How Oral Health and Severity of COVID-19 Complications Might Be Linked

by Dr. Gary Salwin

Right at the onset of the COVID-19 pandemic, it was made clear that older people infected with the coronavirus were most at risk of developing serious illnesses.

Those with diabetes, heart disease, hypertension, cancer, and lung disease were also warned of being at greater risk of experiencing severe COVID-19 symptoms.

Apparently, we can add people with serious gum disease to that list if the findings of studies exploring a possible link between oral health and severity of COVID-19 illness are to be believed.

Oral Bacteria and COVID-19

The British Dental Journal published an article in 2020 putting forward that there might be an association between a high bacterial load in a person’s mouth and severe COVID-19 symptoms.

According to the authors of the article, COVID-19 patients are at risk of aspirating high levels of oral bacteria, which is often caused by inadequate oral hygiene and severe gum diseases like periodontitis, into their lungs.

When this happens, the immune system will produce small proteins called cytokines, which help the body fight off infections.

However, there is a risk of releasing too many cytokines into the bloodstream and causing a cytokine storm, an overreaction by the immune system that can harm or even kill a patient.

According to this study, cytokine storms look like they’re one of the common causes of mortality among COVID-19 patients.

COVID-19 Patients With Gum Disease More Likely To End Up In ICU

Another study, this time published in the Journal of Clinical Periodontology (JCP), also links periodontal disease with more severe symptoms among patients diagnosed with COVID-19.

Conducted in Qatar using medical and dental data from the country’s national electronic health records, the study found out that COVID-19 patients with periodontitis were 3.5 times more likely to end up in intensive care, 4.5 times more likely to need assisted ventilation, and close to nine times more likely to die due to the coronavirus than those who are free of gum disease.

The study involved 568 COVID-19 patients, 258 of whom have periodontitis. Thirty-three out of those 258 COVID-19 patients with gum problems had to be admitted to the ICU, provided mechanical ventilation, or died.

There were also complications among the 310 COVID-19 patients who did not have gum disease, but the number of severe outcomes was pegged at only seven.

Further Studies Needed

The authors of the Qatar study, however, have made it clear that their research has clear limitations, and that people should be a bit cautious when perusing it.

As for the British Dental Journal article, studies are already starting to disprove the role of a cytokine storm in the severity of COVID-19 symptoms, like this one from Radboud University Medical Center claiming that COVID-19 is not characterized by a cytokine storm.

While medical experts understand more about COVID-19 today than they did at the beginning of the pandemic, their varying views underscore the fact that further studies are needed to establish a definitive link between oral health and the severity of COVID-19 illness.

Observing Proper Oral Hygiene Is Crucial

Then again, everyone needs to observe proper oral hygiene practices, with or without COVID-19.

Modern medicine has long established that our oral health affects our overall health, too.

As long as everyone brushes, flosses, and visits the dentist regularly, keeping billions of bacteria inside our mouths in check should be easy enough.

The part about visiting the dentist regularly or even getting emergency dental care in the middle of a pandemic could prove to be tricky, though.

Patients are primarily concerned about the risk of transmission of COVID-19 during a dental appointment, and that is understandable.

The pandemic has already severely impacted dentistry.

However, there is a glimmer of hope in the way dental professionals everywhere have been implementing recommendations from the Centers For Disease Control and Prevention (CDC) that help mitigate the risk of coronavirus infection.

While the risk of contracting the disease while at the dentist remains, the precautions that dental practices have put in place will hopefully have patients coming back soon and trusting their dentists to let them help take care of their oral health needs again.

About the Author

Dr. Gary Salwin leads the Glendale Dental Group, Arizona. He and his team treat dental emergencies and perform a whole range of dental services. He has been practicing dentistry for more than 36 years.