This article and its findings highlight once again the importance of oral hygiene not only in contributing to oral health, but to overall systemic health as well. Considering the medical, social, and financial burdens respiratory diseases place on the population in general, any intervention which eliminates risk factors leading to such diseases is a prudent one. This is particularly true for oral health,where prophylaxis is often simple, easily accessible, and economical.

It is noteworthy that the authors, based on the strength of the evidence, present their strongest recommendations on studies that include decontamination treatment protocols for the removal and reduction of microbial plaque, particularly for at-risk patients. This systematic review thus confirms the role of antimicrobial plaque control measures in reducing the microbial burden and risk for respiratory diseases. Patients at risk for respiratory diseases should be instructed in thorough and routine oral hygiene using products that contain an antimicrobial ingredient, such as a toothpaste containing triclosan/copolymer, and rinses which contain essential oils or chlorhexidine. For the patient at high risk for aspiration pneumonia (patients who are elderly, medically compromised, or residing in institutional settings), procedures should be implemented, using chlorhexidine mouthrinses and topical antimicrobial prophylaxis to decontaminate the oropharynx.

A particularly interesting finding from this study was that patients who were dependent on caregivers for oral hygiene were at higher risk for respiratory diseases, which underlines the strong need for all dental team members to educate other health professionals, caregivers, and their patients regarding the relationship between oral health and respiratory disease, particularly for high risk individuals. Ultimately, this will improve the quality of life for these patients and may lead to significant reductions in overall healthcare costs.