Comorbidity of respiratory diseases and periodontal diseases

Abstract

At the beginning of the 21st century, the concept of “periodontal medicine” was formed, within the framework of which the bidirectional connection of periodontal pathology with systemic diseases of the body is considered. There are two hypotheses regarding the possibility of chronic periodontal infection to contribute to the development of systemic inflammation: 1) changes in the microbiocenosis of the oral cavity and periodontal inflammation lead to an increase in bacterial translocation into the systemic bloodstream, causing the circulation of inflammatory mediators and immune complexes to other organs and systems of the body; 2) changes in the microbiocenosis of the oral cavity can lead to disturbances and changes in the intestinal microbiome due to oral intake of periodontopathic organisms. The relationship between periodontal diseases and respiratory diseases has been less studied. We searched the Pubmed and Scopus databases for articles published up to January 31, 2024, that addressed this relationship. The proximity and continuity of the oral cavity and respiratory tract allows the oral microbiome to be a major determinant of the pulmonary microbiome. It is possible to distinguish 2 main ways of translocation of periodontal bacteria into the lungs - aerogenic and aspiration. The data presented in the review suggest a probable bidirectional relationship between periodontal diseases and hospital-acquired pneumonia, the new coronavirus infection COVID-19, and COPD. The relationship between periodontal pathology and BA can be considered possible, but in a number of studies this relationship has not been confirmed, which requires further study. The connection between periodontal diseases and community-acquired pneumonia has practically not been studied, but it is possible, taking into account the direct interaction of the oral microbiota and the microbiota along the mouth-lung axis, and indirectly along the mouth-intestinal-lung axis. Non-surgical periodontal treatment is likely effective in the treatment and prevention of respiratory diseases. The data presented in the review indicate the importance of periodontal health and the need for the prevention and treatment of periodontitis pathology in pulmonary patients.