COVID 19 and Gums

COVID 19 and Gums
As we get deeper into the Covid 19 Pandemic, we are discovering there are numerous factors that both protect us from the disease and can exacerbate the symptoms and effect the outcomes should one fall ill with the disease. We have been learning, for example, that studies suggest that gum disease may be associated with higher risks of complications from COVID-19, including ICU admission and death. As many as half of all American Adults have some form of gum disease, so it is important to understand the relationship between COVID-19 risks and gum disease.
How are inflammation of the gums, and COVID-19 infections related?
The entrance gate for the SARS-CoV-2 (COVID-19) virus is not only the nose but also the mouth. It is precisely in this area that there is chronic inflammation in gum disease. At the same time, a COVID-19 infection is also characterized by systemic inflammation in the body, so that both processes have certain similarities. This in turn can have an impact on the course of the disease in COVID-19.

Does this mean that patients with periodontal disease are at higher risk of developing severe COVID-19?
Yes. A recent international study showed that patients with periodontal disease, regardless of other risk factors such as heart disease, high blood pressure, or diabetes, are up to 8 times more likely to develop an unfavorable course of COVID-19 infection. This means that these patients are more often required intensive care or have to be ventilated.

But why are periodontitis patients more likely to develop COVID-19 or have serious complications more often?
There are different hypotheses. If the gums are inflamed, the virus can enter the cells more easily. On the other hand, bacteria that cause gingivitis can form a film of bacteria on the gums and teeth that other bacteria can cling to. Bacteria that cause pneumonia, for example, can settle in the oral cavity. If the patient is weakened by COVID-19, bacterial pneumonia can break out and lead to a severe course of the infection and complications.

What is your current advice to patients who suffer from bleeding gums, receding gums, bad breath or who have already been diagnosed with periodontal disease?
In any case, despite the pandemic, you should visit your dentist and keep the regular preventive appointments. Patients who have already been diagnosed with periodontal disease should also have their teeth professionally cleaned every three to four months. Especially in older patients it has been shown that the incidence of pneumonia is lower if their teeth are cleaned more often. In this respect, regular follow-up treatment at the dentist is medically useful for this group of patients, even in times of pandemic.

What can each individual do at home to promote good oral hygiene and reduce sources of inflammation?
In short: brush your teeth twice a day and brush your tongue with a toothbrush in the evening. And ideally also clean the interdental spaces every day with dental floss or interdental brushes. All of this ensures good oral hygiene, reduces gum inflammation and destroys the dangerous bacterial film on the teeth.