It has been almost a year since the COVID-19 pandemic ravaged the world. People got infected, some were asymptomatic, most became sick but recovered from the disease. But some recovered with long-lasting morbidities. Sadly over 2% of the people who contracted the disease died.
During this time, we have learned some patterns about the disease: we have seen that the disease has disproportionately affected those who are most disadvantaged. It seems that populations vulnerable to COVID-19, including those in low socioeconomic groups, minority groups, older adults, low-literacy individuals, those in rural areas, and the uninsured are also at increased risk for oral disease and associated systemic health problems.
The Centers for Disease Control and Prevention (CDC) notes that “non-Hispanic blacks, Hispanics, and American Indians and Alaska Natives generally have the poorest oral health of any racial and ethnic groups in the United States,” and these same populations have disproportionately higher incidence of COVID-19–related infection and death.
Populations at higher risk for many chronic diseases are similar to those at higher risk for developing oral diseases. Common risk factors include stress, poor diet, alcohol and tobacco use, substance misuse, behavioral health issues, domestic violence, and poverty. Many of these factors have been heightened during the pandemic. These and other social determinants of health lead to both exacerbation of chronic disease and poor oral health outcomes.
Because of the observations, some British researchers had done studies and found out that there is a link between poor oral health and severity of COVID-19 disease caused by SARS-CoV-2 infection. There was another study indicating that recovered COVID-19 patients who failed to maintain good oral hygiene continued to test positive for the novel coronavirus for longer periods of time. On average, those who didn’t keep their oral cavities clean continued to shed the virus for an additional two weeks.
Bacteria and COVID-19 outcome
The British team speculates that there may be a connection between SARS- CoV-2 infection and “bacterial load.”
We all know that there is a strong connection between poor oral health and other medical conditions like diabetes, cardiovascular diseases, pneumonia, pregnancy and birth complications.
It is clear that oral health is part of overall health and well-being. The mouth is indispensable to eating, speaking, smiling, and quality of life.
Why are the populations disproportionately affected by COVID-19 also at higher risk for oral diseases and with poorer oral health?
The amounts, varieties and predominant types of bacteria found in the mouths of people with healthy gums and people with poor oral hygiene are different. In general, gram-positive bacteria are more prevalent in healthy mouths than mouths with gum diseases (gingivitis and periodontitis). The “dirty” mouths would have more gram-negative and anaerobic bacteria like Porphyromonas gingivalis, Fusobacterium nucleatum, and Prevotella intermedia.
The four essential risk factors for severe COVID-19, diabetes, high blood pressure, heart disease, and obesity, are also associated with poor oral hygiene, they wrote.
Because of the inflammation created by the infection, inflammatory mediators like immunity cytokine, Interleukin and Tumor necrosis factor etc. are released and carried around by the blood vessels.
The inflammatory mediator’s proliferation generated by gum diseases in the month causes other organs and tissues away from the mouth to have focal or general inflammation in some organs. That is how oral diseases play an important role in diabetes, high blood pressure, heart disease, and obesity.
The correlation between gum diseases and severity of the COVID symptoms lies on the immune response from the body to the invasions of pathogens. Patients with COVID-19 who have severe symptoms are also having unusually high inflammatory responses from their immune systems that ultimately destroy the vital organs, which can lead to death. Patients who have chronic gum diseases tends to have heightened immune responses and that predispose their immune systems to over react to coronavirus in their bodies.
Oral hygiene and COVID-19
The potential positive relationship between COVID-19 and oral health reinforces the idea that prevention is a cornerstone of wellness.
The authors wrote, “We explore the connection between high bacterial load in the mouth and post-viral complications, and how improving oral health may reduce the risk of complications from COVID-19.”
Removal of the risk factors is the best treatments.
These precautions are particularly important for those with diabetes, heart disease hypertension, they wrote.
Patients should continue to see dentists to have their teeth examined and cleaned to maintain their oral health during the pandemic. Decay and other oral diseases should be treated sooner than later to arrest the progression.
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Call Dr. Wong at his dental clinic at (289)-861-5111, Affinity Dental Care, if you want to speak to Dr. Wong about your oral health issues that can be related to your overall health. Smile is the key to better total body health. Check out our Burlington Affinity Dental Care location.