Coronavirus patients who have been hospitalized are far more likely to die of respiratory failure if they suffered from periodontitis before contracting COVID-19, according to an international team of dental researchers.
Hospitalized COVID-19 patients with high levels of interleukin (IL-6), a harmful protein produced by periodontitis, were at significantly greater risk of suffering life-threatening respiratory problems during the three-month study. The study was prompted by earlier research regarding hospitalized COVID-19 patients in Germany who were tested for IL6 while they were in critical condition and unable to breathe without the help of a ventilator. According to the researchers, the study suggests that COVID-19 patients with bad gums face a much greater risk of generating harmful IL-6 proteins that spread to their lungs and trigger a life-threatening respiratory crisis. “Gum disease has been linked to other breathing ailments, including pneumonia and chronic obstructive pulmonary disease, so we weren’t surprised to find a link to respiratory problems with COVID-19,” said researcher Shervin Molayem, DDS, a dental surgeon based on Los Angeles and founder of the UCLA Dental Research Journal. “What shocked us was the discovery of the protein’s devastating, life-threatening impact to patients once they’re hospitalized. One tiny, inflammatory protein robbed them of their ability to breathe,” said Molayem. The researchers determined that hospitalized COVID-19 patients with periodontitis IL-6 levels above 80 pg/ml are 22 times more likely to suffer from acute respiratory problems and placed on a ventilator compared to patients with IL-6 levels below 80 pg/ml. According to the researchers, COVID-19 patients who suffer respiratory failure face grim odds for recovery, with almost 80% of those placed on ventilators in the United States since the beginning of the pandemic dying. The researchers further note that their findings underscore the need for people who believe they may have gingivitis or more serious gum disease to get their teeth and gums checked and cleaned as soon as possible. Elderly patients are more likely to suffer from chronic gum disease than any other age group, the researchers added, and this demographic faces significant risks from COVID-19 as well. “I’m 70 years old, which puts me in the age group of COVID patients who are more likely to die than anyone else,” said Jonathan Green, a Los Angeles resident recently diagnosed with gum disease at Bedford Dental. “That’s why I’ve been compulsive about masking and other precautions. I’ve been lucky so far, but I’m worried my luck may run out now that I’ve been diagnosed with gum disease,” he said. The researchers hope their findings will compel nursing homes to implement a dental screening protocol that will help them determine which patients are more susceptible to gum disease and elevated IL-6 protein levels. They also urge hospitals and emergency room doctors who continue to admit COVID-19 patients to take a moment with each new patient and check them for gum disease, a diagnosis that may prompt them to direct nursing staff to be vigilant over the patient’s breathing. Plus, the researchers hope that dentists will begin to educate their patients about life-threatening disease they may be at risk of contracting if they don’t take care of their teeth and gums by brushing and flossing regularly and getting tested twice a year for hum disease. Since the cause of death with COVID-19 is out of control inflammation, Molayem said, he believes the solution to survival and recovery from the virus is to decrease inflammation in the body wherever possible, including the gums. “While you can’t stop COVID-19 with your toothbrush, you may be able to reduce its severity,” said Dr. David Corradi, president of the California Society of Periodontists. “This highly relevant study demonstrates how inflammation may be associated with severe COVID-19, and it underscores the importance of being screened and treated for periodontal disease,” Corradi said. The researchers also note that periodontal disease is the most underdiagnosed ailment in dentistry and urge everyone who thinks they may have periodontitis to get tested and treated as soon as possible because its link to COVID-19 is real and deadly. “As the death toll keeps climbing, the CDC now predicts the virus will be among the leading causes of death in the United States, just behind heart disease and cancer,” said Molayem. “Now that we’ve confirmed periodontitis makes it even deadlier, if you’re worried that you may have gum disease, your next trip to the dentist may actually save your life,” he said. The study, “The Mouth COVID Connection,” will be published in October by the Journal of the California Dental Association.