Respiratory diseases are responsible for significant morbidity and mortality.
Steps in the pathogenesis of lower respiratory tract infection include colonization of the oral pharyngeal mucosal surface by bacterial pathogens and their shedding into contiguous secretions which then contaminate and infect the lower respiratory mucosa. The failure of host defense mechanisms to eliminate these pathogens from mucosal surfaces can result in their multiplication with subsequent infection and tissue destruction. Lower respiratory infection may therefore be prevented by suppressing initial oral pharyngeal pathogen colonization. Dr. Scannapieco proposes a longitudinal epidemiological investigation to determine the extent of association between exacerbation of chronic obstructive pulmonary disease and poor oral health including periodontal disease. In this study he will relate the incidence of exacerbation of COPD not only with oral hygiene and oral disease, but also with salivary cytokines and the presence of oral and respiratory pathogens in the oral flora.