Pneumonia

Oral biofilm management for

health

1998

Average cost for people over age 65 with community acquired pneumonia is $7166.

Clin Ther. 1998 Jul-Aug;20(4):820-37.The cost of treating community-acquired pneumonia.

2004

Roughly 915,900 cases of community-acquired pneumonia occur annually among seniors in the United States.

2004

Approximately 1 of every 20 persons aged 85 years or over will have a new episode of community-acquired pneumonia each year

2006There is good evidence to show that improved oral hygiene and frequent professional oral health care reduces the progression or occurrence of respiratory diseases among high-risk elderly adults living in nursing homes… 

J Periodontol. 2006 Sep;77(9):1465-82.Systematic review of the association between respiratory diseases and oral health.

Immunocompetent Seniors

cardiopulmonary disease

poor functional status

low weight

recent weight loss

Higher risk for Community-Acquired Pneumonia

cardiopulmonary disease

poor functional status

low weight

recent weight loss

Nursing Home Acquired Pneumonia

 30-day mortality rates ranging from 10 to 30%

A study looking at the charts of 528 persons with NHAP transferred to acute hospitals for treatment found that advance directives were present only 6.4% of the time.

Given the high 1-year mortality rate forNHAP, clinicians caring for nursing home residents should make it a priority to ensure that advance directives are in place. These should be readily available to help with the decision on whether or not the residentshould be transferred to a hospital, and must also accompany the patient to the acute care facility.

You know when you hear it.

All Due to Biofilm

Typical bacterial pathogens

Streptococcus pneumoniae (penicillin-sensitive and-resistant strains)

Haemophilus influenzae (ampicillin-sensitive and -resistant strains)  Moraxella catarrhalis (all strains penicillin-resistant).

Streptococcus pneumoniae

Haemophilus influenzae

Moraxella catarrhalis

Typical bacterial pathogens attributed to pneumonia

The airway is very close to the mouth – ahem.

Mouth

Lungs

Montana State University Center for Biofilm Engineering used with permission

2005

Calculation of population-based attributable fractions showed that 21% of all cases of pneumonia in our cohort could have been avoided if inadequate oral care and swallowing difficulty were not present.

~ $15,000Per person with NHAP

Contributing to Nursing Home Acquired Pneumonia

Poor oral hygiene

Difficulty swallowing Bedridden

Dementia Diabetes

Contributing to NHAPThese two can be addressed by a licensed

dental hygienist

Poor oral hygiene

Difficulty swallowing Bedridden

Dementia Diabetes

A dental hygienistassisting with oral care can

save thousandsof dollars.

To Summarize

10 to 30

Out of 100,000 people

17%

$15 – 20,000 per

case

21% NHAP can be

avoided with oral

care

Conclusion

Pneumonia is expensiveOral care can decrease incidence by 20%Nursing home acquired pneumonia leads to death.

ConclusionDental hygienists cannot work in Long Term Care facilities unless there is also a dentist there to “oversee” them.

Dental hygienists risk their license if they brush someone’s teeth without a prescription by a dentist to do so.

Call to Action

Find out the limitations of dental hygienists in your state.

Strive for a mandate that all Long Term Care Facilities funded by Medicaid have an independent dental hygienist as the Director of Dental Hygiene, a DDH.

Credits

PowerPoint designed by Cross Link Presentations, LLC

Presentation designShirley Gutkowski, RDH, BSDH, FACE

ScriptShirley Gutkowski, RDH, BSDH, FACE

Photos: Dreamstime, Gutkowski, StoneImages: Montana State University Center for Biofilm EngineeringCharacters: PresenterMedia

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