So what's the link between COVID-19 and the mouth?
There is emerging research showing that there is a link between periodontitis and COVID-19. A review due to be published next month in the Journal of the California Dental Association and titled 'The Mouth-COVID Connection: Il-6 Levels in Periodontal Disease - Potential Role in COVID-19-Related Respiratory Complications,' examined the available information and studies related to oral bacteria, periodontitis, the pro-inflammatory chemical mediator interleukin-6 (IL-6) and COVID-19.
The review noted that high levels of IL-6 in hospitalized patients with COVID-19 may predict respiratory failure, and that the same pro-inflammatory mediator is involved in periodontitis. The authors also pointed out that links have previously been found for periodontitis and other respiratory conditions, as well as a potential role for IL-6 in increasing the severity of viral infections in general. Increased levels of IL-6 are found in patients with periodontitis, intimately involved in destruction of the periodontal tissues, and IL-6 is found in serum in patients with periodontitis. As stated, it is also known that significantly lower serum levels of IL-6 have been found in patients with periodontitis after receiving periodontal treatment. Given these facts, it is biologically plausible that there is a link between periodontitis, COVID-19 and its severity.
As dental professionals, it is important that we are aware of these findings and use this information to reinforce the importance of oral hygiene, prevention of periodontal disease and, for patients with periodontal disease, that periodontal therapy is important. Given that the prevalence of periodontitis increases with age, and that older individuals are at increased risk for COVID-19 of greater severity, it is especially important that our older patients understand this.
So what should we do to help our patients?
- Educate patients of the importance of periodontal health and the connection with other systemic conditions, e.g., diabetes, cardiovascular disease
- Let patients know that there is a potential link between periodontal (gum) disease and respiratory problems in patients with COVID-19
- Stress that good oral hygiene is necessary for oral health and mention the associations with systemic health
- For patients who already have periodontal disease, emphasize the importance of periodontal therapy and regular visits for check-ups and periodontal maintenance.
We can also make sure our patients understand how to perform good oral hygiene and provide them with recommendations, such as:
- Educating patients on good oral hygiene technique and recommended toothbrushes, such as the Colgate 360 toothbrush
- Recommending a next-generation toothpaste. Colgate Total is a multi-benefit toothpaste that promotes Whole Mouth Health
- Recommending that patients also use an antibacterial mouthrinse, such as Colgate Total 12hr Pro-Shield Mouthwash which reduces plaque, can help prevent gingivitis, and provides 12-hour protection when used after brushing
- Recommending suitable recall periods for regular dental check-ups as well as an appointment with the dental hygienist.
Ensuring our patients are aware of the importance of oral hygiene and periodontal health is always important. The current situation and recent findings on COVID-19 are one more reason to stress the importance of good oral hygiene and oral health and to make recommendations on how patients can achieve this.
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