Q&A with Dr. Jeff: Exploring the Connection Between COVID-19 and Oral Health

COVID-19 has been part of every Iowan’s life for nearly 2 years. Researchers are continuously learning about the disease, including how oral health affects the severity of the virus.

Dr. Jeffrey Chaffin, Chief Dental Officer for Delta Dental of Iowa, shares an update on the links between COVID-19 and oral health, and the key considerations to help protect your total health.

Q: Can you share a brief overview of the research linking COVID-19 severity and oral health status?

Dr. Chaffin: There is a lot of emerging research on COVID-19 as a whole. It seems like researchers learn more each week during this pandemic, and the new learnings are more evidence based.

Some of the recent studies on oral health and COVID-19 focus on gum disease. We often use gum disease as a more global term, with gingivitis being early gum disease with inflamed gums but no loss of tooth. Gingivitis can progress to periodontitis, the most serious form of gum disease. Periodontitis is when we see destruction of the supporting bone and even tooth loss from inflammation and bacteria.

A recent study reported that COVID-19 patients with gum disease were 3.5 times more likely to be admitted to the intensive care unit, 4.5 times more likely to need a ventilator and nearly 9 times more likely to die compared to those without gum disease.1 It’s important to know that gum disease doesn’t cause COVID-19, but severe gum disease can be a sign of overall poor health — and that overall poor health is a often a factor in how severe a person's COVID-19 case will be.

Q: Based on what we know about these study findings so far, what is the main takeaway patients should understand?

Dr. Chaffin: The latest research emphasizes the importance of good overall and oral health, and that good oral health is a part of overall health. A person’s body must be healthy in order to combat diseases and viruses. COVID-19 is serious, but it’s only one of the viruses we encounter throughout our lives. Taking your overall health seriously will help you lead a happier and healthier life.

Q: Some patients have put their twice-yearly dental visits on hold due to concern for COVID-19. What would you say to patients who might be worried about their risk for contracting COVID-19 in the dental environment?

Dr. Chaffin: I totally understand why patients may have delayed routine dental care early in the pandemic. Many dental offices were closed for a few months. Those closures shouldn’t scare patients, as a major reason for the closure was the shortage of personal protective equipment (PPE). Closing dental offices and delaying routine medical appointments saved the protective equipment for the most serious health conditions and the surge of COVID-19 patients.

Dentistry has always been a leader in infection control and has modified its procedures for COVID-19. To date, there is no known transmission of COVID-19 in a dental care setting.

Many patients have restarted their dental preventive visits over the last year. Given that overall and oral health are so important, I think that almost everyone should keep up with their routine dental preventive care. There may be a small segment of the population that is at extreme risk of getting COVID-19 and other viruses based on their health conditions. In those limited situations, those patients should seek advice from their medical and dental providers before restarting routine preventive dental care.

Q: Looking at how COVID-19 severity and oral health are connected, what does this say about the importance of oral health to the total health picture?

Dr. Chaffin: I believe that this is another scenario that shows the connection between oral and overall health. Good oral health is a major predictor in one’s quality of life, but it is much more than just quality of life. The mouth is a part of the body — just because the providers who treat diseases of the mouth may be different from providers who treat diseases in other parts of the body doesn’t minimize the importance of oral health to overall health.

Q: Do you have any other words of advice for patients about their oral health and COVID-19?

Dr. Chaffin: The first thing is to take COVID-19 seriously. Preventive measures are available for everyone to be safe. Often, those preventive measures are not only for our own personal health, but also for the health of our families and those in our community. Patients should schedule their routine preventive dental care, because minor dental conditions can become worse and more expensive to treat over time.

Everyone should assess their own risk, but most people find that visiting the dentist is safe and an important part of maintaining good health.

REFERENCE:

Association between periodontitis and severity of COVID‐19 infection: A case–control study” by Wenji Cai, Belinda Nicolau and al. was published in the Journal of Clinical Periodontology, 2021

3 Ways Smoking Harms Your Teeth

If you have been smoking for years, you’ve no doubt heard this message over and over: “Smoking is bad for you.”

But have you ever thought about why? Tobacco affects your whole body, including your teeth and mouth, but if you don’t really understand the detrimental affects, you may not feel inspired to quit. Smoking has many adverse effects on your teeth and mouth, but these are three major ways smoking harms your oral health.

Stained Teeth

Having confidence in your smile is important, and tobacco use can quickly erode it by staining your teeth. Tobacco contains nicotine and tar, which can quickly stain your teeth a yellowish tint. If you’ve been a long-time smoker, your teeth may be more of a brown hue. This can impact your self esteem. Although whitening products are available to help, continued smoking will keep stains on your teeth.

Gum Disease and Tooth Loss

Tobacco can quickly affect the appearance of your teeth, but the more serious affects lie beneath your gum line. Smoking causes gum disease — and severe forms of gum disease (called periodontitis) may lead to tooth loss.

Gum disease starts with a build up of bacteria under your gums, which leads to the development of plaque and tartar.

Why is smoking linked to gum disease? Researchers have found that smokers produce more of this bacteria, and all types of tobacco (cigarettes, chewing tobacco, pipes, etc.) raise your risk of developing gum disease. Smoking also depletes the mouth of oxygen and weakens your immune system, which prevents infected gums from healing properly. Smokers are not only more likely to get gum disease, but they’re most likely to get the most severe forms of it.

If your dentist says that you have gum disease, it’s important you quit smoking because smoking will reduce the effectiveness of your treatment. Quitting before you start treatment may just help you keep your teeth.

Oral Cancer

Like many cancers, oral cancer (cancer of the mouth, lips, tongue and throat) is linked to smoking. According to the American Cancer Society, approximately 90% of people diagnosed with oral cancer have a history of tobacco use. The more tobacco you use, the greater your risk.

If you are diagnosed with oral cancer, quitting tobacco plays a big role in your long-term health. Only 6% of patients who quit after their oral cancer went into remission had their cancer return, compared with 37% of patients who continued to smoke.

It’s Not Too Late to Reap the Benefits of Quitting

If you’ve used tobacco for years, the thought of quitting may seem like a waste. After years or even decades of smoking, will kicking the habit now do any good?

The answer is an emphatic yes.

Research shows that people who quit smoking showed significant improvement in their oral health within 12 months of quitting, although many benefits of kicking the habit will appear almost immediately (like the respiratory and financial impacts). Eliminating tobacco from your lifestyle will reduce your chance of developing oral cancer, in addition to a host of other medical diseases (such as heart and lung disease).

It’s hard to change, but today could be a day you assume the proud role of nonsmoker. If you are ready to quit, you have support. Talk to your dentist about resources to help make your smoking cessation journey a success.

SOURCES:

https://www.dentalhealth.org/smoking-and-oral-health

https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html

https://www.webmd.com/oral-health/guide/smoking-oral-health

https://www.qvh.nhs.uk/wp-content/uploads/2017/02/The-effect-that-smoking-has-on-your-oral-health-Rvw-Feb-2020.pdf

https://www.healthline.com/health/smokers-teeth#will-not-smoking-help