Skip to main content

Chronic Obstructive Pulmonary Disease

Emphysema/Chronic Bronchitis#

Emphysema and chronic bronchitis are referred to as chronic obstructive pulmonary disease (COPD).

COPD has been graded according to airflow limitation:

Stage Severity FEV1/FVC FEV1 to normal
Stage IMild COPDFEV1/FVC<0.70FEV1 >80% normal
Stage IIModerate COPDFEV1/FVC<0.70FEV1 50-79% normal
Stage IIISevere COPDFEV1/FVC<0.70FEV1 30-49% normal
Stage IVVery severe COPDFEV1/FVC<0.70FEV1 >30% normal

FEV1 = forced expiratory volume in one second (the volume in a one-second forced exhalation)
FVC = forced vital capacity (the total exhaled breath)

Do you have emphysema?#

Emphysema is caused by injury to the alveolar epithelium, resulting in difficulties during exhaling but not during inhaling.

Patients may become “barrel chested” and are referred to as “pink puffers.”

Do you have chronic bronchitis?#

Bronchitis is caused by bronchial wall injury due to inflammation and mucus production, resulting in difficulties during exhaling and inhaling.

Patients can easily become cyanotic and are referred to as “blue bloaters" or "blue puffers.”

Do you experience difficulties, beyond breathing, due to your COPD?#

Patients with COPD are susceptible to developing bacterial pneumonia, pulmonary hypertension, or cor pulmonale (right-sided heart failure).

Is your COPD stable?#

Patients without shortness of breath at rest, without a productive cough, and with an oxygen saturation percentage above 91% are considered stabilized.

⚠️ Do not provide elective dental care for patients with low oxygen saturation levels.

What type of treatment do you receive?#

There is no cure for COPD. Medications are used to increase bronchodilation and reduce inflammation. Glucocorticosteroids are sometimes used as anti-inflammatory agents.

For stable COPD patients with respiratory symptoms and FEV1 between 60% and 80%: treatment with inhaled bronchodilators may be used.

For stable COPD patients with respiratory symptoms and FEV1 <60%: treatment with inhaled bronchodilators.

For symptomatic patients with COPD and FEV1 <60%: treatment with monotherapy using either long-acting inhaled anticholinergics or long-acting inhaled Ăź-agonists.

For symptomatic patients with stable COPD and FEV1 <60%: treatment with combination inhaled therapies (long-acting inhaled anticholinergics, long-acting inhaled Ăź-agonists, or inhaled corticosteroids).

For symptomatic patients with FEV1 <50%, or exercise-limited patients with FEV1 >50%: treatment with pulmonary rehabilitation.

For patients with COPD and severe resting hypoxemia with <55 mm Hg arterial partial pressure of oxygen (PaO2) or <88% arterial oxygen saturation (SpO2), measured by arterial blood gas: treatment with continuous oxygen therapy.

Related Pages#

References/Websites#