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The Surprising Link Between Ventilator-Associated Pneumonia and Oral Health

Since the COVID-19 pandemic began in March, mechanical ventilators have been in the spotlight. With limited options to treat this new and novel virus, in many cases, health care providers have been relying heavily on mechanical ventilators to help keep patients alive. They’ve helped save many lives.

However, these life-saving machines can also present a risk to a patient's health — one that is directly linked to oral health.

A recent study by the DentaQuest Partnership for Oral Health Advancement examined the relationship between preventive dental care and the occurrence of ventilator-associated pneumonia (VAP). It found a key link between VAP and a patient’s oral health, a link that experts will explore in a webinar this Thursday.

What Is VAP?

Ventilator-associated pneumonia (VAP) is a serious illness frequently caused by bacteria that grows in the mouth and travels to the lungs because the ventilator blocks the normal protection mechanisms within the mouth and throat. VAP is the leading cause of death among critically ill patients with hospital-acquired infections, and has proven to be a serious issue for those battling COVID-19.

But VAP is preventable — and maintaining good oral health is part of the solution.

“COVID-19 put ventilators in the headlines and has prompted us to take a closer look at the connection between oral health and respiratory health,” says Eric Tranby, data and impact manager at the DentaQuest Partnership and an author on the paper. “VAP is a serious and deadly disease, but the risk of acquiring it can be significantly reduced just by going to the dentist regularly.”

Prevention Is Key

As an illness caused by bacteria that grows in the mouth, having a healthy mouth is crucial to minimize the risk of VAP. It is yet another example of the many ways that oral health has a direct impact on overall health, influencing everything from your cardiovascular health to your brain health. In this case, it’s your respiratory health.

The results of the DentaQuest Partnership study showed that Medicaid recipients who are placed on a ventilator for assistance with breathing are 22% less likely to develop VAP if they have received preventive dental care within 3 years of being placed on ventilation.

Patients with neglected oral care are likely to have more infections, uncleaned surfaces or plaque buildup. When left untreated, these dental concerns invite bacteria and pathogenic organisms into the mouth. Given this, when a patient with ill-maintained oral care gets placed on a ventilator and their mouths are already full of bacteria, the likelihood of them developing VAP increases significantly.

An Issue of Equity

The study also found yet another way that our health care system perpetuates racial inequality.

Among those patients on mechanical ventilators for 48 hours or longer, Black people were 39% more likely than white people to be diagnosed with VAP. Males were 20% more likely to be diagnosed than females. And people with one or more comorbidities were at significantly higher risk. These outcomes are an unacceptable extension of the fact that barriers to accessing oral care disproportionately harm poor Black and Brown Americans.

It's clear that a person’s oral health has a direct impact on their overall health. In this case, routine dental visits can help save a person’s life should they need the assistance of mechanical ventilation. This finding reinforces the immediate need for states to include a comprehensive adult dental benefit in their Medicaid plans.

“If we can increase the number of people getting preventive oral care, particularly within the highest risk communities, we can significantly reduce the incidence of oral disease,” says Madhuli Thakkar, biostatistician at the DentaQuest Partnership and an author on the paper. “And this will reduce the burden on our health care system and patients’ lives — regardless of coronavirus or any future pandemic.”

To learn more, sign up for the DentaQuest Partnership webinar on October 15. Click here to register.