A group of diseases that cause airflow blockage and breathing-related problems, including emphysema, chronic bronchitis, and asthma.38 Clinical signs and symptoms are summarized in Figure 6.
Epidemiology and Etiology
At the present time 16 million Americans have been diagnosed with COPD40 and 22 million Americans have been diagnosed with asthma.40 Many people are unaware they have decreased lower pulmonary function so these numbers are likely an underestimate.38 COPD is typically caused by long-term exposure to lung irritants.40 Additional risk factors include genetic factors,38 alpha-1 antitrypsin deficiency,40 smoking (particularly in the US),38,40 air pollutants,38 chemical fumes, dusts,40 and respiratory infections.38,39 The social determinants of health are also a COPD risk factor. Individuals who are unemployed, retired, unable to work, divorced, widowed, or separated, and people who had less than a high school education are more likely to report COPD.38 Figure 7 provides additional statistics about this disease.
Patient Management and Oral Health Considerations for COPD
Asthma medications reduce the quantity and quality of saliva and increase the risk of mouth breathing, dental caries, dental erosion, periodontal disease and oral candidiasis.43 Gastroesophageal acid reflex is more common in patients diagnosed with asthma. This can result in enamel erosion. In patients that are chronic smokers, dental providers may observe leukoplakia, erythroplakia or frank carcinoma.42 COPD has been known to increase the risk of arthritis and depression.38 The oral conditions associated with these diseases could also affect people diagnosed with COPD.