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Gum Disease Associated to COVID-19 and Other Medical Conditions

As we learn more about COVID-19, the virus is being associated to several medical conditions and complications in patients that have been infected. A recent study found gum disease can be associated with severe COVID-19 outcomes and other medical conditions. To understand how gum disease is associated to COVID-19, it's important to know what gum disease is and how it can be linked to other complications in the body.

What is gum disease?

Gum disease is a common type of dental disease that affects the supporting structures of the teeth such as the gum tissue and the bones surrounding the teeth. Gum disease is different than tooth decay in that it causes holes in the bones that support the roots of the teeth. Tooth decay causes holes in cavities. Gum disease is so common that 90% of the population has the disease. It's primarily caused by neglect of not brushing and flossing on a daily basis, and not regularly going to the dentist.

What causes gum disease?

A body responds to a bacterial infection in the gums through inflammation. This process may contribute to the term "cytokine storm" in which proteins are released and may be associated with an over exuberant inflammatory response that destroys tissues elsewhere in the body.

"Those same inflammatory products can enter the blood stream through infected gum pockets around the teeth," says David Okano, DDS, MS, section head of periodontics at the University of Utah School of Dentistry. "When inflammatory products from gum disease enter the blood stream, those products can go to other body organs and potentially cause tissue damage."

How is gum disease and COVID-19 linked?

A study to be published in the October 2020 issue of the Journal of the California Dental Association (JCDA) suggests that hospitalized coronavirus patients with prior underling gum disease may be at higher risk for respiratory failure. The study indicates that symptoms of chronic periodontitis, such as bone loss, may lead to more severe COVID-19 complications.

"They have higher levels of inflammatory products circulating, and, therefore, have more potential to cause damage in the lungs," Okano says.

Damage in the lungs can lead to respiratory failure and require hospitalized COVID-19 patients to be put on a ventilator. While this research is in its early stages, what is known is that periodontal health is connected to your overall systemic health.

There is a growing body of scientific evidence that supports gum disease may be associated with other health complications. Years of research has found diabetic patients are more susceptible to gum disease.

"We know patients who are diabetic and not well controlled can be more prone to infection," Okano says.

The effect of gum disease and diabetes is referred to as "bi-directional" which means there's influence both ways. Gum disease is not only more likely to occur in a patient that has uncontrolled diabetes, but inflammation in gum disease makes it harder to control diabetes. Diabetes has also been listed as an underlying health condition that might increase risk of severe illness from COVID-19.

Who is susceptible to gum disease?

Everyone is susceptible to gum disease, but some may be a greater risk. According to several NHANES studies, individuals over the age of 65 have a greater severity of gum disease. Hispanic populations and African Americans may also have higher incidences of periodontitis.

How can you prevent gum disease?

Prevention is the key to gum disease, stresses Okano. It's important to brush and floss your teeth daily. An individual should also see their dentist regularly, at least every six months. Those with more severe forms of gum disease should see a periodontist.