Dental care may protect against pneumonia recurrence in kids with neurologic impairment

Dental care has the potential to reduce the recurrence of severe pneumonia in children with neurologic impairment (NI), whereas gastrostomy tube placement is associated with an increased risk of recurrence, possibly due to unresolved confounding by indication, according to a study.

The study included 3,632 children with NI who had been hospitalized for pneumonia. Of these, 1,362 children (37.5 percent) had subsequent pneumonia hospitalization.

Researchers explored potential associations between pneumonia hospitalization recurrence and expert-recommended prevention strategies: dental care, oral secretion management, gastric acid suppression, gastrostomy tube placement, chest physiotherapy, outpatient antibiotics before index hospitalization and clinic visit before or after index hospitalization.

Out of the several pneumonia prevention strategies recommended by expert guidelines, only dental care was associated with reduced risk of subsequent pneumonia hospitalization (adjusted odds ratio [aOR], 0.64, 95 percent CI, 0.49–0.85).

Exposures associated with increased risk, on the other hand, included gastrostomy tube placement (aOR, 2.15, 1.63–2.85), chest physiotherapy (aOR, 2.03, 1.29–3.20), outpatient antibiotics before hospitalization (aOR, 1.42, 1.06–1.92), and clinic visit prior to (aOR, 1.30, 1.11–1.52) and after index hospitalization (aOR, 1.72, 1.35–2.20).

Despite the possible residual confounding by indication, the findings support a clinical trial of dental care for prevention of severe pneumonia in children with NI and discourage the widespread use of gastrostomy tubes for that purpose, according to the researchers.