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CHRONIC
OBSTRUCTIVE
PULMONARY
DISEASE(COPD)
PRESENTED BY:
DR BASITH NP
DEPT OF PROSTHODONTICS
CONTENTS
• Introduction
• Definition
• Causes
• Understanding COPD
• Bronchial asthma
• Chronic bronchitis
• References
INTRODUCTION
• A progressive disease that affects the lungs, making it
difficult to breathe.
• Other names : Chronic Obstructive Lung Disease (COLD)
Chronic Lower Respiratory Disease (CLRD)
WHO :
• Currently the 3rd leading cause of death in the world.
• Seventh leading cause of poor health worldwide.
• More than 3.23million people died of COPD in 2019
accounting for 6% of all deaths globally.
• Nearly 90% of COPD deaths in those under 70 yrs of
age occur in low and middle-income countries(LMIC).
DEFINITION
Chronic Obstructive Pulmonary Disease (COPD)
is a common, preventable and treatable disease that
is characterized by persistent respiratory symptoms
and airflow limitation that is due to airway or
alveolar abnormalities usually caused by
significant exposure to noxious particles or gases.
CAUSES
Developed
countries is
tobacco smoking
Developing
world its
because of
exposing
fumes
Genetic condition
called alpha-1
antitrypsin
deficiency
AGE
UNDERSTANDING COPD
• Normal lungs • COPD lungs
BRONCHIAL ASTHMA
A chronic inflammatory disorder of the airways.
This causes an increase in the airway hyper
responsiveness that leads to recurrent episodes
of…
Wheezing Breathlessness Chest Tightness Cough
INCIDENCE
• Asthma effects an estimated 25000 Indians
every year
• Adult women have a 30% greater prevalence
than men
• Around world 9.7% of female adults have
asthma, compared to 6.2% of male adults.
PATHOPHYSIOLOGY
Trigger Factor
Airway Inflammation
Mucous
hypersecretion
Airway muscle
constriction
Swelling Bronchial
membrane
Narrow Breathing
Passages
Wheezing,cough,shortness of
breathe, chest tightness
COMPLICATIONS
• Status asthmatics
• Respiratory failure
• Pneumonia
• Atelectasis
MANAGEMENT OF ASTHMA
•Adrenergics (Beta 2 agonists)
•Steroids
•Theophylline
•Hydration(IV)
•Mask O2
•Anticholinergics
EMERGENCY ON CHAIR
Recognize symptoms
Stop dental procedures
Position pt. upright
Administer bronchodilators
Asthma terminates…
Continue the dental
procedures
Declare status
asthmaticus
Summon EMS
yes NO
CHRONIC BRONCHITIS (BLUE BLOATERS)
It’s a condition associated with excessive
tracheobronchial mucus production to cause
cough with expectoration for atleast 3 months
in a year for more than 2 consecutive years.
PATHOGENESIS
• Chronic bronchitis occurs as a result of
inflammatory process involving the airways
and distal airspace.
• Increased activity of oxidants combined
with reduced activity of antioxidants has
been implicated in development of
inflammation & COPD
Cigarette smoking
High conc. O2 free
radicals
Tissue damage
Activates eosinophils
and neutrophils
Inflammatory response
Further cigarette smoke, various
oxidants and activated neutrophils
damage alpha antitrypsin that is
required to prevent degradation of
elastin
CLINICAL FEATURE
• Persistent productive cough
• Over the period patient develops dyspnoea on exertion
• With further progression- patient develops hypercapnia,
hypoxia and mild cyanosis
• May land in emphysema
• Long standing- cor pulmonale and cardiac failure
HISTOLOGIC FEATURES
• Lymphocytic infiltration
• Enlargement of mucin secreting glands of trachea and
bronchi
• Small airways show:
• Infammatory cell infilteration
• Fibrosis of the bronchiolar wall
• Goblet cell metaplasia with mucous plugging
PATHOLOGICAL CHANGES
• Hypertrophy and hyperplasia of mucus
producing glands
• Reduction in ciliated cells
• Mucosal oedema and intraluminal mucus
plugs
• Reduction in the calibre of air passage.
TREATMENT
• Quitting smoking
• Staying away from secondhand smoke & other lung irritants,
• Taking medicines by mouth (oral) to open airways and assist clear away
mucus eg.Theophylline
• Taking inhaled medicines, like bronchodilators & steroids,
• Pulmonary rehabilitation
• Oxygen therapy
• Having lung reduction surgery to take out damaged parts of the lung
REFERENCES
• Tripathi AK, Salwani KK. Essentials of Medicine for Dental Students.
JAYPEE BROTHERS PUBLISHERS; 2015.
• Text book of Pathology, Harsh Mohan,6th edition
• Guggenheimer J, Moore PA. The patient with asthma: implications for
dental practice. Compend Contin Educ Dent. 2009 May;30(4):200-2,
205-7; quiz 208, 210. PMID: 19441736.
• Barnes PJ. Asthma mechanisms. Medicine. 2016 May 1;44(5):265-70.

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COPD and Asthma Guide for Dentists

  • 2. CONTENTS • Introduction • Definition • Causes • Understanding COPD • Bronchial asthma • Chronic bronchitis • References
  • 3. INTRODUCTION • A progressive disease that affects the lungs, making it difficult to breathe. • Other names : Chronic Obstructive Lung Disease (COLD) Chronic Lower Respiratory Disease (CLRD)
  • 4. WHO : • Currently the 3rd leading cause of death in the world. • Seventh leading cause of poor health worldwide. • More than 3.23million people died of COPD in 2019 accounting for 6% of all deaths globally. • Nearly 90% of COPD deaths in those under 70 yrs of age occur in low and middle-income countries(LMIC).
  • 5. DEFINITION Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway or alveolar abnormalities usually caused by significant exposure to noxious particles or gases.
  • 6. CAUSES Developed countries is tobacco smoking Developing world its because of exposing fumes Genetic condition called alpha-1 antitrypsin deficiency AGE
  • 7. UNDERSTANDING COPD • Normal lungs • COPD lungs
  • 8.
  • 9. BRONCHIAL ASTHMA A chronic inflammatory disorder of the airways. This causes an increase in the airway hyper responsiveness that leads to recurrent episodes of… Wheezing Breathlessness Chest Tightness Cough
  • 10. INCIDENCE • Asthma effects an estimated 25000 Indians every year • Adult women have a 30% greater prevalence than men • Around world 9.7% of female adults have asthma, compared to 6.2% of male adults.
  • 11. PATHOPHYSIOLOGY Trigger Factor Airway Inflammation Mucous hypersecretion Airway muscle constriction Swelling Bronchial membrane Narrow Breathing Passages Wheezing,cough,shortness of breathe, chest tightness
  • 12.
  • 13. COMPLICATIONS • Status asthmatics • Respiratory failure • Pneumonia • Atelectasis
  • 14. MANAGEMENT OF ASTHMA •Adrenergics (Beta 2 agonists) •Steroids •Theophylline •Hydration(IV) •Mask O2 •Anticholinergics
  • 15. EMERGENCY ON CHAIR Recognize symptoms Stop dental procedures Position pt. upright Administer bronchodilators Asthma terminates… Continue the dental procedures Declare status asthmaticus Summon EMS yes NO
  • 16. CHRONIC BRONCHITIS (BLUE BLOATERS) It’s a condition associated with excessive tracheobronchial mucus production to cause cough with expectoration for atleast 3 months in a year for more than 2 consecutive years.
  • 17. PATHOGENESIS • Chronic bronchitis occurs as a result of inflammatory process involving the airways and distal airspace. • Increased activity of oxidants combined with reduced activity of antioxidants has been implicated in development of inflammation & COPD
  • 18. Cigarette smoking High conc. O2 free radicals Tissue damage Activates eosinophils and neutrophils Inflammatory response Further cigarette smoke, various oxidants and activated neutrophils damage alpha antitrypsin that is required to prevent degradation of elastin
  • 19. CLINICAL FEATURE • Persistent productive cough • Over the period patient develops dyspnoea on exertion • With further progression- patient develops hypercapnia, hypoxia and mild cyanosis • May land in emphysema • Long standing- cor pulmonale and cardiac failure
  • 20. HISTOLOGIC FEATURES • Lymphocytic infiltration • Enlargement of mucin secreting glands of trachea and bronchi • Small airways show: • Infammatory cell infilteration • Fibrosis of the bronchiolar wall • Goblet cell metaplasia with mucous plugging
  • 21. PATHOLOGICAL CHANGES • Hypertrophy and hyperplasia of mucus producing glands • Reduction in ciliated cells • Mucosal oedema and intraluminal mucus plugs • Reduction in the calibre of air passage.
  • 22. TREATMENT • Quitting smoking • Staying away from secondhand smoke & other lung irritants, • Taking medicines by mouth (oral) to open airways and assist clear away mucus eg.Theophylline • Taking inhaled medicines, like bronchodilators & steroids, • Pulmonary rehabilitation • Oxygen therapy • Having lung reduction surgery to take out damaged parts of the lung
  • 23. REFERENCES • Tripathi AK, Salwani KK. Essentials of Medicine for Dental Students. JAYPEE BROTHERS PUBLISHERS; 2015. • Text book of Pathology, Harsh Mohan,6th edition • Guggenheimer J, Moore PA. The patient with asthma: implications for dental practice. Compend Contin Educ Dent. 2009 May;30(4):200-2, 205-7; quiz 208, 210. PMID: 19441736. • Barnes PJ. Asthma mechanisms. Medicine. 2016 May 1;44(5):265-70.

Editor's Notes

  1. The main difference between emphysema and COPD is that emphysema is a progressive lung disease caused by over-inflation of the alveoli (air sacs in the lungs), and COPD (Chronic Obstructive Pulmonary Disease) is an umbrella term used to describe a group of lung conditions (emphysema is one of them) which are ..
  2. Particularly at night and early morning
  3. Around 9.7% of female adults have asthma, compared to 6.2% of male adults.
  4. Extreme form of asthma Complete or partial collapse of lung
  5. Cigarette smoke produces high concentration of oxygen free radicals including super-oxide, hydrogen peroxide and hypochlorous acid. These are responsible for tissue damage and activation of eosinophils and neutrophils and inflammatory response is initiated.