COVID-19 Resource Center

COVID-19 Resource Center

Disclosures: Hoss reports no relevant financial disclosures.
June 19, 2020
2 min read

Q&A: Oral health a ’piece of the puzzle‘ in overall health during COVID-19

Disclosures: Hoss reports no relevant financial disclosures.
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Maintaining oral health is an important factor in overall health and may have an essential role during the COVID-19 pandemic, an expert told Healio Primary Care.

Studies have linked oral health to lung health, including one meta-analysis published in Oral Diseases that found periodontitis was associated with asthma, COPD and pneumonia.

Quote from Hoss on oral health in COVID-19

Poor oral health has been associated with a variety of other adverse health outcomes, including increased risks for inflammatory bowel disease, precancerous stomach lesions, coronary heart disease and mortality, and lung and colorectal cancers.

Healio Primary Care spoke with Kami Hoss, DDS, MS, co-founder of The Super Dentists, a large group dental practice in San Diego, to learn more about the relationship between oral health and lung health and its implications during the COVID-19 pandemic.

Q: How is lung health related to oral health?

A: It has long been known that poor oral health is a risk factor in the initiation and/or progression of respiratory infections. Dental plaque can host respiratory pathogens that can be released in saliva and can then be aspirated in the lungs. Pathogens can also enter the bloodstream through bleeding gums in patients with poor oral health and disseminate to the lungs, causing a local infection. In ventilated patients, they can also attach to the endotracheal tube and be aspirated into the respiratory tract.

Q: Why is it important to maintain oral health during the COVID-19 pandemic?

A: We know that COVID-19 affects the young and the healthy differently than [older adults] and those with underlying medical conditions. Oral health impacts overall health in profound ways. The mouth is the opening to the body and pathogens find their way in via the mouth and COVID-19 is no exception.

Q: What signs/symptoms that indicate poor oral health should primary care physicians tell their patients to watch for?

A: Bleeding or swollen gums: Healthy gums should not bleed during routine brushing and flossing. Pain: Dental, gum or jaw pain could be another sign that something’s wrong.

Halitosis: Persistent bad breath that’s not due to something obvious, such as a food source, must be investigated. Sensitivity: Excessive sensitivity to cold or sweet can be due to bone loss and root exposure or cavities. Tooth mobility: In advanced stages of periodontal disease, teeth can get loose and eventually fall out.


Q: How does maintaining good oral hygiene compare with other preventive/mitigative steps?

A: Oral health is another essential piece of the puzzle when it comes to staying healthy. So, as we all put on masks near each other and wash our hands routinely, we should also be paying extra attention to the health of our mouths.

Q: Why is oral health particularly important among nursing home residents during the COVID-19 pandemic?

A: [The] pandemic’s death toll tied to nursing homes has surpassed 50,000. Periodontal disease increases in the older population. In fact, according to CDC, more than 70% of Americans aged 65 and older have periodontal disease. The infection risk is additionally compounded by presence of removal dentures where plaque can accumulate.