Oral Health And Severity Of Covid-19
Coronavirus is a strain of the severe acute respiratory syndrome‐related coronavirus (SARr‐CoV), member of the Coronaviridae family and the responsible agent of the disease referred to as COVID‐2019.
The role of your mouth in COVID‐19 has been controversial. It is common for respiratory viral infections to predispose patients to bacterial superinfections, leading to increased disease severity and mortality.
During lung infection, there is a risk of aspirating the oral secretions into the lungs, which could cause infection. Periodontitis and decay are the two most common oral diseases associated with an imbalance of pathological bacteria in the mouth. These bacteria lead to the formation of cytokines which can reach the lungs leading to infection within them.
Therefore, inadequate oral hygiene can increase the risk of inter-bacterial exchanges between the lungs and the mouth, increasing the risk of respiratory infections and potentially post-viral bacterial complications.
A high bacterial and viral load in the mouth can further complicate systemic diseases such as cardiovascular disease, cancer, neurodegenerative disease and autoimmune diseases, further supporting the link between mouth and body. The established risk factors for COVID-19 (age, gender and comorbidities) are also heavily implicated in imbalances in the oral microbiome.
The four main comorbidities which are diabetes, high blood pressure, heart disease, and obesity-associated with an increased risk of complications and death from COVID-19 are also associated with altered oral biofilms and periodontal disease, hence why the link between poor oral health and COVID-19 complications is suggested.
We recommend that poor oral hygiene be considered as a risk to post-viral complications, particularly in patients already predisposed to altered biofilms due to diabetes, hypertension or cardiovascular disease. Bacteria present in patients with severe COVID-19 are associated with the oral cavity and improved oral hygiene may play a part in reducing the risk of complications.
How can you protect your oral health during COVID-19?
- Wash your hands– aim for at least 20 seconds before and after any personal dental care
- Brush your teeth 2x daily using a pea-sized amount of toothpaste. Avoid brushing vigorously because that can damage your gums.
- Floss your teeth at least once a day.
- Use a mouth rinse after brushing and flossing to help eliminate any leftover particles.
- Limit sugary foods and drinks intake.
- Drink plenty of water throughout the day.
- Maintain a well-balanced diet.
- Avoid smoking.
- Change your toothbrush once every 3 months.
- Routine check-ups and regular cleanings with your dentist.
Bacteria that colonise the mouth are shed into the saliva. The pathogenic bacteria within the saliva can then be aspirated into the lower respiratory tract and cause or aggravate an infection. Reproduced from Scannapieco F A, Role of Oral Bacteria in Respiratory Infection, J Periodontol, 1999.