Why oral health care is vital to a long-term COVID-19 strategy

On March 29, the US Centers for Disease Control and Prevention updated its page¹ listing certain medical conditions predisposing individuals to severe COVID-19 to include:

• Type 1 diabetes
• Asthma
• Liver disease
• HIV infection
• Cystic fibrosis
• Being overweight (in addition to obesity, which was already listed)

The update comes at a time of shift in the COVID-19 pandemic. In early March, the United States passed the benchmark of having vaccinated half of all adults over the age of 65.² (The CDC states that more than 80% of COVID-19 deaths occur in people over the age of 65.¹) Many states have opened vaccine eligibility to include any adult who wants to receive one. However, variants of SARS-CoV-2 and, in some places, rising case numbers remain a cause of concern. No vaccine is currently approved for anyone under the age of 16.

Many chronic diseases, including most of those added to the CDC’s list, have links to oral disease. Yet many people are still wary of accessing, or simply cannot afford, oral health care. Early on in the pandemic, a PPE shortage and concerns about aerosolization of viral particles, among other factors, spurred a shutdown of dentistry for weeks and made many patients fearful about keeping appointments after practices reopened.

However, time has shown that dental practices can operate safely, especially when compared to more general health-care settings. For dentists, studies by the ADA and ADHA have found that the infection rate was 2.0%; for dental hygienists, it was 3.1%; for all other health-care workers, it was 11%.³

Although the oral-systemic link is not yet definitively mapped—and may, because of the logistics involved, never be⁴—for dental professionals, one thing remains true. Uncontrolled oral inflammation is associated with other inflammation-mediated conditions. Many clinicians find that when patients are able to address oral disease, overall health improves.

Many epidemiologists now predict that COVID-19 will become an endemic, seasonal virus.⁵

Some individuals are still hesitant of the vaccine, and some will never choose to receive it. Protecting patients against COVID-19 will continue even after N-95 respirators and temperature checks go away. Dental professionals can help patients manage their disease risk by keeping the oral-systemic link in mind. To that end, we’ve complied a brief list of some of our more recent articles on these conditions.

• Untreated periodontitis and COVID-19: What is the evidence? Part 1 of 3
• Untreated periodontitis and COVID-19: What is the evidence? Part 2 of 3
• Untreated periodontitis and COVID-19? Let’s get progressive! Part 3 of 3
• Periodontitis and its association with type 2 diabetes
• Turning the heat down: Solutions for reducing chronic inflammation in our patients' bodies
• Do we have it backwards? Whole body health depends on input for periodontal treatment
• Was it something I said?
• Respiratory diseases: Do breathing issues signal complications caused by periodontal disease?
• BaleDoneen Method: Medical model emphasizing dental health component in inflammation reduction
• Asthma, allergic rhinitis, and tooth decay
• What will it take to prove the oral-systemic links?

1. People with certain medical conditions. US Centers for Disease Control and Prevention. Updated March 29, 2021. Accessed April 1, 2021. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.htm
2. The US has vaccinated half its seniors. The next half will be harder. Bloomberg. March 5, 2021. Accessed April 1, 2021. https://www.bloomberg.com/news/articles/2021-03-05/u-s-vaccinated-half-its-seniors-the-next-half-will-be-harder
3. American Dental Hygienists’ Association, American Dental Association. New research reveals impact of COVID-19 on dental hygienists [webinar]. February 24, 2021. https://zoom.us/rec/play/_0iUNiKUvWRl2mJrINwOg2acZFxoMqzE0dHSqv4GCp2JYvgHfWjVPiM_9FQYXgZOTEZXtQuGptAbvuaK.3mLGnD63GYvLCO0A?autoplay=true&startTime=1614200330000
4. Nagelberg R. What will it take to prove the oral-systemic links? Dental Economics. January 17, 2018. Accessed April 1, 2021. https://www.dentaleconomics.com/science-tech/article/16385159/what-will-it-take-to-prove-the-oralsystemic-links
5. Phillips N. The coronavirus is here to stay — here’s what that means. Nature. February 16, 2021. Accessed April 1, 2021. https://www.nature.com/articles/d41586-021-00396-2

Amelia Williamson DeStefano, MA, is senior managing editor of the Endeavor Business Media Dental Group. She works to develop high-quality content that empowers oral-health professionals to advance patient well-being and cultivate professional joy and fulfillment. She holds a master's in English Literature from the University of Tulsa and has worked in dental media since 2015.