Periodontal status and chronic obstructive pulmonary disease (COPD) exacerbations: a systematic review

BMC Oral Health

Niamh Kelly¹  Christopher Irwin¹  Lewis Winning²  Gerard J. Linden³  Dermot Linden⁴  Ikhlas A. El Karim⁴  Fionnuala T. Lundy⁴  Lorcan McGarvey⁴ 

[1] Centre for Dentistry, School of Medicine Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK;Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, University of Dublin, Lincoln Place, Dublin, Ireland;Institute of Clinical Sciences Block B, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK;The Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, 97 Lisburn Road, BT9 7BL, Belfast, UK;

关键词: COPD;    Exacerbation;    Periodontal disease;    Oral bacteria;    Oral health;   

DOI  :  10.1186/s12903-021-01757-z

来源: Springer

【 摘 要 】

BackgroundA growing body of evidence suggests a role for oral bacteria in lung infections. This systematic review aimed to analyse the association between poor periodontal status and the frequency of chronic obstructive pulmonary disease (COPD) exacerbations.MethodsPubMed, Embase, Web of Science, CINAHL and Medline were searched for studies published until May 2020, with no language restriction. Studies reporting periodontal condition, or periodontal treatment outcomes, with data on the frequency of exacerbations of COPD, were identified. The primary outcome was the frequency of exacerbations and secondary outcomes included quality of life (QoL) and hospitalisation. Quality and risk of bias assessment were carried out using the Newcastle Ottawa Scale for observational studies, Robins-1 tool for non-randomised intervention studies and Cochrane risk of bias assessment (RoB-2) tool for randomised clinical trials. Studies were assessed for eligibility and quality by two assessors independently.ResultsSearches identified 532 records and 8 met the inclusion criteria. Included studies were three clinical trials, one prospective cohort study, one case–control, and three cross-sectional studies. A narrative synthesis was performed. The data from intervention studies showed reduction in the frequency of exacerbations following periodontal treatment. Data from observational studies suggest association of worse plaque scores and fewer teeth with exacerbation, but not pocket depth or clinical attachment loss. Better periodontal health was also associated with reduced frequency of COPD exacerbations, hospitalisations and improved quality of life in COPD patients. Due to the high heterogeneity no meta-analysis was performed. The quality of some of the included studies was low and there was evidence of a high risk of bias.ConclusionThe data supports possible association between poor periodontal health, the frequency of exacerbations, hospitalisation and quality of life in COPD patients. The evidence is of moderate to low certainty and is limited by high risk of bias suggesting the need for well-designed and adequately powered randomised controlled trials, to inform future research and clinical practice.The PROSPERO registration number CRD42020180328.

【 授权许可】

CC BY