In an article so titled, and published in the British Dental Journal on June 26, 2020, a team of researchers looked at the potential connection between oral bacterial load and COVID-19 complications. We here at Page Dental Group have reviewed the article as part of our ongoing effort to provide the best overall-, not just oral-, health care advice that we can to you, our patients.
Addressing the most commonly identified risk factors for developing SARS-CoV-2 complications – diabetes hypertension), obesity, and heart-disease– while noting that these factors do not account for a majority of deaths in seemingly healthy individuals, the article’s authors explore correlations between bacterial load (the measurable quantity of bacteria in an organism compartment, such as your mouth or your lungs) and bacterial superinfections (a second infection superimposed on an earlier one), to better understand why some patients may suffer from COVID-19 more severely than others.
The authors observe that it is common for respiratory viral infections to predispose patients to bacterial superinfections, leading to increased disease severity and mortality. As they point out, such was the case with both the influenza pandemic of 1918 and the H1N1 influenza pandemic of 2009, each of which resulted in more deaths from bacterial superinfections than from the respective viruses themselves. They go on to cite a variety of earlier COVID-19 studies, each having deduced a connection between the severity and the incidence of bacterial superinfection.
The article’s authors discuss several mechanisms to explain the potential role of oral bacteria in the pathogenesis of a respiratory infection, while noting both (1) that high bacterial and viral loads in the mouth can complicate a variety of systemic diseases, and (2) that the established comorbidities for COVID-19 are more likely to be present in individuals with periodontal disease.
The authors cite a number of other studies in support of the link between good oral care and a reduced risk of acute viral respiratory infections, including one systematic study that concluded one in ten pneumonia-related deaths in the elderly could be prevented by improving oral hygiene, and another that concluded improved oral care can significantly reduce the incidence of ventilator-associated pneumonia in ICU patients.
In view of all this, the article’s authors suggest the connection between the oral microbiome and COVID-19 complications should be more closely investigated, and recommend (1) that oral hygiene be maintained, if not improved, during a SARS-CoV-2 infection in order to reduce the oral bacterial load and the potential risk of bacterial superinfection, and (2) that poor oral hygiene be considered a risk to post-viral complications.
If you would like to read the article, the full citation is as follows:
Sampson, V., Kamona, N. & Sampson, A., Could there be a link between oral hygiene and the severity of SARS-CoV-2 infections?, Br Dent J 228, 971–975 (2020), available at Nature article.
We’ve done our best to summarize it for you, but like the underlying content itself, it’s a little complicated. If nothing else, however, the article’s content and recommendations leave us confident that maintaining good oral hygiene, whether by ensuring that you don’t suspend regularly-scheduled care or by simply maintaining a good home care routine, is as important as ever. In conclusion, we hope this post finds you well (and well-brushed).
* Image of coronavirus SARS-CoV-2 virus is courtesy of the Centers for Disease Control and Prevention (CDC)