How COVID-19 Complications Can Start in the Mouth

How Covid-19 Complications can start in the mouth

The COVID-19 pandemic has been with us since the end of 2019 and, like it or not, it continues to affect Americans every day. Since this novel coronavirus continues to be a threat to Americans and the world alike, researchers have focused on learning more and more about the virus. Recently, a new study has shown a possible connection between one’s oral health and COVID-19. 

The study, titled The COVID-19 Pathway: A Proposed Oral-Vascular-Pulmonary Route of SARS-CoV-2 Infection and the Importance of Oral Healthcare Measures, postulates that the SARS-CoV-2 virus enters the body through the mouth, where it is then absorbed into the bloodstream and passes into the lungs. The article also insinuates that the severity of a COVID-19 infection can be affected by oral health. Specifically, it is noted that people with periodontitis are more likely to have severe cases. 


In order to fully understand this relationship, you must first understand a few basics about periodontitis. For starters, periodontitis is an advanced form of gum disease that is caused by excess oral bacteria. Since periodontitis causes gum inflammation, people with periodontitis contain higher levels of gingival crevicular fluid (GCF), which is produced by the body in response to the inflammation caused by periodontal disease. 

The SARS-CoV-2 virus is found in saliva, as well as in GCF. According to the article, around 64% of COVID-19 positive patients had the virus present in GCF samples. GCF tends to reside within periodontal pockets, which is another effect of periodontitis. Periodontal pockets form when the gums pull away from the tooth roots. In addition to collecting plaque and bacteria, periodontal pockets also collect GCF. When the SARS-CoV-2 virus is in the GCF, periodontal pockets provide an ideal environment for the virus to replicate. 

Another important thing to know about periodontitis is that the bacteria responsible for the infection can eventually overwhelm the mouth’s immune defenses. When this happens, it allows the bacteria to enter the bloodstream and increases the risk of complications elsewhere in the body. The article has found evidence suggesting that the SARS-CoV-2 virus can also pass into the bloodstream in the same way. 

how COVID reaches the lungs from the bloodstream
Image Source:

Once the virus has entered the bloodstream, it travels through the veins in the face and neck to reach the heart. The heart then pumps the blood into the lungs, along with the virus. The article notes that this is how the virus reaches the lungs. The article also notes that once the virus has infected the lungs, people with periodontitis are more likely to suffer complications. 

For starters, periodontitis weakens the mouth’s immune defenses, which makes it easier for the virus to pass into the bloodstream and infect the lungs. The article also predicts that people with active periodontal infections have a constant supply of the SARS-CoV-2 virus being delivered to the lungs via the bloodstream. This is why, the article explains, people with periodontitis are more likely to require ventilation and/or the admission to intensive care units. The death rate is also higher in people with periodontitis. 

Therefore in order to minimize the risk of COVID-19 complications due to periodontitis, the article concludes by stating the need for good oral hygiene. Although the theory that periodontitis can increase the severity of COVID-19 infections has not fully been proven, the article notes that good oral hygiene can help to prevent complications and should be practiced regularly in both people with or without COVID-19. 

Dr Alina Huang DMD

Dr. Alina Huang has been practicing dentistry in Manhattan for the last eight years. She was born in New York City, and raised in California where she received her Bachelor’s degree at UCLA, and her D.D.S. at the University of the Pacific in San Francisco. She then made her return to NYC where she completed her General Practice Residency at Montefiore Medical Center and has been working in private practice ever since. She continues her learning by attending courses to stay current with the latest advancements in dentistry and refine her skills.