THERE just might be a connection, little noticed, between oral bacteria and COVID-19 complications.
There is evidence that suggests bacteria are involved in respiratory diseases, such as those implicated in COVID-19.
Bacteria are also associated with chronic inflammatory systemic diseases including type 2 diabetes, hypertension and cardiovascular disease.
‘’These diseases are frequently reported comorbidities associated with an increased risk of severe complications and death from COVID-19,’’ say Jay Patel of the School of Dentistry, University of Leeds, United Kingdom, and Victoria Sampson of the Devonshire Street Dental Practice, London.
They make the observation in Lancet Microbe published online in July.
They cite the relevance of co-infections in the clinical outcomes and mortality of patients with Coronavirus Disease 2019 (COVID-19).
“We believe the role of oral bacteria in facilitating co-infections in COVID-19 is pertinent, yet overlooked,” Patel and Sampson observe.
Poor oral hygiene is considered to be a major ecological pressure that steers complex microbial communities in the mouth into dysbiosis or microbial imbalance inside the body.
It leads to an increased prevalence of oral bacteria that cause diseases.
Mastication, flossing and tooth brushing can induce bacteremia, the presence of bacteria in the blood. They facilitate the dissemination of oral bacteria.
This is why good oral hygiene is essential for controlling the total bacterial load in the mouth.
Numerous studies, for example, report that oral hygiene interventions in patients with pneumonia have substantially improved clinical outcomes and reduced mortality.
One in 10 pneumonia-related deaths of older nursing home residents (≥65 years) are considered preventable by improving oral hygiene.
Improved oral care has been shown to significantly reduce the incidence of ventilator-associated pneumonia in patients in an intensive care unit.
Patel and Sampson believe that further studies and clinical trials are required for the characterization of co-infections in COVID-19 and the potential connection between the role of the oral microbiome and complications arising from the virus.
“These data are vital to ascertain whether poor oral hygiene is a modifiable risk factor for COVID-19 complications and if there is a place for the promotion of good oral hygiene as a preventive public health intervention during the pandemic.”
In another paper, Sampson also looked into the risk factors already identified for developing complications from a COVID-19 infection.
The risk factors are age, gender and comorbidities such as diabetes, hypertension, obesity and cardiovascular disease.
These risk factors, however, do not account for the other 52 percent of deaths arising from COVID-19 in often seemingly healthy individuals, Sampson writes.
She says there is the potential link between SARS-CoV-2, the virus that causes COVID-19, and bacterial load.
It has been shown, for example, that bacteria may play a role in bacterial superinfections and complications such as pneumonia, acute respiratory distress syndrome and sepsis.
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Dr. Joseph D. Lim is the former Associate Dean of the UE College of Dentistry, former Dean of the College of Dentistry, National University, past president and honorary fellow of the Asian Oral Implant Academy, and honorary fellow of the Japan College of Oral Implantologists. Honorary Life Member of Thai Association of Dental Implantology. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515./PN
