Periodontal disease and pulmonary complications

Oral pathology is varied, as the oral cavity communicates directly with the external environment and thus represents a gateway for a multitude of bacteria.

Being thus exposed to different stimuli, the balance of microflora involved in the protection of the oral cavity is precarious, being always susceptible to microbial attack.

The oral cavity has some peculiarities that make it so permeable to bacteria:

  • It communicates with the external environment and is located in the front, anterior region of the face – being in an exposed area, in the event of trauma the oral cavity suffers, the manifestations being visible especially in the mucous membranes but also in the teeth, which can fracture.

Plaques and pulp communications that can result from trauma are the gateway for bacteria to enter the tissues found deep down. Thus, bacterial infections can take the form of abscesses, cellulitis or other inflammatory and infectious processes that are painful, prevent the patient from eating properly and alter the general state of health, leading to a medical emergency.

  • The oral cavity performs the first stage of swallowing – being part of the digestive system, the dental arches, tongue, palate and oral mucosa facilitate the mastication of food, which will be crushed at this level, salivated and sent to the lower structures of the digestive system. However, food introduced into the oral cavity may have a pH that alters the mucous membranes or even temperatures and consistencies that are unfavorable to oral health.

Whether they cause thermal or chemical irritation or even minor trauma, food introduced into the oral cavity can seriously disrupt the defence mechanisms and favor the development of oral pathologies.

Pulmonary complications may also be related to oral pathology. Bacterial pneumonia is a pathology that occurs when the lung parenchyma is contaminated by micro-organisms.

In general, it is a broad bacterial spectrum that can produce such manifestations.

Nearly half of bacterial pneumonias are caused by aspiration of oropharyngeal contents.

Normally, the oral cavity is lined with numerous bacteria, but the host’s defence mechanisms can counteract their pathogenic effect, so there is a balance.

However, if oral bacteria grow beyond the strength of the local defence mechanisms, the result is bacteremia. By aspiration of the bacteria into the lungs, pneumonia occurs.

Dental plaque is a real source of micro-organisms. Some bacteria are known to colonies only hard dental surfaces.

In the absence of effective brushing, supplemented by secondary methods of hygiene, dental plaque acquires new layers, the bacteria creating between them real complexes, very adherent and increasingly difficult to remove. Plaque begins to build up within hours of brushing.

Plaque causes gingivitis, which is inflammation of the gums that is reversible if early action is taken.

If the concentration of microorganisms is constantly increasing, the micro-organisms infiltrate deep into the tissues and eventually damage the bone and ligaments supporting the teeth.

This leads to periodontal disease, a pathology that cannot be reversed, but only palliated and possibly prevented.

Patients with periodontal disease develop bone pockets containing a multitude of micro-organisms that can lead to the development of bacterial aspiration pneumonia.

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