Periodontitis Linked with Greater Risk of Developing a Severe COVID-19 Infection

According to a study published in Dentistry Journal, the probability of developing a severe COVID-19 infection was greater among patients with periodontitis; however more research is warranted to understand the impact.

Researchers indicated that the correlation between periodontitis and COVID-19 may exist, as highlighted by several hypothetical models; however, the evidence is limited.

In an effort to ascertain whether an association exists between periodontitis and COVID-19, researchers conducted a cross-sectional study involving patients diagnosed with COVID-19 who were divided into three groups—mild, moderate, and severe COVID-19—based on the COVID-19 severity score of high-resolution computed tomography (HRCT) chest scans.

For all three groups, periodontal parameters—including the plaque index (PI), ratio of sites with gingival bleeding (BOP), pocket depth (PD), gingival recession (REC), clinical attachment loss (CAL), and average numbers of mobile and missing teeth due to periodontitis—were documented.

A total of 294 participants underwent clinical examinations of which,163 had mild COVID-19, 83 had moderate COVID-19, and 48 had severe COVID-19.

Results revealed that of 294 patients with COVID-19, around 50.68% (n = 149) had periodontitis, and the greatest percentage (87.5%) was reported in the severe COVID-19 group. Moreover 79 (26.87%) had gingivitis, and 66 (22.45%) exhibited periodontal health.

Severe and advanced stages of periodontitis (stage III–IV) were discovered to be significantly more frequent in subjects with severe COVID-19 than in the other two groups. The HRCT severity score (CT-SS) was moderately correlated with heightened levels of periodontal parameters.

In this study, a larger number of patients who practiced oral hygiene measures twice daily exhibited mild COVID-19.

The authors also indicated that periodontitis was discovered to be more prevalent and severe in patients with severe COVID-19, suggesting that periodontitis may have an effect on the course and outcome of COVID-19. Moreover, after adjusting for the common predictors that could impact COVID-19 severity, the correlations between periodontitis and severe COVID-19 remained significant. However, periodontitis was not associated with either moderate COVID-19 or mild COVID-19.

One major limitation of this study was that the patients were not assessed for periodontal status during the active phase of the viral disease. However, since periodontitis is a chronic inflammatory illness, it is believed the disease would have been present in individuals even before they contracted COVID-19.

The authors concluded that the results of this logistic regression analyses demonstrated that the probability of developing severe COVID-19 was 2.81 times greater in patients with periodontitis. They also indicated that based on their findings, it can be concluded that periodontitis is correlated with severe COVID-19, and establishing whether the effect is direct or indirect still necessitates further research.

Lastly, they wrote, “Nevertheless, the evaluation and appropriate management of individuals’ periodontal status should be a part of the COVID-19 treatment protocol, as periodontitis could be a risk factor for severe COVID-19, strengthening the need for maintaining oral health and the commitment to seek periodontal care.”

Reference

Mishra S, Gupta V, Rahman W, Gazala MP, Anil S. Association between Periodontitis and COVID-19 Based on Severity Scores of HRCT Chest Scans. Dent J (Basel). 2022;10(6):106. Published 2022 Jun 10. doi:10.3390/dj10060106.