the unexpected risk factor for coronavirus that is found in the mouth

The upholsterer, an older man, said while extending the metro that he had had coronavirus in January. He had had a bad time and had had after-effects: “The teeth… you don’t know. They move me. And the gums, all inflamed ”. By pulling this rope, a novelty has appeared: international research teams are watching with concern the link between Severe Covid and the periodontal disease, O gingivitis, chronic inflammation of the tissues that “grip” the teeth.

On Google, it’s easy to find stories worse than the upholsterer, marked by nightmarish images, such as tooth loss without bleeding, effect of the “end” Covid. However, it will be explained in these lines, it is isolated information, without precise scientific proof, it is therefore necessary to put it into perspective.

Either way, the relationship works, but the other way around: it would be yours periodontal disease, a condition which, according to the Argentinian Society of Periodontology (SAP), has – to some extent – more than 95% of the adult population (although the majority ignore it), who would amplify the body’s inflammatory response to Covid infection.

How do you know? Experts come to find periodontal disease bacteria in the lungs of people who have died from the coronavirus. The bridge, there is almost no doubt, exists.

For periodontists, this is nothing new. From the pre-pandemic they know that while the less the mouth is clean, the more the entry route for viruses and bacteria. In fact, the relationship of periodontitis with various infectious and cardiovascular diseases as well as with diabetes has been proven for years.

Some concrete facts about the Boca-Covid relationship can be found in a paper April this year at the prestigious Journal of Oral Medicine and Dental Research. It is entitled “Association between periodontitis and severe Covid-19 infection: a case-control study”.

Experts from Complutense Universities in Madrid (Spain), McGill in Montreal (Canada) and the University of Qatar studied 568 patients who had had Covid. The conclusions were overwhelming.

They deduced that periodontal disease had increased in these people 3.5 times the chance of hospitalization for the coronavirus, 4 times the need for mechanical breathing and almost 9 times the risk of death.

But how does this bridge come about?

Highway of pathogens

According to Claudio furman, specialist in periodontics, co-director of the career devoted to this specialty at Maimonides University and former president of SAP, “when there is periodontal disease, including gingivitis, which bleeds from the gums and the first stage of the periodontal disease, generates periodontal pockets. The epithelium, which is the skin that covers the inner part of the gum tissue, is shown ulcerada, something which in itself is linked to systemic pathologies of all kinds ”.

“These ulcers are an entry point for all kinds of pathogens. Viruses are comfortable in bags, which end up being viral reservoirs. From there to the blood circulation, the relation is direct. And that’s why a person who contracts Covid ends up having a faster negative progression of the disease if they also have periodontal disease, ”he continued.

There is more: “On top of that, periodontal disease itself is systemic inflammation. It seems to be localized in the mouth, but it affects the whole body. It is a generalized inflammatory process. “

Therefore, “if the Covid patient develops multisystem inflammatory syndrome (N. del R .: Also called a “cytokine storm”, an excessive immune response of the body against the virus), this answer could be overlap and amplify with the inflammation that periodontitis itself generates“.

Immunothrombosis

All this is also detailed in another paper recently published in the same journal, titled “The Covid-19 Pathway: A Proposed Oral-Vascular-Pulmonary Pathway for SARS-CoV-2 Infection and the Importance of Oral Health Care Measures.”

There, a team of British, American and South African scientists is examining the role of nasal, oral and saliva cavities as entry points and reservoirs for pathogens. They clarify how this bridge is reinforced if the patient, above, have periodontal disease.

“In the periodontitis, the entry of the virus into the circulation could be facilitated by micro-ulcerations in the epithelium of the bursa. Poor oral hygiene and plaque buildup can further intensify this path“, ensures the study.

Be marked: “From the gingival capillaries, the virus could reach the lungs via the vascular route, where it would trigger the main known pathological factor of the disease, the immunothrombosis“.

After a detailed examination of how this process works, the experts conclude with advice that should not be ignored: “Give priority to daily oral hygiene and oral medical care, because Such measures could save the lives of patients with Covid-19“.

Debate

In the absence of local statistics, Bugle consulted the American team “Covid survivors“(Survivorcorps.com) if they had received dental reports from their large community, which exceeds 160,000 members. They reported, based on a poll conducted by Facebook, that 28% of those consulted declared having had post-Covid oral sequelae.

However, in light of what has been said, these cases might rather reflect the worsening of a previous condition rather than the “sudden” onset of periodontal problems, which Furman called “very unlikely.”

“Logic Says Teeth Don’t Fall Out or Loosen Overnight. Of course, the weather could indicate something else, but at the moment nothing like that can be said, ”he said.

Consulted on this subject, Daniel Casim, head of the oral-maxillofacial service of Garrahan hospital and surgeon of the Clinic for Attention to Patients at High Medical Risk (CLAPAR-Faculty of Dentistry of UBA), confirmed to have seen “very rare cases Last year”.

“I didn’t do any scientific work, but what I saw was that the patients who had Covid and who came to my office they had their mouths destroyed, with loss of bone tissue, periodontitis with rapid progression, inflammation of periodontal tissue with loss of attachment and bone resorption, ”he recalled.

For Casim, “it is obvious that these patients went through a significant immune stress. Their defenses were lowered, the bacteria in their mouth surely increased and this could have caused periodontal deterioration. I have seen patients with almost exposed implants. In total, there will have been 10 or 12 cases throughout the year ”.

It would be risky to say that, in addition to periodontal disease can increase the severity of Covid, something similar is happening in the opposite direction.

For now, Furman has pointed out that “we need to make people aware that it is not normal for the gums to bleed. Inflammation is the first symptom. Good hygiene reduces the viral load in the mouth. It is as important as washing your hands. “

AS

TOPICS APPEARING IN THIS NOTE