Oral Microbial and Respiratory Status of Persons with Mental Retardation/Intellectual & Developmental Disability – An Observational Cohort Study

Objective—The objective of this study was to determine the prevalence of select microorganisms in oral biofilms and to investigate relationships between oral and respiratory status in persons with mental retardation/intellectual and developmental disabilities (IDD). Study Design—We conducted a 6-month-long observational cohort study with 63 persons with IDD. Oral examinations, oral sampling, and medical record reviews were performed at baseline and then monthly. Polymerase chain reaction (PCR) was used to analyze all baseline oral samples for the presence of Streptococcus pneumoniae (S. pneumoniae), Methicillin-Resistant Staphylococcus aureus (MRSA), Prevotella melaninogenica (P. melaninogenica) and Candida albicans (C. albicans). PCR analyses were also performed on participants’ samples collected in the month prior to being diagnosed with a respiratory infection. Results—All subjects had P. melaninogenica detected by PCR in their oral samples. Fifty-five percent (35 of 63) of participants had S. pneumoniae, MRSA and C. albicans in their oral samples at baseline. No dental decay was detected clinically, oral hygiene was fair, and dysphagia was common. During the 6 months of the study, there were 22 respiratory infections (35% of participants) – 12 pneumonias, 7 sinusitis, 1 bronchitis, and 1 upper respiratory tract infection. Participants with microorganisms in their baseline samples were significantly more likely to develop any respiratory infection and those who had poor oral status were significantly more likely to develop pneumonia. Almost 60% of participants who developed respiratory infections had the same microorganism detected in the sample collected in the month prior to infection as had been detected in their baseline sample. Conclusion—Potentially pathogenic microorganisms in the oral cavity and poor oral status significantly increased the risk of developing respiratory infections, including pneumonia, in persons Corresponding author, [email protected], phone 502-852-5083, fax 502-852-5988. A preliminary report was presented at the IADR annual meeting in New Orleans, LA in March 2007. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author Manuscript Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Author manuscript; available in PMC 2010 November 1. Published in final edited form as: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 November ; 108(5): 722–731. doi:10.1016/ j.tripleo.2009.06.027. N IH PA Athor M anscript N IH PA Athor M anscript N IH PA Athor M anscript with IDD. The results suggest that colonization with these microorganisms may persist despite routine tooth brushing. Meticulous comprehensive oral hygiene of the oral cavity may be needed to reduce oropharyngeal microbial load.