Could there be a link between oral hygiene and the severity of SARS-CoV-2 infections?
The mouth is the gateway to the body. So it makes sense that good overall health starts with good oral health. A new study published in the highly respected, peer-reviewed British Dental Journal in June 2020 reflects that in a very relevant and urgent way. It concludes that poor oral hygiene may be connected to serious COVID-19 complications due to high levels of harmful oral bacteria. And that supporting good oral health should be included in your best practices during the pandemic.
COVID-19 affects people in different ways, with patients exhibiting a range of symptoms and severity. So why do some people suffer more severely? It’s become clear that bacterial superinfections are common in patients suffering from a severe case of COVID-19. Over 80% of COVID-19 patients in ICUs exhibited an exceptionally high bacterial load, with more than 50% of deaths exhibiting bacterial superinfections.
So while COVID-19 has a viral origin, it’s suspected that in severe cases, complications such as pneumonia and acute respiratory distress (ARDS) may be caused by bacterial superinfections.
And those bacteria may originate in the mouth.
How bacteria travel from the mouth to the lungs
Doctors know that lower respiratory infections are often caused by the inhalation of microorganisms—bacteria—into the body’s airways. The oral cavity houses more than 700 bacteria, viruses and fungi that can colonize the mouth. Various microbiological habitats exist within the mouth; however, the primary bacterial inhabitants are P. intermedia, S. mutans, F. nucleatum and P. gingivalis.
Bacteria that colonize 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. Periodontitis and decay are the two most common oral diseases associated with an imbalance of pathological bacteria in the mouth. This illustration from the British Dental Journal shows how that works.
Image by British Dental Journal
Reduce your risk with good oral hygiene
One key takeaway from this study is that, with COVID-19 and other viral diseases, 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.
Good oral hygiene has been recognized as a means to prevent airway infections in patients, especially in those over the age of 70. In fact, studies show that improved oral care can significantly reduce the incidence of ventilator-associated pneumonia in ICU patients.
“We 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.”
The other key takeaway? Improved oral hygiene may play a part in reducing the risk of complications. The authors write, “We 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.”
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- Could good oral health prevent severe cases of COVID-19?