Oral hygiene and severity of COVID-19 – the connection


British researchers have discovered a link between poor oral hygiene and the severity of the disease COVID-19 caused by a serious infection with the coronavirus, 2 of severe acute respiratory syndrome (SARS-CoV-2). The study researchers Victoria Sampson, of the dental practice 38 Devonshire Street, London, Nawar Kamona, Center for Nutrition Education & Lifestyle Management (CNELM), London and Ariane Sampson of Orthodontics, Cambridge University Hhospital Trust, United Kingdom have collaborated to find the link between the severity of the infection and poor oral hygiene. Their study entitled “Could there be a link between oral hygiene and the severity of the infections by SARS-CoV-2?” has been published in the latest issue of the magazine British Dental Journal.

Virus SARS-CoV-2 binding to the receptor ACE-2 in a human cell, the initial stage of the infection by COVID-19. Credit illustration: Kateryna Kon / Shutterstock

The pandemic of COVID-19

Since December of last year, there has been a steady increase in the number of SARS-CoV-2 or a new infection with coronaviruses that cause the COVID-19 diesase. The world health Organization (WHO) has declared the COVID-19 global emergency 30e January 2020, and the 11e in march 2020, was declared a pandemic when this virus is highly contagious and has infected people around the world. To this day, in the world, 10 434 385 people have been infected and there have been 509 779 deaths attributed to the virus in the world due to this infection.

On what was this study?

To date, researchers have identified several risk factors associated with the evolution and outcome of severe disease at the COVID-19. While many patients infected with the virus recover without complications, some may need hospitalisation, supplemental oxygen, and even a breakdown. Some of the risk factors associated with poor outcome of the disease include high blood pressure, obesity, diabetes, and heart disease. The team of researchers explained that 52% of the deaths due to the COVID-19 also occur in individuals in good health, and the cause behind this is not clear. They have written that the main complications of COVID-19 include “blood clots, pneumonia, sepsis, septic shock and ARDS (acute respiratory distress syndrome)”. These complications are seen mainly in those with comorbidities and overload bacterial, they wrote.

Results on the bacteria and COVID-19

The team assumes that there might be a link between infection by the SARS-CoV-2 and the “bacterial load”. They have tried to explore if high levels of bacteria or of bacterial infections and complications of bacterial infections, such as pneumonia, sepsis and respiratory distress syndrome could be associated with poor results from COVID-19.

Oral hygiene and COVID-19

This study explored the complications of the COVID-19 observed in people with poor oral health and periodontal disease. The microbiome oral or in the microbial flora of the mouth have been explored and its connection with the result COVID-19 was analyzed. The authors write: “We are exploring the link between high bacterial load in the mouth and the complications of post-viral, and how improved oral health can reduce the risk of complications of COVID-19”.

The authors of the study wrote that during a pulmonary infection, there is a risk of aspiration of oral secretions in the lungs, which could cause an infection. Some of the bacteria present in the mouth that could cause such infections include “Porphyromonas gingivalis, Fusobacterium nucleatum, Prevotella intermedia”, they wrote. They explained that the periodontitis or infection of the gums is one of the most common causes of harmful bacteria in the mouth. These bacteria lead to the formation of cytokines such as interleukin-1 (IL1) and tumor necrosis factor (TNF), which can be detected in saliva and can reach the lungs, causing an infection in their breast. As well, the researchers wrote: “an oral hygiene inadequate, may increase the risk of trade inter-bacterial between the lungs and the mouth, increasing the risk of respiratory infections and bacterial complications, potentially post-viral. “

Results of the study

The team wrote: “A good oral hygiene has been recognized as a means of preventing respiratory tract infections in patients, especially in those over 70 years old”. People with periodontal disease have an increased risk of 25% of heart disease, three times the risk of developing diabetes and a 20% increased risk of high blood pressure, the researchers write. These are all risk factors for COVID-19 severe, they wrote.

Conclusions and implications

This study concludes that 20 percent of patients with COVID-19 evolve into a serious disease, with high levels of “inflammatory markers (IL-2, IL-6, IL-10), bacteria and neutrophils in lymphocytes.” They noted that the microbial environment of oral and COVID-19 could be related. The four risk factors essential COVID-19 severe, diabetes, high blood pressure, heart disease and obesity, are also associated with poor oral hygiene, they wrote. They recommend that “oral hygiene is maintained, if not improved, during infection with SARS-CoV-2 in order to reduce the bacterial load in the mouth and the potential risk of secondary bacterial infection”. These precautions are particularly important for people with diabetes, high blood pressure, heart, they wrote.


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