The oral cavity has long been considered a potential reservoir for respiratory pathogens. With the Covid-19 pandemic, there has been a renewed interest in the relation between oral flora and respiratory infection among “at-risk” patients such as patients from intensive care units or frail older adults. This has been especially born out in what happened in New York after Governor Cuomo ordered Covid patients to be placed in nursing homes.
The mechanisms of infection, particularly in assisted living and nursing homes could be colonization of the oral biofilm by respiratory pathogens followed by aspiration. More recent hypotheses relate to the presence in saliva of enzymes and cytokines associated with oral pathogens, and that could modulate the colonization of the respiratory tract or promote infection by respiratory pathogens. New research suggests bacteria from gum disease travel through airways and into the lungs. And this may lead to potentially life-threatening respiratory illnesses such as Covid-19.
British researchers have found a link between poor oral hygiene and severity of COVID-19 disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. One of the major issues for our elderly is there limited access to proper oral healthcare. The study from researchers Victoria Sampson, from the dental practice 38 Devonshire Street, London, Nawar Kamona from the Centre for Nutrition Education & Lifestyle Management (CNELM), London and Ariane Sampson from Orthodontics, Cambridge University Hospital Trust, United Kingdom collaborated to find the connection between the severity of the infection and poor oral hygiene.
In elderly patients living in chronic care facilities, the colonization of dental plaque by pulmonary pathogens is frequent, if not the norm. This overreaction may explain the association between periodontal disease and chronic obstructive pulmonary disease, the fourth leading cause of death in the United States. While these studies are in their infancy, good oral hygiene has been recognized as a means to prevent airway infections in patients, especially in those over the age of 70.
These findings underline the necessity for improving oral hygiene among patients who are at risk and those living in long-term care institutions. Maintaining periodontal health may contribute to a healthy respiratory system, according to research published in the Journal of Periodontology.
The best way to prevent excessive harmful bacteria in the mouth of elderly patients being housed in assisted living facilities is to provide patients with the good oral hygiene. Brush twice a day with fluoride toothpaste, floss once a day and follow through with their semiannual dental visit.
This article is intended to promote understanding of and knowledge about general oral health topics in our ‘high risk’ elderly community. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment. If we can be of help, please contact us.
Novy Scheinfeld, DDS, PC
ZoAnna Bock, MS, DMD
Hanna Orland, DMD
Howard Abrahams, DDS
290 Carpenter Drive, 200A
Sandy Springs, GA 30328
3781 Chamblee Dunwoody Road
Chamblee, GA 30341
 Oral Health and Respiratory Infection • Philippe Mojon, DMD, PhD, 2002
 American Academy of Periodontology, 2008
 British Dental Journal
 Sampson, V., Kamona, N. & Sampson, A. Could there be a link between oral hygiene and the severity of SARS-CoV-2 infections?. Br Dent J 228, 971–975 (2020). https://doi.org/10.1038/s41415-020-1747-8, https://www.nature.com/articles/s41415-020-1747-8