Unfortunately, the COVID-19 pandemic is far from over. As healthcare professionals struggle with the challenges of new variants and low vaccination rates, research continues on treatment options and preventative measures. An encouraging recent finding, however, may prove to provide an extra layer of protection against the attack of the virus on the lungs of patients.
In December we reported on studies that showed a possible link between COVID-19 and oral health. The data suggested coronavirus patients with underlying gum disease may have a higher risk of life-threatening health complications from the virus, and pointed to the levels of inflammation caused in the body from gum disease. Studies showed that COVID-19 patients with high levels of IL-6, the inflammatory proteins present in gum disease, are at greater risk of being hospitalized, putting them at 22x higher risk of being placed on a ventilator.
A recently published hypothesis, however, has the potential to change the course of the pandemic.
A Surprising Radiologic Finding
This game-changing hypothesis, recently published in the Journal of Oral Medicine and Dental Research, was founded from radiologic lung image findings in COVID-19 patients. The radiologist credited with the findings noticed that the disease pattern seen radiographically in COVID-19 lung disease did not match other viral lung infections. COVID-19 lung disease develops in the base of the lung, as opposed to the mid- and upper areas, as typically seen with infections caused by inhaled pathogens. So if the virus is not inhaled, then how does it reach the lung vessels?
“With the knowledge that saliva is a reservoir for the virus and that salivary viral levels are strong predictors of poor outcome and disease severity, as well as findings suggesting that SARS-CoV-2 does not reach the lungs through inhalation, we propose that the virus enters the blood circulation in the mouth, from where it reaches the lungs.”*
As described in our December post, the inflammatory proteins in the mouth flood the site of gum disease, and can then travel through the bloodstream to the lungs. If the virus is present in your saliva, it may reach the lungs that way as well. So not only does gum disease increase your risk of being hospitalized and placed on a ventilator, it can actually be the pathway of the virus INTO the lungs.
So what does this mean?
“If the hypothesis is proven correct, decreasing the viral load in saliva can mitigate transmission and decrease the risk for lung complications and death. Simple measures can prevent the virus from entering the blood circulation in the oral cavity.”*
This means that simple measures could reduce your risk of contracting COVID-19, measures such as toothbrushing twice daily for at least 2 minutes with a fluoridated toothpaste, along with daily flossing and regular dental visits. (Periodontitis patients are likely to need longer brushing times).
More significantly, the use of commercial mouthwash products, for 30 seconds twice a day, could inactivate the virus before it has a chance to get to the lungs. Although there are few clinical studies on the effect of oral rinses on COVID lung disease, this simple measure could potentially lower the risk for viral entrance to the blood circulation and COVID-19 lung disease, while we wait for clinical studies to confirm the hypothesis. Science strongly suggests that COVID-19 lung complications can start in the mouth, so this is also where preventive measures should begin.