THERE could be a link between bad teeth and gums and the consequences of COVID-19.
Unhealthy oral hygiene could be dire for COVID patients, suggests a study conducted at the University of Health Sciences (SBÜ) in Istanbul, Turkey.
Over in Canada, an international study also linked poor dental hygiene to more severe COVID symptoms.
It found that those with gum disease were 3.5 times more likely to be admitted to the Intensive Care Unit, 4.5 times more likely to require a ventilator and 8.8 times more likely to die from COVID-19 compared to those without gum disease.
The study in Turkey was conducted by SBÜ Associate Professor Dursun Ali Şirin and Associate Professor Fatih Özçelik.
“A healthy mouth is the first natural barrier against bacteria and viruses,” Dr. Şirin said, pointing out that the oral cavity is home to germs and bacteria. These pathogens may cause respiratory disease, a significant consequence of COVID infection.
The study does not prove a definitive link between poor dental health and more severe COVID-19 symptoms, Dr. Şirin emphasized. While its findings are significant, there are other factors to consider, he pointed out.
However, poor oral health impacts on the immune system, he said.
The study involved 1,500 people aged 20 to 65 years old and who had all tested positive for COVID-19. The study looked at their dental records.
It looked as well at their dental x-ray records, records of tooth cavities, gum bone loss, chronic oral infections and treatments. The patients were classified into four groups according to levels of dental damage: healthy, mild, moderate or severe damage.
“When we compared the data statistically, those who had severe dental damage, or the group with the worst dental and oral health, suffered more severely from COVID-19,” Dr. Şirin said.
Those who had severe complications or died had weak immune systems or had existing conditions such as lung conditions, obesity, diabetes and hypertension.
Ailments are linked to dental conditions as indicated by the higher risk of pneumonia in patients who had gum diseases, Dr. Şirin told the Anadolu Agency, a government news agency in Turkey. “For this reason, we believe that strengthening oral and dental health can help decrease the severity of COVID-19 symptoms.”
The study in Canada, led by researchers at McGill University in Ottawa, also looked at digital medical and dental records, this time of 568 Qatari patients with COVID-19.
Of the 258 patients with gum disease, 33 experienced complications during COVID infection. Only seven of the 310 patients with healthy gums experienced a complication.
“Looking at the conclusions of our study we can highlight the importance of good oral health in the prevention and management of COVID-19 complications,” said Dr. Belinda Nicolau, one of the study’s authors and a Professor at McGill’s School of Dentistry. “There is a very strong correlation between periodontitis and disease outcome.”
The Canadian study, published in the Journal of Clinical Periodontology, found that patients with gum disease had elevated levels of D-dimer and C-reactive protein in the blood; these are indicators of increased inflammation in the body.
The researchers believe that high levels of these indicators explain why patients have more severe reactions to the COVID virus.
Gum disease causes inflammation of the gums that, when untreated, can spread throughout the body,” said Wenji Cai, the study’s co-author and a PhD student at the McGill dental school.
“In patients with severe cases of COVID-19, the virus causes an inflammatory response that can lead to complications such as being intubated or even death,” she said, adding that the McGill research shows gum disease can worsen COVID conditions.
More study is needed to better understand the link between the two and to improve treatments, Ms. Cai said.
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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
