Oral Hygiene, Aspiration, and Aspiration Pneumonia: From Pathophysiology to Therapeutic Strategies

Current Physical Medicine and Rehabilitation Reports

Volumn 1, Issue 4, 2013, Pages 292-295

  Ortega Fernández, Omar ^a   Clavé, Pere ^a,b  

^a UNIVERSITAT AUTÒNOMA DE BARCELONA   (Spain)

^b INSTITUTO DE SALUD CARLOS III   (Spain)

Author keywords

Aspiration; Aspiration pneumonia; Oral health; Oropharyngeal dysphagia

Indexed keywords

EID: 84947867870     PISSN: None     EISSN: 21674833     Source Type: Journal    
DOI: 10.1007/s40141-013-0032-z     Document Type: Review

References (26)

1. Carrión S, Verin E, Clavé P, Laviano A. Complications of oropharyngeal dysphagia: malnutrition and aspiration pneumonia. In: Ekberg O, editor. Dysphagia. New York: Springer; 2012. p. 575–99.
2. Clave P, Terre R, De Kraa M, Serra M. Approaching oropharyngeal dysphagia. Rev Esp Enferm Dig. 2004;96(2):119–26. DOI: 10.4321/S1130-01082004000200005
3. Ekberg O, Hamdy S, Woisard V, Wuttge-Hannig A, Ortega P. Social and psychological burden of dysphagia: its impact on diagnosis and treatment. Dysphagia. 2002;17(2):139–46. DOI: 10.1007/s00455-001-0113-5
4. Rofes L, Arreola V, Romea M, Palomera E, Almirall J, Cabre M, et al. Pathophysiology of oropharyngeal dysphagia in the frail elderly. Neurogastroenterol Motil. 2010;22(8):851–8. DOI: 10.1111/j.1365-2982.2010.01521.x
5. Clave P, Verdaguer A, Arreola V. Oral-pharyngeal dysphagia in the elderly. Med Clin. 2005;124(19):742–8. DOI: 10.1157/13075447
6. Carrión S, Cabré M, Monteis R, Roca M, Palomera E, Clavé P. Association between oropharyngeal dysphagia and malnutrition in elderly patients with acute diseases admitted to a general hospital. Clin Nutr Suppl. 2012;7(1):8.
7. Almirall J, Cabre M, Clave P. Aspiration pneumonia. Med Clin. 2007;129(11):424–32. DOI: 10.1157/13110467
8. Marik PE, Kaplan D. Aspiration pneumonia and dysphagia in the elderly. Chest. 2003;124(1):328–36. DOI: 10.1378/chest.124.1.328
9. Almirall J, Cabre M, Clave P. Complications of oropharyngeal dysphagia: aspiration pneumonia. In: Cichero J, Clave P, editors. Stepping stones to living well with dysphagia. Basel: Karger; 2012. p. 67–76. DOI: 10.1159/000339989
10. Ortega O, Sakwinska O, Mukherjee R, Combremont S, Jankovic I, Parra C, et al. High prevalence of colonization of oral cavity by respiratory pathogens in dysphagic patients. Twenty-first annual meeting of the Dysphagia Research Society; 2013. p. 89.
11. Tada A, Miura H. Prevention of aspiration pneumonia (AP) with oral care. Arch Gerontol Geriatr. 2012;55(1):16–21. DOI: 10.1016/j.archger.2011.06.029
12. Parra C, Zarcero S, Nart J, Ortega O, Clavé P. Oral health in older patients with oropharyngeal dysphagia. Dysphagia. 2011;26:479.
13. Serra-Prat M, Hinojosa G, Lopez D, Juan M, Fabre E, Voss DS, et al. Prevalence of oropharyngeal dysphagia and impaired safety and efficacy of swallow in independently living older persons. J Am Geriatr Soc. 2011;59(1):186–7. DOI: 10.1111/j.1532-5415.2010.03227.x
14. Serra-Prat M, Palomera M, Gomez C, Sar-Shalom D, Saiz A, Montoya JG, et al. Oropharyngeal dysphagia as a risk factor for malnutrition and lower respiratory tract infection in independently living older persons: a population-based prospective study. Age Ageing. 2012;41(3):376–81. DOI: 10.1093/ageing/afs006
15. • Almirall J, Rofes L, Serra-Prat M, Icart R, Palomera E, Arreola V, et al. Oropharyngeal dysphagia is a risk factor for community-acquired pneumonia in the elderly. Eur Respir J. 2013;41(4):923–8. “This study shows that OD is strongly associated with CAP and is an indicator of disease severity and bad prognosis. Consequently, older patients with CAP must be screened for OD.
16. Cabre M, Almirall J, Clave P. Aspiration pneumonia: management in Spain. Eur Geriatr Med. 2011;2(3):180–3. DOI: 10.1016/j.eurger.2011.03.004
17. •• Cabré M, Serra-Prat M, Force L, Almirall J, Palomera E, Clavé P. Oropharyngeal dysphagia is a risk factor for readmission for pneumonia in the very elderly: observational prospective study. J Gerontol. 2013. doi:10.1093/gerona/glt099. This study shows that OD increases readmissions for pneumonia and AP and highlights the importance of proper treatment of and screening for OD to avoid complications.
18. Teramoto S, Fukuchi Y, Sasaki H, Sato K, Sekizawa K, Matsuse T. High incidence of aspiration pneumonia in community- and hospital-acquired pneumonia in hospitalized patients: a multicenter, prospective study in Japan. J Am Geriatr Soc. 2008;56(3):577–9. DOI: 10.1111/j.1532-5415.2008.01597.x
19. Sura L, Madhavan A, Carnaby G, Crary MA. Dysphagia in the elderly: management and nutritional considerations. Clin Interv Aging. 2012;7:287–97.
20. Clave P, Arreola V, Romea M, Medina L, Palornera E, Serra-Prat M. Accuracy of the volume-viscosity swallow test for clinical screening of oropharyngeal dysphagia and aspiration. Clin Nutr. 2008;27(6):806–15. DOI: 10.1016/j.clnu.2008.06.011
21. Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T, et al. Validation of the mini nutritional assessment short-form (MNA®-SF): a practical tool for identification of nutritional status. J Nutr Health Aging. 2009;13(9):782–8. DOI: 10.1007/s12603-009-0214-7
22. Greene JC, Vermillion JR. Simplified oral hygiene index. J Am Dent Assoc. 1964;68(1):7–13.
23. Logemann JA, Curro FA, Pauloski B, Gensler G. Aging effects on oropharyngeal swallow and the role of dental care in oropharyngeal dysphagia. Oral Dis. 2013. doi:10.1111/odi.12104.
24. Sjogren P, Nilsson E, Forsell M, Johansson O, Hoogstraate J. A systematic review of the preventive effect of oral hygiene on pneumonia and respiratory tract infection in elderly people in hospitals and nursing homes: effect estimates and methodological quality of randomized controlled trials. J Am Geriatr Soc. 2008;56(11):2124–30. DOI: 10.1111/j.1532-5415.2008.01926.x
25. van der Maarel-Wierink CD, Vanobbergen JN, Bronkhorst EM, Schols JMGA, de Baat C. Oral health care and aspiration pneumonia in frail older people: a systematic literature review. Gerodontology. 2013;30(1):3–9. DOI: 10.1111/j.1741-2358.2012.00637.x
26. • Sorensen RT, Rasmussen RS, Overgaard K, Lerche A, Johansen AM, Lindhardt T. Dysphagia screening and intensified oral hygiene reduce pneumonia after stroke. J Neurosci Nurs. 2013;45(3):139–46. This study shows the importance of a dysphagia screening and treatment program in reducing complications such as pneumonia prevalence.