COVID-19 and Dental Practice

The COVID-19 pandemic has highlighted the essential role that dental healthcare professionals play in the larger healthcare system and the promotion of patient wellness and disease prevention. Based upon the emerging evidence of the association between periodontitis and COVID-19 infection rates and severity, it has been proposed that periodontal care as a mechanism to establish oral and overall health could play a role in the prevention and management of severe COVID-19 complications.⁸⁵ Enhanced identification of patients with periodontal disease, through regular comprehensive periodontal examinations and health promotion in patients without periodontitis is critical to reduce periodontitis incidence.⁸⁶ Periodontitis prevention through meticulous oral hygiene measures (e.g., professional dental prophylaxis) to remove and/or prevent the formation of a dysbiotic biofilm is appropriate for patients without periodontal attachment loss who are at low risk of disease development.^86,87 Such care can reduce the incidence of gingivitis and the associated gingival sulcular ulceration which would subsequently prevent viruses and bacteria from the oral cavity from entering the systemic circulation.^88,89

In addition to the primary prevention of periodontal diseases, treatment of ongoing periodontal infection and inflammation could decrease systemic inflammation and ameliorate comorbid diseases, such diabetes mellitus.^90-92 The elimination of pathologic periodontal pockets and the niches for bacteria that are formed within them could also reduce those sites as potential reservoirs for oral pathogens and SARS-CoV-2 that could worsen coronavirus-associated pneumonias.