ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Smokers with COPD as Compared to Smokers Without COPD Have No Significant Difference in Oral Health
Clinical Question In adult smokers with COPD, are the oral impairments significantly worse than in matched smokers without COPD?
Clinical Bottom Line The oral susceptibly for smokers with COPD does not significantly differ from smokers without COPD. Bergstrom concluded in a case controlled study that harmful effects of smoking do not affect an association between COPD and periodontitis.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 23544074Bergstrom/2013Matched groups of smokers with COPD and without COPDCase Control
Key resultsBoth matched groups (in tobacco levels) of smokers with and without COPD presented significant dental impairment as compared to the non-smokers group. When the authors examined plaque levels, gingival bleeding, periodontal pocket depth and tooth loss on these 3 groups, results showed there was no significant difference between smokers with or without COPD at a CI level of 95%. According to Bergstrom et. al., there is no “association between the development of tissue damage in the lung and in the mouth.”
Evidence Search "Smoking"[All Fields] AND "COPD"[All Fields] AND "dental health"[All Fields]
Comments on
The Evidence
The evidence presented by Bergstrom was sufficient to address this clinical question. However, in order to increase accuracy of such study a larger study with an upper age range is essential. It is important to note that currently, there are limited studies on the correlation between COPD and oral health, especially those including data regarding lung function. Is it essential to acknowledge that there is no association between smokers with COPD as compared to those without (Bergstrom, 2013) when counseling for smoking cessation. It would be misleading to think that lung pathology is linked to weakened oral health due to the positive correlation between smoking and periodontitis.
Applicability The case controlled study by Bergstrom was not able to demonstrate a significant correlation between COPD and oral health status. The small range of matched groups (less than 30) can be misleading. Therefore, a larger sample of participants over the age of 20 years old is needed to examine further development of COPD in these patients. The data from this study is therefore limited, however, the overall conclusion remain unaffected.
Specialty/Discipline (Public Health) (General Dentistry) (Periodontics)
Keywords Smoking, COPD, Tobacco, Oral Health
ID# 2690
Date of submission: 03/06/2014spacer
E-mail patelk9@livemail.uthscsa.edu
Author Krupa Patel
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Moshtagh Farokhi, DDS, MPH
Faculty mentor/Co-author e-mail farokhi@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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