What do we know about the relationship between toothbrushing and reducing the chances of suffering a serious form of covid-19?

You have sent us an article from Infobase that raises the possibility that poor bucodental health may contribute to an acute covid-19 case. At the moment, this is a NON VERIFIABLE information because it is based on a hypothesis formulated in April by a group of scientists from Birmingham University in the journal Genesis Publications. It is true that periodontitis is being studied to see whether it can favour the development of more severe covid-19 forms. Periodontitis can be a consequence of poor bucal hygiene, but it appears when an inflammation or infection of the gums (gingivitis) is not treated, and it spreads to the ligaments and bones where teeth are rooted.

"Brushing the teeth could reduce the risk of suffering severe covid-19"

The Spanish Society of Periodontology (SEPA in Spanish) also pointed out in April the hypothesis that “periodontitis aggravates the systemic condition of covid-19 patients and increases the risk of complications”, although it based its thesis “on observational studies” that “do not allow extracting definitive conclusions”. If confirmed, periodontitis should be considered as a risk factor tied to a severe covid-19, point out the British experts, as has been done for la diabetes, cardiovascular diseases and respiratory diseases, among others. 

The gingival sulcus

SARS-CoV-2 is spread by breathing in respiratory droplets from an infected person or when a person touches its mouth, nose or eyes after having been in touch with a contaminated surface. This is the reason why sanitary authorities insist on the use of masks, in keeping the social distance and in washing the hands frequently. The theory from the scientists from Birmingham points to that the gingival sulcus -a deep space formed by the inner part of the glum and the tooth surface- could allow the entry of viral particles and bacteria. Hence, SARS-CoV-2 could introduce itself in the capillaries of the glums and would reach the lungs through the bloodstream. 

“Although to some extent the crossing of the virus through the nasal and bucal mucous membranes can happen in healthy individuals, the presence of a poor bucodental health could act as a risk factor to identify the more prone individuals to develop the covid-19 lung disease, or those that could progress towards a more severe disease leading to admission to intensive care, mechanical ventilation or death”, the scientists note.

Periodontitis plays an important role in the worsening of some diseases. For diabetes, it contributes to uncontrolled blood glucose levels and, in those cases of advanced periodontitis, it rises threefold the risk of cardiorenal mortality compared to the diabetic people without periodontitis. Periodontitis also favours a major risk of suffering an heart attack and multiplies the possibilities to suffer pneumonia, bronchitis or the worsening of a COPD (chronic obstructive pulmonary disease).

More studies

The researchers ask for more studies because “it is not yet known if the virus can be transported” through the bloodstream from the glums. “The theory could be even more corroborated by matching the jugular viral load with the salivary viral load, the seriousness of the periodontitis and the use of specific mouthwashes or other buccal hygiene measures, they point out. While waiting for results, they recommend daily bucal hygiene and measures to control the advance of the dental plaque.