Those who neglect their teeth and then become infected with the Sars-Cov-2 virus run an increased risk of up to 3.5 times of ending up in intensive care, of 4.5 times of needing assisted ventilation and an even 8.8 times of succumb. This was stated by a study conducted from February to July 2020 on 568 patients from Qatar, a rich emirate of the Persian Gulf where dental data are all digitized by the Health Service.
I study
Just posted on Journal of Clinical Periodontoly by researchers from the local university of Doha under the direction of Faleh Tamimi, together with the Spanish ones from the Universitat Autnoma of Barcelona and the American ones from the NYU College of Dentistry in New York, the study explains how the reason for the exaltation of the Covid infection should be ascribed not so much to simple oral hygiene itself, as to what the habit of brushing one’s teeth little can cause: the most common oral disease known as periodontitis. Almost half of Italians are affected by the chronic form of this oral disease which causes tooth loss due to root damage (10-14% of cases), as well as caries and gingivitis. Adding up the acute and chronic forms of periodontitis, the affected Italians would be over 23 million, a prevalence linked to the fact that just over a third of our compatriots (39.1%), according to some studies, devote adequate attention to hygiene and to dental care.
Risks to the heart
The danger of this disease is independent of the aesthetic damage of tooth loss, but linked to a chain of pathological events that are reflected above all on the heart, but also on the metabolic system: it is no mystery that oral hygiene also protects against diabetes and overweight . The same American authors from the NYU College of Dentistry in New York of the study also reported an increased risk of Alzheimer’s disease due to the dysbiosis it causes last year in the same journal. This is also at the basis of the damage caused to the heart: the numerous bacteria that it develops in the oral cavity enter the circulation and trigger a particularly dangerous systemic bacteremia in the heart since it damages the coronary walls through toxins such as tumor necrosis factor-alpha or interleukin 2 and 6. Coronary heart disease, inflammatory damage from C-reactive protein and autoimmune damage with thrombo-platelet alterations and bleeding risks, as well as endocarditis, with inflammation of the heart valves and the inner lining of the heart, the endocardium, can result. This is easier when there are prostheses, lesions and congenital valve defects and especially if the immune defense system is under pressure from other causes: the bacteria can thus invade the heart undisturbed organizing themselves in vegetations that reduce blood flow with consequent heart failure and potentially complications. fatal, with atrial fibrillation, arrhythmias and cardiac infarction, all situations that in any case carry a heavy burden of systemic embolism, hospitalizations and sudden deaths.
Duplicate inflammation
Hence the short step to understand the results of the study conducted in Qatar: in those who already have systemic inflammation such as that induced by periodontitis, the COVID-19 infection does nothing but add inflammation to inflammation, so much so that the levels plasma levels of inflammatory indices such as leukocytes, D-dimer and C-reactive protein in patients with periodontitis are increased compared to other patients without dental problems, although all of them had been affected by the pandemic. Of the 568 COVID positive patients in the study, just under half (258 subjects) were also affected by periodontitis, but among them, those who presented complications of COVID-19 infection were 33, while among the other 310 they appeared only in 7 cases. Brushing your teeth therefore does not protect against Covid, but certainly reduces the harmful consequences of the pandemic
Attention to oral hygiene
Furthermore, the role of the oral mucosa in the transmissibility and pathogenesis of SARS-COV2 infection reported in previous studies should not be forgotten, and this highlights the importance of periodontal health in the prevention and management of complications of COVID-19 infection. . The mouth and the pathologies that affect both the mucous membranes, both the teeth, and their supporting bone structures, are often the site of not only local but systemic diseases, a concept that the general public ignores due to an erroneous cultural heritage. Aldo Bruno Giann, director of the Department of Biomedical, Surgical and Dental Sciences of the State University of Milan – But what is even more serious is how often even the experts do not remember it. The mouth, especially in new pathologies transmissible by air such as Covid-19, represents a microcosm to be investigated as the authors of this study did: only in this way can the pathogenetic mechanisms underlying these diseases be understood by finding means of treatment more quickly. effective. In the meantime, however, a good rule of thumb is careful daily oral hygiene with timely recourse to specialists when necessary – he concludes – Certainly daily tooth brushing or an extra visit to the dentist are not enough to chase away Covid, but this study shows that we need to improve the result, as on the other hand it has already been demonstrated for heart and metabolic diseases.
April 21, 2021 (change April 21, 2021 | 17:18)
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