Streptococcus oralis Meningitis with Gingival Bleeding in a Patient: A Case Report and Review of the Literature

An 81-year-old man with a history of gingival bleeding presented with a fever, headache, and drowsiness. His mouth and full dentures were unsanitary. Laboratory tests revealed Streptococcus oralis meningitis caused by odontogenic bacteremia. We reviewed eight reported cases, including the present case, because S. oralis meningitis is rare. Our review indicated that S. oralis meningitis needs to be considered when encountering cases of a fever, disturbance of consciousness, and headache with episodes of possible odontogenic bacteremia.

[The Triangular Relationship Among Swallowing Disorders, Aspiration Pneumonia, and Poor Oral Hygiene]

Persons with dysphagia have difficulties chewing and swallowing food because of functional, structural, or psychological reasons. Dysphagia may cause choking or the inhalation of food into the trachea and lungs. Patients with dysphagia often induce the coughing reflex when drinking water and brushing teeth and tend to suffer from gum bleeding. As a result, their caregivers tend to reduce the frequency of or discontinue teeth brushing, which promotes the spread of periodontal disease, dental caries, and oropharyngeal secretions colonizing in the oral cavity or throat. When a patient suffers a choking attack or aspiration, bacteria is inhaled into the trachea and lungs, causing aspiration pneumonia. Furthermore, patients with choking issues are often be fitted with nasogastric tubes to facilitate the delivery of nutrients and water. Long-term use of nasogastric tubes also significantly increases the risk of aspiration pneumonia. Adjusting eating posture, improving food texture, conducting swallowing rehabilitation, providing training, and practicing proper oral care are an effective approach to preventing the onset of chewing and swallowing disorders and aspiration pneumonia.

Risk indicators for prevalence, extent and severity of periodontitis among rural Indian population aged 35-54 years

AIMS

This study aimed to identify risk indicators associated with periodontitis and the contribution of each of the indicators towards the prevalence, extent and severity of periodontitis in a rural Indian population.

METHODS

A cross-sectional study design was used to collect data according to National Survey of Adult Oral Health Australia guidelines. A multistage stratified random sampling was followed to select 1401 participants, who were in the age group of 35-54 years. The participants were selected from 50 villages belonging to the 5 sub-provinces of 2 Indian districts. Data were collected through face-to-face interviews and oral examination. Statistical analysis was performed using SAS version 9.3. The univariate, bivariate and multivariate analyses were performed to determine the risk indicators of prevalence, extent and severity of periodontitis. Population attributable fraction was estimated for each of the significant risk indicators of prevalence and extent.

RESULTS

In this study, factors such as age, education, tobacco chewing and plaque accumulation were significantly associated with the prevalence of periodontitis. Age, socioeconomic status, method of tooth cleaning, alcohol consumption and plaque accumulation were significant risk indicators for generalized periodontitis. Age, tobacco chewing and plaque were associated with severity of periodontitis in the population.

CONCLUSION

The rural population had a high prevalence of periodontitis. Sociodemographic factors, poor oral hygiene, tobacco and alcohol were the main risk indicators attributable to periodontitis.

Poor periodontal health: A cancer risk?

Evidence indicates that chronic infections and inflammation are associated with increased risk of cancer development. There has also been considerable evidence that proves the interrelationship between bacterial and viral infections and carcinogenesis. Periodontitis is a chronic oral infection thought to be caused by gram-negative anaerobic bacteria in the dental biofilm. Periodontal bacteria and viruses may act synergistically to cause periodontitis. Many studies have shown that periodontal pockets may act as reservoirs for human papilloma virus, cytomegalovirus, Epstein Barr virus, and suspected agents associated with oral cancer. Periodontitis, characterized by epithelial proliferation and migration, results in a chronic release of inflammatory cytokines, chemokines, growth factors, prostaglandins, and enzymes, all of which are associated with cancer development. This review article intends to shed light on the association between periodontal health and carcinogenesis.

Causal relationship between periodontitis and chronic obstructive pulmonary disease

CONTEXT

Recently, it has been recognized that oral infection, especially periodontitis, may affect the course and pathogenesis of a number of systemic diseases. An association between periodontal disease and chronic obstructive pulmonary disease (COPD) has been observed.

AIMS

The aim of the present study was to evaluate the potential association between periodontal health and COPD and to assess the potential health status of patients with and without COPD.

SETTINGS AND DESIGN

In this observational study, the association between periodontal disease and COPD has been assessed.

MATERIALS AND METHODS

HUNDRED PATIENTS WERE CHOSEN FOR THE STUDY: group A comprising 50 COPD patients and group B consisting of 50 patients without COPD. Gingival Index (GI) and Papilla Bleeding Index (PBI) were used to assess the gingival status. Periodontal indices included Russell's Periodontal Index (PI) and Periodontal Index for Risk of Infectiousness (PIRI), which were assessed in all 100 patients. Analysis of covariance (ANCOVA) was the statistical analysis used.

RESULTS

After eliminating age affects using ANCOVA, the mean indices of all variables between groups were found to be highly significant (P<0.001). The scores were highly significant in COPD group than in non-COPD group.

CONCLUSIONS

The findings of the present study show that there is an association between periodontal disease and COPD. It is suggested that periodontitis is one of the risk factors for COPD.