A Link Between Oral Hygiene And Post-COVID Complications: Super Infections & Super Bacteria

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For the past year, the COVID-19 pandemic has affected millions of people all over the world. Even after recovering from COVID-19, patients have reported ongoing symptoms and further complications.

As COVID is a respiratory virus that enters the body primarily through the nose and mouth, it raises the question as to whether the severity of post-COVID complications results from the level of oral hygiene of the patient. In June 2020, research published in the British Dental Journal indicated that this may indeed be true.

Super Infections and Super Bacteria

Bacterial super infections have shown to be prominent in patients who have experienced a severe case of COVID-19. The study carried out by the British Dental Journal shows that over 80% of ICU patients carry remarkably high levels of infectious bacteria, and over 50% of patients who have died from COVID-19 and complications thereof exhibited bacterial super infections.

Although COVID-19 is a virus, much of the illnesses and complications it creates are bacterial and are linked to the respiratory system. The illnesses include pneumonia and acute respiratory distress. The complications may share a link with bacterial super infections, and may in fact be exacerbated by poor oral hygiene.

The risk of an increase in super bacteria likely occurs when healthy oral habits and the prevalence of “good oral bacteria” are disrupted, resulting in high accumulation of bacterial plaque. Too much plaque produces acids that attack tooth enamel, breaking down the tooth’s natural defenses to caries and can also cause systemic infections. In extreme cases, this can cause pneumonia, which is one of the causes of death associated with COVID-19. Studies have shown that one in every ten deaths from pneumonia as a complication of COVID-19 might have been prevented if the patient’s oral hygiene had been better.

Wearing partial dentures can also lead to increased plaque buildup as well as pathogenic oral bacteria and fungi. For this reason, it is crucial to thoroughly clean dentures regularly and remove them overnight to prevent this detrimental buildup of damaging bacteria and super infections.

For hospitalized patients, especially those on a ventilator, it is even more crucial to monitor the levels of oral bacteria to reduce the risk of bacteria overgrowth which can easily lead to systemic infections and complications. As these patients cannot carry out basic oral hygiene practices themselves, the responsibility falls to their medical team to provide them with hygiene assistance in order to increase their chances of overcoming COVID with minimal complications.

The Effects of Bacteria on Oral Hygiene

Bacteria is present in everybody’s mouth. There is a combination of ‘good’ bacteria and ‘bad’ bacteria. Individuals need to populate the mouth with ‘good’ bacteria that helps “drive out” harmful bacteria. When there is a negative imbalance, the risk of infections dramatically increases.

These infections include gingivitis, periodontal (gum) disease and cavities. These conditions put the patient at higher risk of infection that can lead to severe complications.

For this reason, it is extremely important to keep a healthy balance of beneficial bacteria in your mouth by following exceptional oral hygiene routines.

How to Avoid Post-COVID Complications

In view of emerging links between post-COVID complications and inadequate oral hygiene, it is therefore essential to understand how to minimize the risk of contracting complications should one contract the virus. Maintaining excellent oral health is something everyone should always strive for. By recognizing the severe problems that may occur when suffering from COVID, everyone should be vigilant to take preventative steps towards improving their oral hygiene practices.

Improving your everyday dental hygiene routine will undoubtedly reduce the risk of bacterial super infections within the mouth. As a result, patients can work to minimize the chances of experiencing extreme complications should they contract COVID-19.

In addition to washing hands, wearing a mask, and adhering to social distancing measures, people should also dutifully brush their teeth twice a day using toothpaste with triclosan and stannous fluoride. If they do not already, using a mouthwash preferably that contains chlorhexidine and delmopinol is advantageous. While these ingredients cannot especially inactivate the coronavirus, they do offer disinfectant properties that help reduce the risk of bacterial super infections.

Flossing should also be a high priority, as this can remove plaque and food particles stuck between teeth. If left unchecked, plaque and food will accumulate and lead to infections in the gums and oral tissues and increase the risk of complications should a patient be diagnosed with COVID-19.

For elderly individuals who are statistically more susceptible to experiencing post-COVID complications, proper denture care should also be a high priority.

Potential Problems

One primary issue with maintaining and improving oral hygiene during the pandemic is the availability of dental care. Many dental practices were forced to close or operate at reduced hours and capacity this past year due to ”lockdowns”. Like medical offices and hospitals, dental offices prioritized treatment for emergency cases, meaning that some people unfortunately missed out on routine hygiene appointments and non-emergency treatment.

While this was unavoidable, many people did not get necessary routine dental care. Even as more dental offices have reopened, many people are still reluctant to return to the dental office for care and treatment. It is easy to see why neglected dental treatment can increase the risk of complications. Infections and bacteria can quickly multiply, which poses a severe risk for patients waiting for treatment regardless of whether they currently have COVID-19.

There has unfortunately been a significant lack of media coverage regarding oral health. Rather than promote the idea of brushing your teeth in addition to washing your hands, wearing a mask, the general population is unaware of the impact that poor oral hygiene can have. This means there is a greater risk of complications both during and after an experience with COVID-19.

Maintaining Oral Hygiene

Oral hygiene fundamentals should be followed by everyone at all times regardless of the presence of a pandemic. Still, it is arguably now more important than ever to focus on oral health to minimize the risk of complications after contracting COVID-19. By practicing good oral hygiene and striving to improve in areas you may be lax in or tend to neglect, you can significantly reduce your chances of suffering further problems should you contract COVID-19.


NCBI - WWW Error Blocked Diagnostic. (n.d.-b). https://pubmed.ncbi.nlm.nih.gov/9238872/

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