Oral Health and Aspiration Pneumonia: Why Good Oral Care Matters
Good oral health is important for everyone, but it becomes even more important for older adults and people with swallowing difficulties (dysphagia).
Many people are surprised to learn that good oral hygiene may play a role in reducing the risk of aspiration pneumonia. While oral care cannot prevent every case of aspiration pneumonia, it is an important part of supporting overall health and mealtime safety.
What Is Aspiration Pneumonia?
Aspiration pneumonia is a lung infection that can develop when material enters the lungs instead of travelling safely into the stomach.
This material may include:
saliva
food
drinks
If the material contains bacteria from the mouth, it may increase the risk of developing aspiration pneumonia.
Not everyone who aspirates will develop aspiration pneumonia. The risk depends on many factors, including swallowing function, oral hygiene, overall health, mobility, immune function, and existing medical conditions.
How Is Oral Health Related to Aspiration Pneumonia?
Our mouths naturally contain bacteria.
Without regular oral care, bacteria can accumulate on:
teeth
gums
dentures
the tongue
other surfaces inside the mouth
For people with dysphagia, saliva may sometimes enter the airway instead of being swallowed normally. Read this article to find out why choking still happens in aged care settings.
If saliva contains higher levels of bacteria because of poor oral hygiene, those bacteria may also enter the lungs, potentially increasing the risk of aspiration pneumonia.
Good oral hygiene helps reduce the amount of bacteria in the mouth and is recognised as one strategy that may help reduce this risk.
Who Is at Higher Risk?
Some people have a higher risk of aspiration pneumonia than others.
This may include people who have:
dysphagia (swallowing difficulties)
stroke
dementia
Parkinson's disease
poor oral health
reduced ability to perform their own oral care
dependence on others for feeding or daily care
Many residents in aged care facilities have several of these risk factors at the same time.
What Does Good Oral Care Involve?
Good oral care is more than simply brushing teeth.
It may include:
brushing teeth twice a day
cleaning dentures regularly
removing dentures overnight when appropriate
cleaning the tongue
keeping the mouth clean and moist
arranging regular dental reviews
reporting any changes in oral health
For people who are unable to complete oral care independently, carers and healthcare staff may need to provide assistance.
Oral Care Is Part of Mealtime Safety
When discussing mealtime safety, people often think about food textures, thickened fluids, or supervision during meals.
However, oral care is also an important part of safe swallowing management.
Supporting mealtime safety involves multiple strategies working together, including:
maintaining good oral hygiene
following speech pathology recommendations
providing appropriate food and fluid textures
supporting safe positioning during meals
providing the correct level of supervision when required
Each of these strategies contributes to reducing risk and supporting safer eating and drinking.
Why Staff Education Is Important
Supporting oral health is everyone's responsibility.
Staff who assist with eating and drinking should also understand the importance of good oral hygiene and how it relates to dysphagia and aspiration pneumonia.
Education can help staff:
recognise changes in oral health
understand why oral care is important
provide appropriate daily oral care
know when to escalate concerns to a speech pathologist, dentist, oral health therapist, or other healthcare professional
A team approach helps provide safer and more consistent care.
Oral Health Is One Part of Dysphagia Management
Aspiration pneumonia is a complex condition with many contributing factors.
Good oral hygiene alone cannot eliminate the risk of aspiration pneumonia.
However, maintaining good oral health is recognised as an important part of comprehensive dysphagia management and may help reduce the risk when combined with appropriate swallowing management, safe mealtime practices, and person-centred care.
Final Note
Good oral care supports more than healthy teeth and gums.
For people living with dysphagia, maintaining good oral hygiene may help reduce the amount of bacteria in the mouth and forms an important part of a broader strategy to support mealtime safety and reduce the risk of aspiration pneumonia.
By working together, speech pathologists, oral health professionals, nurses, carers, dietitians, and other healthcare professionals all play an important role in supporting safer eating, drinking, and overall health. Training is essential in aged care facilities to achieve safe mealtimes.
