Bidirectional relationship between chronic obstructive pulmonary disease and oral disease

Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that has various comorbid conditions and systemic complications. One of the complications is dental and oral disease, which can occur through systemic inflammatory mechanisms and the long-term side effects of inhaled drugs. Dental and oral diseases can also cause COPD progression, increase the risk of exacerbations, and affect the patient's quality of life. Some mechanisms that may play a role include aspiration of oral pathogens, aspiration of inflammatory proteins, and systemic inflammation.  Dysbiosis of the lung microbiome can result from dental and oral conditions, increasing the risk of COPD and pulmonary infections. The association between COPD and oral disease includes the presence of systemic inflammatory conditions, the risk factor of smoking, and the indirect effects of inhaled medication use. Comprehensive management of COPD patients regarding dental and oral health is needed, which includes prevention of dental and oral disease, routine assessment of dental and oral health, provision of specific dental therapy, and personalized treatment in selecting COPD therapy.