COPD

dr. Wilson Arthur Zein, M. Biomed

Department of Anatomy
Universitas Methodist Indonesia
Universitas Prima Indonesia
Chronic obstructive pulmonary disease (COPD)
is a chronic inflammatory lung disease that
causes obstructed airflow from the lungs
Emphysema and chronic bronchitis are the two
most common conditions that contribute to
COPD.
These two conditions usually occur together and
can vary in severity among individuals with
COPD.
Chronic bronchitis is
inflammation of the
lining of the bronchial
tubes, which carry air
to and from the air sacs
(alveoli) of the lungs.
It's characterized by
daily cough and mucus
(sputum) production.
Emphysema is a
condition in which
the alveoli at the end
of the smallest air
passages
(bronchioles) of the
lungs are destroyed as
a result of damaging
exposure to cigarette
smoke and other
irritating gases and
particulate matter.
COPD is a progressive disease that gets worse
over time, COPD is treatable.
With proper management, most people with
COPD can achieve good symptom control and
quality of life, as well as reduced risk of other
associated conditions.
 Risk factors
1. Smoking
2. non-smoking COPD
– Burning biomass fuel
– prolonged exposure to occupational smoke/dust
– Tuberculosis
– Recurrent respiratory infections
– poorly treated asthma
– Genetic
 Signs and symptoms of COPD
• Shortness of breath, especially during physical
activities
• Wheezing
• Chest tightness
• A chronic cough that may produce mucus (sputum) that
may be clear, white, yellow or greenish
• Frequent respiratory infections
• Lack of energy
• Unintended weight loss (in later stages)
• Swelling in ankles, feet or legs
 Diagnose COPD
• Which includes chronic bronchitis and
emphysema
• Will evaluate your symptoms
• Ask for your complete health history
• Conduct a health exam and examine test
results.
 Diagnose COPD
Health History
• Smoke or have a history of smoking
• Are exposed to secondhand smoke, air
pollution, chemicals or dust
• Have symptoms such as shortness of breath,
chronic cough or lots of mucus
• Have family members who have had COPD
• Spirometry: If you are at risk for COPD or have
symptoms of COPD, you should be tested through
Spirometry.
• Spirometry is a simple test of how well your lungs
work. For this test, you blow air into a mouthpiece and
tubing attached to a small machine. The machine
measures the amount of air you blow out and how fast
you can blow it.
• Spirometry can detect COPD before symptoms
develop. Your doctor also might use the test results to
find out how severe your COPD is and to help set your
treatment goals.
Other tests:
• Chest X-ray
• Arterial blood gas test, which measures the
oxygen level in your blood. This test can show
how well your lungs are able to move oxygen
into your blood and remove carbon dioxide
from your blood.
 Complications
• Lung Infections
• Collapsed Lung (Pneumothorax)
• Lung cancer.
• Poor Gas Exchange
• Heart Problems
• Atrial Fibrillation
• Thinning Bones (Osteoporosis)
• Weak Arms and Legs
• Weight Issues
• Sleep Problems
• Diabetes
• Depression and Anxiety
 Treatment of acute exacerbations
• Oxygen supplementation
• Bronchodilators
• Corticosteroids
• Antibiotics
• Sometimes ventilatory assistance with
noninvasive ventilation or intubation and
ventilation
Patients with COPD may experience worsening
of respiratory function during dental treatment; a
number of precautions are therefore
recommended.
Specifically, it is advisable to treat the patient in
the vertical position.
Specialized clinics are able to offer oxygen
equipment and personnel trained in its use.
Hypnotics, narcotics, antihistamines and
anticholinergic agents are to be avoided.
If the patient is receiving corticosteroids,
supplements may be needed.
In the case of individuals receiving theophylline,
macrolide antibiotics (erythromycin,
clarithromycin) are to be avoided.
Ambulatory general anesthesia is totally
contraindicated.
Patients with COPD, particularly those admitted to
hospital, can suffer infectious lung diseases
secondary to the aspiration of microorganisms in the
presence of deficient periodontal conditions. The
teeth and periodontium can serve as a reservoir for
respiratory infections. In this sense, loss of alveolar
bone has been associated to an increased risk of
COPD.
Smoking is an important risk factor for both
periodontitis and COPD.
The main disease states that can give rise to
respiratory problems during dental treatment
procedures are COPD, asthma, tuberculosis,
OSAS and foreign body aspiration.
The dental professional must know these
diseases in order to be able to offer effective and
safe treatment, and must be able to recognize the
oral and/or dental manifestations that might
arise.