CLL Support Association

Regular dental check ups linked to significant protection against bacterial pneumonia!

Regular dental check ups linked to significant protection against bacterial pneumonia!

With death from illness responsible for between 20 and 50% of all CLL patient deaths, many due to pneumonia, I was encouraged to read that just having regular dental check ups can almost halve the risk of pneumonia in the general population.

'Data from a national survey suggest that people who never get a checkup have almost twice the risk of bacterial pneumonia as those who see their dentists twice a year, according to Michelle Doll, MD, of Virginia Commonwealth University in Richmond.':

Thomas File Jr., MD, chief of the Infectious Disease Service at Summa Health System in Akron, Ohio, who was not part of the study but moderated a media briefing at which some details were discussed stated (with my emphasis):

'Bacterial pneumonia is a serious illness "associated with significant morbidity and mortality," he said, adding, "Anything we can do to reduce the burden of disease is important."' And that's for otherwise healthy people!

PaulaS covers the importance of having the PCV 13 (Prevnar 13) and PPV 23 (also known as Pneumovax 23 (Pneumovax) pneumonia vaccinations in part 1* of her valuable collection of what we can do to improve our health while living with CLL: In the updated part 2, just posted, Paula states:

12) Have regular and THOROUGH DENTAL CHECKUPS – don’t leave pockets of infection in teeth or gums. Chronic infection and inflammation is not good for CLL:

To that recommendation, I've repeated my recent response to a question about CLL and the risk of extra cavities: 'to-improve-our-chances-on-the-cll-journey.-part-one-updated

To that recommendation, I'd add that you should have any dental surgery you are deferring attended to before your immunity worsens or you need treatment, when dental surgery becomes more complicated. I'll also repeat my recent response to a question about immunity compromise due to CLL (specifically neutropenia) and whether there's a risk of extra cavities (I'm not aware of one): 'Our mouths are obviously a prime route of bacteria into our bodies; hence the large amount of protective lymphatic tissue around our throat - namely our tonsils, adenoids and lymph nodes. With our increased risk of infection during any dental procedure, prevention is by far the best approach! That goes for the food you eat too - we need to avoid foods naturally high in bacteria:

With severe neutropenia, you need to be very careful with your dental hygiene - only use a soft tooth brush to avoid the risk of causing scratches that can open up a route for bacterial infection of your blood stream - which can result in neutropenic sepsis, a very dangerous acute infection with a high fatality rate if not promptly brought under control.

Likewise you shouldn't floss your teeth if you are sufficiently neutropenic, due to the risk of giving bacteria entry into your blood stream by cutting your gums. I was told to stop flossing my teeth by my haematologist specialist when I was diagnosed and have only flossed my teeth when I'm stage 3 neutropenic or better (ANC >0.5). My specialist has prescribed a prophylactic antibiotic I take before any dental procedure.'

Finally, note that there's definitely an increased risk of other systemic diseases from oral infections, including cardiovascular disease and diabetes, so it is definitely worth getting on better terms with your dentist:

*I've recently unintentionally referred several members to Paula's old version of part 1, but I've now pinned the updated version referenced above. My apologies to those who read the old version.


Photo: Wild Pea flower

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Thanks Neil.

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Great info! I'm going to send the link to my sister (who avoids the dentist). :)

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Very interesting post, thanks Neil - made me think!

Lovely photo.



Thank you, Neil. Always great advice. I love how your data is corroborated with useful links.


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