OBJECTIVE

1. The purpose of this systematic review (SR) was to answer the focused research question: Is there an association between periodontal disease and pneumonia or chronic obstructive pulmonary disease (COPD)? OBJECTIVE Search strategy and criteria for Systematic Review METHODS RESULTS: STRENGTH OF THE EVIDENCE Quality of Evidence and Grades for Recommendations SUMMARY CONCLUSIONS Brooke E. Agado, RDH, MS and Denise M. Bowen, RDH, MS SYSTEMATIC REVIEW OF THE ASSOCIATION BETWEEN CHRONIC OBSTRUCTIVE PULMONARY DISEASE OR PNEUMONIA AND PERIODONTAL DISEASE (1997-2012). Four systematic reviews provided fair evidence (Level I – Grade B) of an association between periodontal disease and respiratory diseases (i.e., pneumonia OR COPD). One additional systematic review (Level I – Grade B) concluded that periodontal disease is a significant and independent risk factor of COPD. Seven studies (counting one that also studied COPD) provided fair evidence (Level II-2 – Grade B) of an association between pneumonia and periodontal disease, including four well-designed and controlled studies and three studies with research design limitations that affected the strength of the evidence. Two studies (counting one that also studied COPD) at lower levels in quality of research design (Level II-3 – Grade C) indicated conflicting results regarding the association of pneumonia and periodontal disease. Ten additional well-designed longitudinal or case control studies (Level II-2 – Grade B) provided fair evidence of an association between periodontal disease and COPD. Three additional studies at lower levels in quality of research design (Level II-3) supported the association between periodontal disease and COPD.