

Other articles of this Issue 1/2019

BMC Pulmonary Medicine 1/2019 Go to the issue