The paper follows evidence published earlier this year in the Journal of Clinical Periodontology, the official publication of the European Federation of Periodontology (EFP), that patients with COVID-19 were three times more likely to experience complications if they also had gum disease.
The authors compiled existing evidence to propose a pathway by which the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted to the lungs, where it causes COVID-19 lung disease.
They suggest that the virus enters the body through the upper airways (nose and mouth), collects in the saliva in the mouth and enters dental plaque under the gums. It then crosses the gums into the blood vessels, where it travels to the arteries in the lungs – rather than travelling to the lungs via the airways. The biological basis for this route of infection is outlined. In addition, the authors put forward the idea that diseased or damaged gums could weaken the mucosal barrier in the mouth and allow the virus to more easily enter the bloodstream.
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