The Geriatric Oral Science Project (UOSP) brings a focused multidisciplinary approach to defining the dental and oral-pharyngeal health status of approximately 600 senior citizens. The GOSP seeks to identify those parameters, both clinical, bacteriological and immunological, that may predispose the individual to a disease outcome such as dental decay, periodontal disease, swallowing disorders and possibly pneumonia and heart disease. The basic approach is an in-depth dental, medical, bacteriological, immunological. oral pharyngeal examination, and questionnaire given on an annual basis. The pneumonia patients exhibited significantly higher numbers of Capnocytophaga species and F. nucleatum in their salivas compared to individuals known not to have pneumonia. We restricted admission in the main study to those individuals from whom a complete oral/dental examination could be obtained, and who could be interviewed. We chose four convenience groups who represented """"""""a priori"""""""", four different medical health situations, i.e., an independent-living non-VA group who were white, well educated, older and 70% females (n=l23); an independent-living VA group who were white, were mostly non-college graduates and 90% males (n=218); veterans who were institutionalized in a long-term care facility (n-132), and veterans who had just been admitted from an independent-living status to an acute care ward with swallowing difficulties secondary to a neurologic event (n=81). The descriptive statistics of more than 1000 variables obtained at the baseline patient visit, revealed a striking association between good medical health, as measured by independent living status and longevity, and good dental health. The medically healthy, non-VA groups averaged 78 years of age, had a 5% edentulous rate, and those with teeth had an average of 25 teeth. This contrasted with the three VA groups who were on the average, 10 years younger, had more edentulous individuals, and more missing teeth among the dentate individuals. The veterans, newly admitted with a swallowing disorder, were 55% edentulous and were missing an average of 12 teeth per dentate patient. As most of these latter individuals had a recent stroke, we examined the relationship between a reported history of stroke and the dental parameters. The 68 individuals who had a history of stroke had significantly more missing and decayed teeth and a higher percentage of edentulous individuals than did the 248 individuals who reported no history of stroke and were not receiving anticoagulants. These findings are consistent with decent reports in the literature and have caused us to refocus our direction as to whether there is a causal relationship between dental/oral problems and cardiovascular disease. A relationship between dental disease and pneumonia is evident in our data. Individuals who met our strict criteria for pneumonia, are likely to have significantly more periodontal disease than are individuals without pneumonia. We have perhaps the most extensive dental/oral database in the work upon which to explore these relationships between dental and medical health.
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| Terpenning, M S; Taylor, G W; Lopatin, D E et al. (2001) Aspiration pneumonia: dental and oral risk factors in an older veteran population. J Am Geriatr Soc 49:557-63 |
| Loesche, W J; Grossman, N S (2001) Periodontal disease as a specific, albeit chronic, infection: diagnosis and treatment. Clin Microbiol Rev 14:727-52, table of contents |
| Bretz, W A; Loesche, W J; Chen, Y M et al. (2000) Minor salivary gland secretion in the elderly. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 89:696-701 |
| Taylor, G W; Loesche, W J; Terpenning, M S (2000) Impact of oral diseases on systemic health in the elderly: diabetes mellitus and aspiration pneumonia. J Public Health Dent 60:313-20 |
| Loesche, W J; Taylor, G W; Dominguez, L D et al. (1999) Factors which are associated with dental decay in the older individual. Gerodontology 16:37-46 |
| Loesche, W J (1999) The antimicrobial treatment of periodontal disease: changing the treatment paradigm. Crit Rev Oral Biol Med 10:245-75 |
| Langmore, S E; Terpenning, M S; Schork, A et al. (1998) Predictors of aspiration pneumonia: how important is dysphagia? Dysphagia 13:69-81 |
| Loesche, W J; Lopatin, D E (1998) Interactions between periodontal disease, medical diseases and immunity in the older individual. Periodontol 2000 16:80-105 |
| Loesche, W J; Schork, A; Terpenning, M S et al. (1998) Assessing the relationship between dental disease and coronary heart disease in elderly U.S. veterans. J Am Dent Assoc 129:301-11 |
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