The Relationship Between Oral Health and Chronic Obstructive Pulmonary Disease Exacerbations

Thumbnail Image

Persistent link to this item

View Statistics

Journal Title

Journal ISSN

Volume Title


The Relationship Between Oral Health and Chronic Obstructive Pulmonary Disease Exacerbations

Published Date




Thesis or Dissertation


Introduction: Poor oral health has been implicated as an independent risk factor for the development of chronic obstructive pulmonary disease (COPD), but few studies have evaluated the association between oral health and COPD exacerbations. We aimed to determine if poor oral health is associated with COPD exacerbations and/or worse respiratory health. Methods: We performed a case-control study of oral health among COPD exacerbators and non-exacerbators. Cases (exacerbators) had experienced ≥1 exacerbation in the previous 12 months, while controls (non-exacerbators) had no exacerbations in the previous 24 months. We excluded those with <4 teeth. We evaluated the global oral health assessment, Oral Health Impact Profile (OHIP-5), dental symptoms/habits, and St. George’s Respiratory Questionnaire (SGRQ). In a subset, we performed blinded dental exams to measure bleeding on probing, probing depth, clinical attachment loss, periodontitis severity, plaque index, gingival index, and carries risk. We evaluated associations between oral health and COPD exacerbations using logistic regression. Linear regression was used to assess relationships between oral health and SGRQ scores. Results: Screened non-exacerbators (n=118) were significantly more likely to have <4 teeth, compared to screened exacerbators (n=100) (44% vs. 30% respectively; p=0.046). After excluding those with <4 teeth there were 70 cases and 66 controls. Self-reported oral health and objective dental exam measures did not vary significantly between cases vs. controls. However, the odds of severe COPD exacerbations requiring hospitalizations and/or emergency department visits trended higher in those with worse dental exam compared to those with better dental exam. Worse OHIP-5 was strongly associated with worse SGRQ scores. Conclusions: Oral health status was not related to COPD exacerbations, but was associated with self-reported respiratory health. Larger studies are needed to address oral health as a potential method to improve respiratory health in patients with COPD.


University of Minnesota M.S. thesis. May 2019. Major: Clinical Research. Advisor: Chris Wendt. 1 computer file (PDF); viii, 27 pages.

Related to



Series/Report Number

Funding information

Isbn identifier

Doi identifier

Previously Published Citation

Suggested citation

Baldomero, Arianne. (2019). The Relationship Between Oral Health and Chronic Obstructive Pulmonary Disease Exacerbations. Retrieved from the University Digital Conservancy,

Content distributed via the University Digital Conservancy may be subject to additional license and use restrictions applied by the depositor. By using these files, users agree to the Terms of Use. Materials in the UDC may contain content that is disturbing and/or harmful. For more information, please see our statement on harmful content in digital repositories.