Poor outcomes for COVID 19 and several health conditions may be linked to periodontal disease.
Health researchers from different parts of the world have found an unexpected connection between poor oral health, more severe symptoms, hospitalisation and admission to ICU among those infected with COVID 19.
This connection was no surprise to an increasing number of specialists in diverse areas of medicine, dentistry, biostatistics and epidemiology who are investigating links between poor oral health and several non communicable diseases. To date, credible links have been found between patients with advanced periodontal disease and diabetes, chronic renal disease and cardiovascular disease. Separately researchers in Japan have found a strong correlation between the number of functional teeth present and life expectancy. 
The strongest evidence relates to the effect of severe periodontal disease and its association with poor blood sugar control and greater complications in type 2 diabetes. The relationship is unusually bidirectional in that the worse the glycaemic control, the worse the periodontal disease is, and vice versa.
Crucially treating the periodontal disease improves diabetes control to the same extent as certain drugs used to treat diabetes. A similar bidirectional causal relationship has been found between severe periodontal disease and chronic kidney disease. The World Heart Federation has joined up with the European Federation of Periodontology to produce recommendations for dental professionals, physicians and their patients on periodontal care in cardiovascular disease patients. It is becoming increasingly apparent that many expert scientific groups are convinced by the evidence linking severe periodontal disease with an expanding list of non communicable diseases.
The mechanism of how this happens is still the subject of ongoing research. The most compelling evidence supports the hypothesis of periodontal bacteria entering the bloodstream through micro ulcers in the gums of people with severe periodontal disease causing the elevation of C-reactive protein in the liver. This drives inflammation, increasing stickiness of red blood cells and a tendency towards blood clotting; it also generates oxygen radicals and alters lipid balance. These changes are part of a complex series of events that may lead to certain non communicable diseases in some but not all people. Some people may have a genetic predisposition to producing too much inflammation in response to a stimulus such as severe periodontal infection. A similar type of mechanism may also be present in those with severe periodontal disease and COVID 19 resulting in increased hospitalisations, ICU admissions and poorer outcomes. 
Maintaining good oral health and caring for your mouth could significantly improve your general health and also reduce your risk of developing severe COVID symptoms;
- Brushing twice daily
- Use a pea sized amount of fluoride toothpaste (1450ppm)
- Using dental floss and other inter-dental cleaners to keep your gums healthy
- Visit your dentist at least once a year and ask about your gum health
Hopefully we don’t catch COVID-19, but if we do, having good oral health and caring for our mouths could significantly reduce our risk of developing severe symptoms. Good oral health is also good for our general health.
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