Infrequent Denture Cleaning Increased the Risk of Pneumonia among Community-dwelling Older Adults: A

The present study revealed that infrequent denture cleaning was associated with the incidence of pneumonia within the last one year among community-dwelling older adults. Daily cleaning of dentures may reduce the risk of pneumonia among community-dwelling older adults. In the chair side, dental professionals need to instruct their patients to keep their dentures clean to prevent pneumonia. Even for community-dwelling older adults, dental professionals should pay more attention to oral hygiene for pneumonia prevention.

Pneumonia is a leading cause of death among older adults. The effectiveness of oral care in preventing pneumonia in nursing homes and hospitals has been reported. However, in community-dwelling older adults, the role of denture cleaning in preventing pneumonia remains unknown. We aimed to investigate the association between infrequent denture cleaning and the risk of pneumonia in community-dwelling older adults. This cross-sectional study was based on the self-reported questionnaire targeting towards community-dwelling older adults aged ≥65 years. Responses of 71,227 removable full/partial denture users were included. The incidence of pneumonia within the last one-year and the frequency of denture cleaning (daily/non-daily) were treated as dependent and independent variables, respectively. The mean age of the participants was 75.2 ± 6.5 years; 48.3% were male. Overall, 4.6% of the participants did not clean their dentures daily; 2.3% and 3.0% who did and did not clean their dentures daily, respectively, experienced pneumonia. This study suggests that denture cleaning could prevent pneumonia among community-dwelling older adults.

Pneumonia is a leading cause of hospitalization and death. It is widely prevalent among the older population because of the decline in immune system and respiratory function with advancing age. Aspiration is one of the mechanisms that explains the onset of pneumonia among older adults. In fact, oral bacteria have been identified in the lungs of the patients who developed pneumonia; therefore, a relationship between aspiration of oral bacteria and pneumonia is strongly suggested. In addition, because a substantial proportion of older adults are affected by dysphagia, the risk of pneumonia through aspiration may increase. To reduce the risk of aspiration pneumonia, oral care has been implemented in nursing homes and has successfully decreased the incidence of pneumonia among the nursing home residents.

Although the role of oral care in reducing the risk of pneumonia has been recognized, the importance of denture cleaning has been relatively neglected. The presence of fewer or no teeth is prevalent among the older adults; therefore, the use of removable dentures is a common treatment option. On the surface of the denture, a biofilm composed of microorganisms called “denture plaque” rapidly develops upon insertion after cleansing. There is a possibility that the denture plaque may reach the lungs by aspiration, causing aspiration pneumonia. Although generally included as a part of oral care, previous studies have not focused on denture cleaning alone. In addition, most of the previous studies on the relationship between oral hygiene and pneumonia were carried out in nursing homes and hospitals. However, the risk of aspiration pneumonia is considered to be high in community-dwelling older adults. To the best of our knowledge, no study has investigated the association between denture cleaning and pneumonia among community-dwelling older adults. From a public health viewpoint, as the majority of older adults are community-dwellers and not institutionalized, the prevention of pneumonia among community-dwelling older adults is important.

Full research study can be found here.