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picture of a hand holding a picture that reads "just breathe"Just as your mouth and gut are connected – the health of one depending on the other – so, too, your mouth and lungs. As one recent review put it, the mouth and lungs 

are part of a continuum. This continuity is reflected in their microbiomes. Emerging evidence suggests that dysbiosis of the oral cavity is at the very least associated with and may impact the progression of several lung pathologies.

That is, an overload of harmful bacteria in the mouth may contribute to lung conditions such as cystic fibrosis, COPD, and pneumonia by being inhaled. One study cited in the review, for instance, found that 

Accumulation of dental plaque increased with ICU stay duration, which also increased the likelihood of colonization by aerobic pathogens. This then led to nosocomial infections. [“Nosocomial” means originating in a hospital.]

This reinforces studies like the one we told you about this past spring, which found “substantial evidence” that poor periodontal health is associated with respiratory disease. And new studies on the mouth/lung connection continues to be published all the time. 

This is certainly understandable considering that breathing issues stemming from COVID-19 infections are severe enough to put nearly 20% of US patients diagnosed with the virus in the hospital. Many go on to develop more severe complications such as pneumonia and acute respiratory distress syndrome (ARDS). 

Because of what we know about the link between oral and lung health, a new paper in the BDJ asks the question explicitly: “Could there be a link between oral hygiene and the severity of SARS-CoV-2 infections?” And could that mean that good oral hygiene – keeping a healthy balance of bacteria in the mouth – be in some way protective? After all,

The four main comorbidities 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. Periodontopathic bacteria are implicated in systemic inflammation, bacteraemia, pneumonia and even death. Periodontopathic bacteria is also present in the metagenome of patients severely infected with SARS-CoV-2, where high reads for Prevotella (493 reads), Staphylococcus (1,659 reads) and Fusobacterium (463 reads) were discovered. It is clear that bacterial superinfections are common in patients suffering from a severe case of COVID-19, with more than 50% of deaths exhibiting bacterial superinfections. Furthermore, it is common for respiratory viruses to predispose patients to bacterial superinfections, as seen in the influenza outbreaks in 1918 and 2009. Over 80% of patients in ICU exhibited an exceptionally high bacterial load, and treatment has been successful with a dual regime of an antiviral and an antibiotic.

woman brushing her teethBecause of this, the authors recommend “that oral hygiene be maintained, if not improved, during a SARS-CoV-2 infection in order to reduce the bacterial load in the mouth and the potential risk of a bacterial superinfection.” Better oral hygiene, they add “may play a part in reducing the risk of complications.”

So does that just mean brushing and flossing as you should – twice daily for brushing and once for flossing? 

That’s a start. But there’s more you can do. For instance, oil pulling is well-known to be effective at reducing harmful bacteria and staving off gum disease. Probiotics and prebiotics – through foods, supplements, and even toothpastes and other hygiene products – may also help you maintain healthy bacterial balance in your mouth. Healthful eating also plays a role. 

Additionally, recent research suggests that oral rinses containing ingredients such as chlorhexidine and hydrogen peroxide may reduce infection risk, at least in the short term. 

So what do you plan on doing to take your home hygiene to the next level? 

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