Dental Health Risks

About respiratory diseases

Diseases and infections that affect different parts of your respiratory system can cause permanent damage to lung tissue. Chronic lower respiratory diseases are the fourth leading cause of death in the U.S.¹ They are typically caused by smoking, exposure to secondhand smoke, allergens, air pollution, or genetics, but can also be due to viral infections.

The most common lung disorders include:

• Asthma
• Chronic obstructive pulmonary disease (COPD) which includes chronic bronchitis and emphysema.
• Pneumonia
• Lung cancer
• Cystic Fibrosis

Respiratory disease and your oral health

There is emerging evidence that suggests there may also be a link between poor oral health and some of these diseases.² Researchers believe that the bacteria that cause tooth decay and periodontal disease may increase the risk of lung conditions or aggravate their effects. These bacteria may cause problems when they enter the bloodstream or when they are inhaled into the lungs.³

The first signs of an emerging respiratory condition are often in your mouth. Because of this, your dentist may be the first healthcare provider to suggest that you may have a respiratory disease. Some of the oral effects of respiratory infections or diseases that may help to reveal the condition during a dental visit include⁴:

• Inflammation (red, swollen, bleeding, or tender gums) generally from increased plaque build-up, which can lead to a greater risk of tooth decay and periodontal disease.
• Thrush (oral candidiasis), a fungal infection often associated with COPD. It typically presents itself as white, raised lesions on the tongue and cheeks.
• Dry mouth, either due to mouth breathing that often results from respiratory conditions, or from some medications used to treat respiratory conditions.
• Jaw pain, swelling, and tumors, which may indicate lung cancer that has metastasized.

Inform your dentist: Your dentist and hygienist are great frontline resources if you are suffering from COPD or another respiratory illness. Both dentists and hygienists are in a unique position to identify symptoms, discuss the issues with you, and provide referrals to healthcare professionals who will help treat your illness.

• Tell your dentist or hygienist that you have asthma or are being treated for another respiratory disease when they conduct your health history and current health status.
• Mention all medications you are taking. This includes any supplements or natural remedies.
• If you smoke, be honest with your dentist about how much you currently smoke and how long you have been smoking. This is an important indicator in determining your increased risk of respiratory health. Keep in mind that your dentist is not judging your decisions. They are just trying to determine your level of risk.
• Ask if any of the inhalers or other medications you are taking have oral side effects.
• Let your dentist know if you've noticed any issues such as dry mouth, swollen or bleeding gums, mouth sores, or jaw pain.
• Provide your dentist and physicians with each other's contact information. This is important if they need to discuss your disease, oral health status, or medications.
• You and your dentist should let your physician know about any treatment your dentist recommends.
• Try to schedule your dental visits at times when you are not coughing as much or having breathing problems. Your dentist may be able to adjust their normal procedure to help you avoid stress or other problems. For example, if it is easier for you to breathe better while sitting up more upright, your dentist may be able to conduct your cleaning or other procedures with your dental chair at a more upright angle.
• Have your rescue inhaler on hand in case you need to use it during your visit.

Make oral health a priority: Be proactive about your oral health. This will put you in a better starting position if a respiratory disease negatively impacts your oral health.

• Make sure you are brushing at least twice a day with a soft-bristled brush and fluoride toothpaste. If you have symptoms of dry mouth, specially labeled toothpaste or gel are available to help reduce these symptoms. If your gums bleed, don't stop brushing your teeth. Bleeding gums may be a sign of inflammation or plaque build-up below your gum line, which requires more attention, not less.
• Flossing at least once a day is essential to remove plaque from between teeth where brushes do not reach.
• Visit your dentist regularly for exams and professional teeth cleanings on the schedule your dentist recommends.
• Strictly follow your course of treatment.

Maintain a healthy lifestyle:

• Avoid tobacco products. Your dentist or physician may be able to help you calm nicotine cravings by suggesting over-the-counter products, prescriptions, or support group referrals.
• Focus on a proper diet and avoid sugary or acidic snacks and beverages.

Medication: Prolonged use of inhalers or nebulizers can contribute to dry mouth, tooth decay, periodontal disease, enamel erosion, thrush, mouth sores, and bad breath due to acidic ingredients in some of these medications.⁴ Your dentist can recommend ways to help offset these effects and prevent worsening problems.

Children: People with more acute risk for respiratory conditions are at even greater oral health risk. This is especially true for children and young adults, particularly those with asthma, if they are exposed to secondhand smoke.⁵

Hospitalization: Studies have shown that people with extended hospital stays tend to have less focus on their dental health. This can lead to an increased build-up of plaque and bacteria. Experts believe this may contribute to pneumonia or other infections. If you or someone you are caring for is expected to need hospitalization for an extended period of time, take extra steps to ensure you or they are following a normal daily oral health regimen.²