The Relationship between Productive Cough and Periodontitis Affecting Teeth near the Maxillary Sinuses

In recent years several studies have suggested an association between periodontal infection and increased risk for cardiovascular diseases (Kuramitsu et al, 2001), preterm birth (Jeffcoat et al, 2001), and poor glycemic control in diabetes mellitus (Taylor, 2001). In addition, clinical evidence for an association between chronic inflammatory periodontal disease and productive cough (chronic bronchitis) has emerged (Scannapieco and Ho, 2001). Epidemiological studies also show similarities between these two diseases. Both are highly prevalent with a social gradient, and tobacco smoking plays a major role in their process of development (Albandar, 2002; Fletcher et al, 1976). Cooperation between dentistry and clinical medicine is needed to define the nature of a possible connection. The potential mechanisms by which periodontitis may influence the lower airways remain obscure. Existing literature often focus on aspiration of oral pathogens (Scannapieco et al, 2001), but since 50% of healthy people aspirate oropharyngeal contents during sleep (Megran and Chow, 1986), other factors must be involved. Tobacco and alcohol as well as neurological disorders are often considered (Terpenning, 2001). However, it seems possible that two well-known syndromes affecting the upper airways may form a link between periodontitis and productive cough. The term dental sinusitis syndrome (endo-antral syndrome) was proposed in 1989 (Selden, 1989), but extension of periapical infections into the maxillary sinuses was described much earlier (Bauer, 1943). Today it is generally accepted that endodontic infections may give rise to sinusitis A Dentobronchial Syndrome. The Relationship between Productive Cough and Periodontitis Affecting Teeth near the Maxillary Sinuses