Oral health and pneumonia

[John1]

We all know what a threat pneumonia poses to PALS. I had a visit with a speech pathologist today and we discussed a broad range of ALS-related matters. She asked me whether I had suffered from pneumonia. I replied that I hadn't and in fact had developed almost no colds in the past several years since beginning a regimen of 1000 mg a day of vitamin C. She mentioned that choking and aspiration of fluids or food particles into the lungs is dangerous because it can lead to pneumonia. What was surprising to me was her assertion that the pneumonia is caused by bacteria in the mouth being carried into the lung area by the food. The fluid or food itself is just the vehicle, not the cause.

Has anyone else heard this? If true, then oral hygiene including the use of a good antibacterial mouthwash like Listerine should be a regular part of a PALS day.

 

[Atsugi]

Two things. Yes. Pneumonia can be caused by bacteria getting into the lungs. And yes, PALS oral hygiene can abe important. People who can't chew or move their tongue normally around the mouth will leave trash in their mouths like pieces of pills, old applesauce, and just plain dirt.

Brushing the teeth is OK, but I prefered to "clean out" the PALS mouth instead.

Of course, you don't want to create a choking hazard. I used the tiniest bit of gel toothpaste so as to pick up the trash, bit by bit.

 

[affected]

Hi John, yes there is truth in that indeed.

However, if food particles are aspirated the foreign body will set up an irritation and infection anyway as all food particles have bacteria. If a mouth is clean, the amount of bacteria in the saliva is low and not likely to cause infections. But as Mike said, oral hygiene is so important especially once bulbar symptoms start because it's incredible how poorly their mouths become at emptying. Food that has been sitting for hours (and I'm talking just little bits of food) in the mouth are already starting to culture a good lot of bacteria and I suspect this is what your speechie was thinking about.

I had to work hard on oral hygiene for Chris. As he had problems with jaw clamping and clonus, poor swallowing reflex and any stimulation in his mouth would cause his salivary glands to go berserk so it was a delicate operation. I did brush his teeth, but it had to be done carefully and cleaning the mouth out was at least as important as cleaning the actual teeth.

Antibacterial mouthwashs are not something I favour too much as we need lots of good bacteria in the mouth too, so I would be careful about doing that too often. (maybe once a day if you feel you need it)

Another of the important things is the poor cough reflex. Usually if something attempts to go down the airways we give a reflexive cough and out it comes. With PALS as their breathing deteriorates, not only is that first reflexive cough difficult but as any irritation begins there is not enough strength to cough and shift it.

I would add that using a cough assist machine is an important early prevention so that those lungs are able to clear anything out.

 

[tripete]

John, I got the exact same lecture last week at clinic.

 

[starente15]

My dad was also just lectured on that last week. I never knew about the bacteria thing. Makes sense though.

 

[affected]

Guess the lecture is accurate then huh