Gum disease linked to severe COVID-19 complications

Defence against inflammation from gum disease can potentially protect COVID-19 patients against life-threatening respiratory complicationsDefence against inflammation from gum disease can potentially protect COVID-19 patients against life-threatening respiratory complications.

This is according to research conducted by oral surgeon Dr Shervin Molayem and published in the California Dental Association Journal.

The new study links gum disease and COVID-19, suggesting the virus is more severe in the presence of inflammation caused by gum disease.

Bacteria in the gums travels through the body and spreads IL-6 protein, a harmful inflammatory. And high levels of IL-6 is a predictor for respiratory failure – carrying a 22 times higher risk for respiratory complications.

Higher mortality rate

As a result, the researchers are calling on better periodontal screening and treatment to help combat the spread of the virus.

‘Considering the potential impact of poor oral hygiene and periodontitis on respiratory infections and COVID-19, periodontal interventions are important to reduce the burden of oral bacteria and potentially decrease systemic inflammation,’ it reads.

It adds that periodontitis is a risk for other health conditions, such as cardiovascular disease and diabetes. These are also linked with a higher COVID-19 mortality rate.

‘Good personal hygiene has never been so crucial, including optimal daily oral hygiene,’ the study states.

‘Bacterial plaque can harbour respiratory and periodontal pathogens, which can reach the systemic circulation and invade host cells.

‘Keeping the burden of oral bacteria as low as possible can reduce the risk of aspiration to the respiratory tract.

‘Additionally, patients should be encouraged to brush their teeth twice per day for a minimum of two minutes with fluoridated toothpaste and perform interproximal cleaning.’

Improve and protect

The study’s take-home messages include:

  • COVID-19 can dysregulate the host immune response and increase IL-6
  • Oral diseases – especially periodontitis – can contribute to a systemic inflammatory response
  • Oral bacteria can affect the function of the lungs, increasing the risk for pneumonia and potentially COVID-related pulmonary complications
  • Additionally, oral hygiene interventions, as well as periodontal and dental treatment, can decrease the burden of oral bacteria.

It adds: ‘Despite the current lack of studies on this topic, the potential of oral hygiene and periodontal interventions to decrease the burden of oral bacteria and inflammation, improve general health and protect against severe complications from coronavirus disease, should not be underestimated.’

Importance of dental teams

Dental hygienist and therapist Karenn Helmrichne Davila emphasises the importance of her role in reducing COVID-19 transmission.

‘The role of dental hygienists and therapists has always been vital in the prevention of dental diseases such as tooth decay. But more-importantly gum diseases, an inflammatory diseases formerly known as periodontal diseases,’ she said.

‘Notably with the sound growing evidence of the correlation between gum diseases and COVID-19 infection. Especially the risk factors of COVID-19, which are the same as periodontal diseases (e.g. diabetes heart conditions). Our role has become a necessity to prevent the development of severe symptoms from COVID19 infection.’

She believes oral hygiene education is crucial – adding that tips and advice should be tailored to each patient.

Work together

‘Oral hygiene coaching plays a major role in the management of periodontal diseases and in lessening the development of severe symptoms from COVID-19 infection,’ she said.

‘As a dental therapist and hygienist, it is my job to make sure patients understand that the inflammatory processes caused by gum diseases have a knock on effect on the lungs which exacerbate COVID-19 symptoms. All this can be prevented by removing the bacteria within their plaque.

‘Having assessed my patient’s physical and systemic conditions, I tailor new oral hygiene habits specifically for them.

‘I do not give orders, neither tell them what to do. Instead, we work together using patient’s current habits with some modification – tell show do techniques usually works well.

‘Patients are normally good at telling what they like about cleaning their teeth or what makes brushing their teeth easier. Based on this, I modify their oral hygiene tools. I do not stick to a particular oral hygiene device because one does not fit all.’

The full study can be read here.

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