And difficulty swallowing [bp 1.

Devastating effects of poor oral hygiene may include a variety of local and systemic diseases, including local abscesses

education, the rapid spread of infection through fascial planes and infective endocarditis [

BЂ "]. Elderly people suffering from these diseases, and several excellent recent reviews are the author

on this subject (see [

], etc.). Probably the most common infectious complications of poor oral hygiene in seniorsBЂ " especially those who live in homes

homesBЂ "is aspiration pneumonia. Studies in the University of Michigan (Ann Arbor), Yale University (New Haven, Connecticut

), Japan examined the mouth and teeth cause aspiration pneumonia. These studies related >> << result aspiration pneumonia with caries, periodontal diseases, poor hygiene, the need for food assistance, and trouble swallowing

[

BЂ "]. These studies differ in methodology, measurement and determination and has been put into the context of current

understanding of oral microflora. In the 1970s and 1980s, many studies of aspiration pneumonia focused on its probable origin, anaerobic pulmonary infection

[

BЂ "]. These studies attempted to differentiate the large atmospheric mixture of organisms from the mouth of the body actually

involved in lower respiratory tract using methods such as transtrahealnoy aspiration. Technology transtrahealnoy desire >> << Now rarely used and widely replaced by bronchoscopy with washing or protected brush specimens. Aspiration pneumonia

is a dynamic disease, and the exact combination of anaerobic and aerobic part is likely to change over time, and based on

functional state. Medical risk factors include swallowing and problems with food (which have been fully quantified

) [

], reducing the effectiveness of the protective mechanisms of the lungs, including the poor and weak cough clearance [

] diabetes [] violation of the immune status [], poor feeding methods [] position [], neurological problems [,,

] and the functional state of the patient [

]. Dental risk factors documented included caries, periodontal diseases, high

S. aureus in saliva, saliva, occasional visiting hygienist, and generally poor oral hygiene [

]. In this difficult situation, few studies included both medical and dental risk factors [,,

]. In the study, 358 older veterans, most known risk factors for aspiration pneumonia were requirements through diet, oral

Staphylococcus aureus colonization (as evidenced by positive culture of saliva), periodontal disease and caries (

) []. In the second study, 613 elderly residents of nursing homes in Connecticut, risk factors for surveyed for nursing homeBЂ "

acquired pneumonia, although the study did not specifically focus on aspiration pneumonia [

]. Nine modifiable risk factors were considered, including lack of oral care, difficulty swallowing, lack of vaccination against influenza

depression, feeding position 90B ° from horizontal, active smoking, intake of sedative drugs, a stomach acidBЂ " ;

reduce drugs and the use of angiotensin-converting enzyme. Only 2 risk factors were demonstrated considerable

association with pneumonia risk and both (inadequate oral care [BP 1 55;.

P = 03.] And difficulty swallowing [BP 1. 61;

P = 043]) remained significant after multivariable analysis .. The main limitation in studies of aspiration pneumonia at present is that the methods used to quantify swallowing were poor

[

]. These limits were measured in the pathology of language with fiber-optic strattera side effects endoscopic evaluation of swallowing (FEES) exams

, but in most patients with aspiration pneumonia have not been studied, but noted that non-specific signs or symptoms of medical cards

like BЂњtrouble swallowingBЂ "or BЂњcoughs being fedBЂ" [

]. As the methods for evaluating variables swallowing food, coughing and advance quality research pneumonia

probably better, and [

BЂ "]. . << >>