Although there has yet to be a single documented case of a patient getting COVID from visiting the dentist, some people remain hesitant about keeping up with their regular dental visits, especially as the news remains filled with stories of surging cases.
Truth be told, your dentist or hygienist is apt to be more exposed to dental aerosols than you are – and thus more apt to become infected. Yet research done in Italy during their terrible initial surge found that even dental workers faced a near-zero risk of exposure when standard safety procedures are followed, such as those we implemented back in the spring and continue to follow for both your protection and ours.
And this is good, because regular exams and cleanings are an important part of maintaining good oral health, and research continues to suggest that keeping your mouth healthy may also help protect against COVID.
For instance, one paper published last month in Medical Hypotheses focused on the relationship between gum disease and COVID severity.
Diverse factors and comorbidities have been closely associated with PD [periodontal disease] such as diabetes, obesity, aging, hypertension, and so on; although, underlying mechanisms or causal associations have not been established completely. Interestingly, these same factors have been widely associated with progression or severe coronavirus disease 2019 (COVID-19), an illness caused by coronavirus SARS-CoV-2. Since inflammatory and dysbiotic factors as well as comorbidities affect systemic health, it is possible that periodontal status indicates the risk of complication of COVID-19.
And a slightly earlier study in fact found a higher risk of COVID-related death in patients with poor periodontal health.
Hospitalized COVID-19 patients with high levels of interleukin (IL-6), a harmful protein produced by periodontitis, were at significantly greater risk of suffering life-threatening respiratory problems during the three-month study.
The study was prompted by earlier research regarding hospitalized COVID-19 patients in Germany who were tested for IL6 while they were in critical condition and unable to breathe without the help of a ventilator.
According to the researchers, the study suggests that COVID-19 patients with bad gums face a much greater risk of generating harmful IL-6 proteins that spread to their lungs and trigger a life-threatening respiratory crisis.
“Gum disease has been linked to other breathing ailments, including pneumonia and chronic obstructive pulmonary disease, so we weren’t surprised to find a link to respiratory problems with COVID-19,” said researcher Shervin Molayem, DDS, a dental surgeon based on Los Angeles and founder of the UCLA Dental Research Journal.
Earlier this year, a review of the literature similarly suggested a link between poor oral health and worse COVID outcomes. “Good oral hygiene,” its authors wrote, “has been recognised as a means to prevent airway infections in patients, especially in those over the age of 70.” This is because the mouth is a primary route of entrance for pathogens like SARS-CoV-2. The virus is easily inhaled into the respiratory tract, where it can trigger superinfections.
It is common for respiratory viral infections to predispose patients to bacterial superinfections, leading to increased disease severity and mortality; for example, during the influenza pandemic in 1918, where the primary cause of death was not from the virus itself but from bacterial superinfections. The same was apparent in the 2009 H1N1 influenza pandemic, where again bacterial superinfections were the primary cause of death as opposed to the virus itself.
Meantime, other research has found that certain oral hygiene practices may reduce the viral load and thus reduce transmission of the coronavirus. Several studies – such as this one, for instance – have found that certain mouthwashes may be helpful.
Another study looked at the oral hygiene and infection-control habits of just over 300 COVID-positive patients in Spain who were living with others. The researchers found that patients were less likely to pass along the virus to others in the household if they routinely cleaned their tongues.
This result can be interpreted to indicate the tongue as the main oral organ acting as a reservoir of COVID-19 and the importance of brushing to decrease the viral load of the individual carrier.
If you’ve been putting off that dental visit out of fear of COVID, maybe think of it another way: By avoiding the dentist, you might actually be raising your risk in the long run.