Better access to dental care could help reduce COPD in Brazil

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COPD Brazil dental care
Photo: Naruedom Yaempongsa 123RF

Oral health in Brazil needs better promotion and more accessible public dental services, in order to help tackle the impact of Chronic Obstructive Pulmonary Disease—the country’s third leading cause of adult death, according to a new UK study.

Despite poor oral health being associated with worse clinical outcomes in COPD, many patients and primary health care professionals in Brazil do not know enough about the link between a lack of oral hygiene and the killer disease.

Interviewing COPD patients and health care professionals in São Paulo, researchers from the University of Birmingham discovered that many of those with the disease viewed tooth loss and decay as normal, and seldom practise preventative oral health.

Working with Brazilian research partners, the team published their findings in npj Primary Care Respiratory Medicine, noting that a lack of oral health advice relating to COPD, alongside poor oral hygiene practices and difficulties accessing free dental care, has worsened the problem.

“There is a clear desire for greater integration between medical and dental services to promote preventative oral health,” lead co-author Amber Swann said.

“This could be through developing educational programs or integrating oral health protocols into the primary care pathway for COPD patients.”

Co-lead Matthew Riley added: “Dentists felt that the problem lay with patients avoiding preventative care, whilst patients highlighted significant barriers to accessing oral healthcare. Our research indicates that incorporating preventative oral health into COPD management and expanded public dental services would help this group of vulnerable patients.”

COPD is a long-term incapacitating respiratory condition—the fourth leading cause of death worldwide. Caused mainly by smoking and exposure to air pollution, it is more common in low- and middle- income countries with disadvantaged populations most affected. 

Worsening of COPD symptoms is a common and costly complication, often associated with irreversible loss of lung function, hospitalisation and death. Up to half of such COPD ‘flare-ups’ may result from bacterial infections and recent evidence suggests a significant decrease in flare ups following periodontal (gum) treatment

While Brazil’s universal healthcare system was introduced in 1988, oral health was a low priority and services were limited. The 2004 Oral Health National Policy aimed to expand access to public services, but Brazil’s elderly population may have missed out—over 50 per cent of Brazilian 65-74-year-olds are missing teeth, whilst the remainder have some degree of periodontal disease.

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