Periodontal disease or periodontitis is a chronic infection of the supporting tissues of the teeth that has the potential to cause systemic effects. The relationship between oral health and overall systemic conditions has become an important focus in modern research.
A study conducted by a Faculty of Dentistry UGM student, Ichfan Aji Nugroho, under the supervision of dr. Dyah Listyarifah, M.Sc., D.Med.Sci; drg. Asikin Nur, M.Kes., Ph.D.; and drg. Heribertus Dedy Kusuma Y., M.Biotech., Ph.D., entitled “The Relationship between Periodontal Disease and the Risk of Pneumonia Severity in COVID-19 Patients,” explains that the primary target of COVID-19 infection is the respiratory tract, which can lead to pneumonia and death. On the other hand, poor oral hygiene and periodontal disease can contribute to the development of several systemic diseases, including pneumonia. Several studies also show that in about half of severe and fatal COVID-19 cases, periodontopathogenic bacterial superinfections were found, supported by the detection of these bacteria in bronchoalveolar fluid.
Mechanisms of Systemic Association
- Aspiration of periodontal bacteria: Oral bacteria such as Porphyromonas gingivaliscan be aspirated into the lungs, increasing the risk of pneumonia, especially in COVID-19 patients.
- Cytokine storm: Periodontitis triggers systemic inflammatory responses. When combined with SARS-CoV-2 infection, this can worsen inflammation, trigger a cytokine storm, lead to Acute Respiratory Distress Syndrome (ARDS), and increase mortality risk.
- Pathogenic bacterial superinfection: The combination of periodontopathogens and SARS-CoV-2 can result in secondary superinfections, reduce immune function, worsen lung conditions, and increase viral virulence.
Additional Evidence from Scientific Literature
- Case-control studies have found that individuals with high plaque scores, gingivitis, significant attachment loss, and severe periodontitis have a higher risk of contracting COVID-19 or experiencing complications.
- Systematic reviews report that periodontal treatment and good oral hygiene practices can reduce the burden of respiratory infections and the risk of severe COVID-19.
Clinical and Public Health Implications
- Active role of oral hygiene
Maintaining good oral hygiene is crucial to prevent bacterial spread to the respiratory tract and reduce the risk of systemic complications such as pneumonia, especially during pandemics. - Periodontal intervention as a preventive strategy
Periodontal therapy is not only beneficial locally for the gums and teeth but also has the potential to reduce systemic risks, including COVID-19 severity and pneumonia. - Cross-disciplinary collaboration
Integration of oral healthcare protocols with the management of systemic conditions such as COVID-19 is highly relevant in clinical interventions and public health policy.
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Periodontal disease is not merely a local oral problem but can worsen systemic conditions. Poor oral hygiene and periodontal disease can contribute to systemic diseases such as pneumonia. Several studies show that in about half of severe and fatal COVID-19 cases, periodontopathogenic bacterial superinfections were detected in bronchoalveolar fluid. This highlights the importance of raising awareness of periodontal health as part of maintaining overall health—not only to prevent tooth damage, but also to prevent serious systemic diseases.
References
Ichfan Aji Nugroho, dr. Dyah Listyarifah, M.Sc., D.Med.Sci; drg. Asikin Nur, M.Kes., Ph.D.; drg. Heribertus Dedy Kusuma Y., M.Biotech., Ph.D., HUBUNGAN PENYAKIT PERIODONTAL TERHADAP RESIKO KEPARAHAN PNEUMONIA PADA PASIEN COVID-19, https://etd.repository.ugm.ac.id/penelitian/detail/212232
Author: Rizky B. Hendrawan | Photo: Freepik
