Article | 2020-07-20 03:01:02
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Relationship between Oral Health and the Severity of COVID-19 Complications
Most patients with severe complications from COVID-19 have underlying conditions such as obesity, diabetes, and hypertension. There is also evidence of an association between periodontitis and non-oral systemic disease. The oral cavity is also a gathering place for bacteria that are harmful to the respiratory tract, and patients with periodontal disease are at greater risk of developing hospital-acquired pneumonia than healthy people.
The new SARS-CoV-2 Coronavirus was first detected in late 2019 and quickly developed into a global pandemic. Age is one of the highest risk factors for experiencing severe symptoms of COVID-19 or a disease caused by infection with SARS-CoV-2. Thus, individuals over the age of 65 and those who live in long-term health facilities are highly vulnerable to morbidity and mortality due to SARS-CoV-2 infection. However, people with chronic lung disease, moderate to severe asthma, severe obesity, diabetes, chronic kidney disease, and liver disease are also at high risk for severe symptoms of COVID-19. A recent study included the conditions of hypertension, obesity, and diabetes as three main conditions that underlie poor conditions in COVID-19 patients who require hospitalization.
While COVID-19 can affect many organs in the body, including the kidneys and liver, the main cause of death is due to the ability of SARS-CoV-2 to infect the respiratory tract, which causes severe pneumonia. Patients with COVID-19 show symptoms of fever, cough, shortness of breath, and other complications associated with acute respiratory distress syndrome.
Oral health and non-oral systemic diseases
Over the past few years, it has been proven that oral health has a large impact on general health. Several studies have shown that cytokines or microbial products released systemically in response to oral infections cause inflammation of the body's organs far from the mouth, which increases the development of systemic diseases such as Alzheimer's disease, diabetes, atherosclerotic heart disease and cerebrovascular disease. Research also shows that poor oral health can increase complications of systemic diseases such as diabetes, chronic kidney disease and liver disease. In contrast, obesity affects individuals against oral diseases, especially gum inflammation and periodontitis.
In addition, the oral cavity is a gathering place for bacteria harmful to the respiratory tract, including Chlamydia pneumoniae; and patients with periodontal disease are more likely to suffer hospital-acquired pneumonia as a complication. Several mechanisms can explain the ability of oral pathogens to exacerbate lung infections, including inhalation of bacteria into the lower respiratory tract, especially in high-risk individuals; changes in the surface of the mucosa along the respiratory tract by salivary enzymes, thereby facilitating the colonization of harmful bacteria. Improving oral hygiene can reduce oropharyngeal colonization and risk of respiratory complications.
It has been proven that improving oral hygiene and frequent oral health care by dental professionals reduces the development or occurrence of respiratory diseases, especially in the elderly population and those in intensive care units. This population is also most at risk of developing serious complications associated with COVID-19.
Older adults and people of all ages who have serious medical conditions such as chronic lung disease, diabetes, heart conditions or chronic kidney disease are at high risk for severe illness due to SARS-CoV-2 infection. At the same time, poor oral health increases the risk of suffering from this medical condition. Therefore, improving oral health in people of all ages, by reducing the risk of developing non-oral systemic disease, can reduce the risk of COVID-19 disease. Although the relationship between oral health and the severity of COVID-19 symptoms seems logical, more research is needed to show this relationship empirically.
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