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Exploring the Connection between Oral Health and Infection Prevention: Insights from Dr. Rupak Datta

Dr. Rupak Datta, an esteemed Assistant Professor of Medicine focused on infectious diseases at Yale School of Medicine (YSM), offers valuable insights on an unconventional infection prevention method – daily toothbrushing. Besides his role at YSM, he serves as an assistant hospital epidemiologist in the Veterans Affairs Connecticut Healthcare System, dedicating his research to enhancing clinical outcomes for older adults through effective antimicrobial stewardship. In a recent commentary for JAMA Internal Medicine, he underscored the potential of toothbrushing in preventing hospital-acquired pneumonia, drawing an intriguing link between oral health and overall health.

It was during his infectious diseases fellowship at YSM that he first realized the profound correlation between oral hygiene and health. He noticed patients with subpar oral care were more susceptible to invasive infections, including bloodstream infections and endocarditis. Moreover, interactions with dental professionals and surgeons reinforced a crucial understanding that periodontal disease is a major risk factor for infection. Therefore, proper oral care gain precedence particularly in preparation for complex cardiothoracic surgeries. Bacteria, fungi, and protozoa flourish in the large reservoir that is the human mouth. A compromised oral ecology, especially in immunocompromised individuals, can let these microorganisms infiltrate the bloodstream or the local tissue, potentially causing invasive conditions.

Good oral hygiene practices, such as regular toothbrushing, serve to limit the prevalence of these microorganisms. One of the key outcomes of toothbrushing is the removal of dental plaques, or biofilms, thriving with microorganisms. Accumulation of dental plaques can welcome bacterial invasions into the oral cavity, respiratory tract, bloodstream, and even heart valves. Measures to reduce this biofilm, specifically toothbrushing, have proven efficacy in infection management.

Recent meta-analysis corroborates that toothbrushing can diminish the risk of hospital-acquired pneumonia. Initially, studies concentrated on the use of chlorhexidine, an antiseptic mouthwash, as a strategy to cut down biofilms and oral microbial burden as a way to stave off pneumonia. However, the evidence in this regard has been mixed. Conversely, toothbrushing, which mechanically removes biofilms, has been reaping favorable evidence, especially in reducing pneumonia in mechanically ventilated patients.

Regular toothbrushing achieves two critical objectives – it removes harmful bacteria, thus diminishing the chances of oral infections like gingivitis and periodontal disease, and crucially, it may also curb severe systemic infections such as pneumonia, bloodstream infection, and endocarditis. The practice of maintaining good oral hygiene stands as a straightforward and effective tool, on par with hand hygiene, in infection prevention. Therefore, the infectious disease prevention community can start considering toothbrushing on similar terms as handwashing, recognizing both as vital infection prevention measures. YSM’s Department of Internal Medicine, Section of Infectious Diseases excels in offering comprehensive patient care, research, and educational activities across a broad spectrum of infectious diseases.

Source: https://medicine.yale.edu/internal-medicine/news-article/toothbrushing-and-infection-prevention-rupak-datta/

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