Chronic obstructive pulmonary disease (COPD) is a critical health experience of increasing significance. Preliminary evidence suggests an association between COPD and oral health status, which means that improving oral health might be a simple and cost-effective way to impact this group of patients. Although epidemiologic reports have reported this connection, the relationship between oral and sputum inflammatory markers has not been investigated, and no intervention studies to improve oral health have been reported. This proposal represents an initial step toward a planned intervention study of oral health in persons with COPD.

The specific aims of this study are to

1. determine the feasibility of collecting and measuring the proposed indicators of oral and respiratory inflammation in COPD patients, and
2. investigate the relationship between inflammatory markers and other measures of oral health and pulmonary status in COPD patients. A sample of 45 patients will be drawn from all patients over the age of 18, who attend the asthma/ COPD clinic at the Veterans Administration Medical Center (VAMC) in Richmond, Virginia. All data collection will be obtained during one clinic visit. Sputum samples will be assessed for amount, color, viscosity, MPO, cytokines, LTB4, neutrophil count, Gram stain and culture. Measures of oral health will include DMF, plaque score, neutrophil count, oral cavity culture, and pocket measurement, as well as salivary volume, IgA, lactoferrin, and salivary inflammatory markers. Spearman's correlations will be generated to assess the relationship between the oral variables and the pulmonary function/sputum variables. Because the oral flora variable is categorical an analysis of variance model will also be used to look for differences in the pulmonary function/sputum means across these levels. This pilot study will provide preliminary data for an eventual intervention study that addresses the role of improvement of oral health in COPD.