Oral bacteria will naturally accumulate around your teeth and gums.  However, when these bacteria increase to abnormal levels, signs of gum disease may become evident.  About 75% of all Americans show signs of mild gum disease (periodontal disease) and gingivitis.  Almost 30% show signs of the more significant disease, chronic periodontitis. 

Bacteria from gum disease can easily get into the saliva.  From the saliva, it may adhere to tiny water droplets that you inhale as you breathe.  A mouth that has an abundance of bacteria will more easily infect the lungs.  For those patients who have a compromised immune system or chronic obstructive pulmonary disease (COPD), this can be very dangerous.

Elderly patients in nursing homes, who have lost mental motivation, and much of their ability to clean their teeth properly, have high levels of oral bacteria. This makes them particularly prone to oral bacteria induced pneumonia. The oral bacteria levels in the elderly may also increase due to the lack of salivary flow often seen with age and certain medications.

Pulmonologists should routinely ask patients if they have signs of periodontal disease. If  bleeding gums (the most common sign of periodontal disease) are reported, the patient immediately should be referred to a periodontist or dentist trained in the diagnosis and treatment of periodontal disease. Although early treatment may be very beneficial to preventing secondary pneumonia, good oral maintenance and prevention should be the goal.

Patients who have compromised pulmonary function should have a comprehensive Periodontal Risk Evaluation.  They must also maintain a frequent professional hygiene schedule with their periodontist or dentist.  At the very least, proper oral hygiene will diminish the potential bacterial load to the lungs.