ISSN : 0376-4672
The purpose of this study is to investigate the relationship between periodontal disease and coronavirus disease 2019 (COVID-19) as a respiratory disease, and to suggest its molecular biological mechanism. Oral bacteria and viruses can be aspirated into the respiratory tract and may cause respiratory diseases. The COVID-19 virus can inhabit, replicate and spread in the oral environment including dental plaque, saliva, and periodontal pockets. The COVID-19 virus can induce strong innate immunity and inflammatory responses by binding to the angiotensin-converting enzyme 2 receptors, which are abundantly present in the oral stratified epithelium in the oral cavity. The COVID-19 virus may activate inflammasome, one of inflammatory key factors in cell cytoplasm. In patients with periodontal disease, oral hygiene habits, professional oral cleaning, and plaque control management are effective for reducing the possibility of COVID-19 infection. This review is based on the evidences from COVID-19 related literature in the last two years.
1. World Health Organization. WHO Coronavirus (COVID-19) Dashboard. 2022 Feb. 11; https://covid19.who.int/.
2. 질병관리청. 코로나바이러스감염증-19(COVID-19). 2022; http://ncov.mohw.go.kr/.
3. Centers for Disease Control and Prevention. Similarities and Differences between Flu and COVID-19. 2022 Feb. 14; https://www.cdc.gov/flu/symptoms/flu-vs-covid19.htm.
4. France K and Glick M, Long COVID and oral health care considerations. J Am Dent Assoc, 2022. 153(2):167-174.
5. Centers for Disease Control and Prevention. Infection Control Guidance. 2022 Feb. 2; https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html.
6. Diamond MS and Kanneganti TD, Innate immunity: the first line of defense against SARS-CoV-2. Nat Immunol, 2022. 23(2):165-176.
7. Samaranayake L, Fakhruddin KS, and Bandara N, Oral Manifestations of Coronavirus Disease 2019 (COVID-19): An Overview. Dental Update, 2021. 48(5):418-422.
8. 정진석, 허석모, 노년의 구강 질환과 호흡기 질환의 관계. 대한치과의사협회지, 2013. 51:494-500.
9. Scannapieco FA, Bush RB, and Paju S, Associations between periodontal disease and risk for nosocomial bacterial pneumonia and chronic obstructive pulmonary disease. A systematic review. Ann Periodontol, 2003. 8(1):54-69.
10. Heo SM, Sung RS, Scannapieco FA, and Haase EM, Genetic relationships between Candida albicans strains isolated from dental plaque, trachea, and bronchoalveolar lavage fluid from mechanically ventilated intensive care unit patients. J Oral Microbiol, 2011. 3.
11. Heo SM, Haase EM, Lesse AJ, Gill SR, and Scannapieco FA, Genetic relationships between respiratory pathogens isolated from dental plaque and bronchoalveolar lavage fluid from patients in the intensive care unit undergoing mechanical ventilation. Clin Infect Dis, 2008. 47(12):1562-70.
12. 허석모, 대한민국 치과의료종사자의 코로나19 : 2년간 감염발생 현황분석 및 치과감염관리지침 최신지견. 대한치과의사협회지, 2022. 60:269-280.
13. Bourgonje AR, Abdulle AE, Timens W, Hillebrands JL, Navis GJ, Gordijn SJ, et al., Angiotensin-converting enzyme 2(ACE2), SARS-CoV-2 and the pathophysiology of coronavirus disease 2019 (COVID-19). J Pathol, 2020. 251(3):228-248.
14. Loos BG and Van Dyke TE, The role of inflammation and genetics in periodontal disease. Periodontol 2000, 2020. 83(1):26-39.
15. Yang M, Soh Y, and Heo SM, Characterization of Acidic Mammalian Chitinase as a Novel Biomarker for Severe Periodontitis (Stage III/IV): A Pilot Study. Int J Environ Res Public Health, 2022. 19(7).
16. Albandar JM and Rams TE, Global epidemiology of periodontal diseases: an overview. Periodontol 2000, 2002. 29:7-10.
17. Tamimi F, Altigani S, and Sanz M, Periodontitis and coronavirus disease 2019. Periodontol 2000, 2022. 89(1):207-214.
18. Marouf N, Cai W, Said KN, Daas H, Diab H, Chinta VR, et al., Association between periodontitis and severity of COVID-19infection: A case-control study. J Clin Periodontol, 2021. 48(4):483-491.
19. Brandini DA, Takamiya AS, Thakkar P, Schaller S, Rahat R, and Naqvi AR, Covid-19 and oral diseases: Crosstalk, synergy or association? Reviews in Medical Virology, 2021.
20. Guo H, Callaway JB, and Ting JP, Inflammasomes: mechanism of action, role in disease, and therapeutics. Nat Med, 2015. 21(7):677-87.
21. Marchesan JT, Girnary MS, Moss K, Monaghan ET, Egnatz GJ, Jiao Y, et al., Role of inflammasomes in the pathogenesis of periodontal disease and therapeutics. Periodontol 2000, 2020. 82(1):93-114.
22. Rodrigues TS, de Sá KSG, Ishimoto AY, Becerra A, Oliveira S, Almeida L, et al., Inflammasomes are activated in response to SARS-CoV-2 infection and are associated with COVID-19 severity in patients. J Exp Med, 2021. 218(3).
23. Jeong JS, Lee KB, Kim SR, Kim DI, Park HJ, Lee HK, et al., Airway epithelial phosphoinositide 3-kinase-δ contributes to the modulation of fungi-induced innate immune response. Thorax, 2018. 73(8):758-768.
24. Isaza-Guzmán DM, Medina-Piedrahíta VM, Gutiérrez-Henao C, and Tobón-Arroyave SI, Salivary Levels of NLRP3 Inflammasome-Related Proteins as Potential Biomarkers of Periodontal Clinical Status. J Periodontol, 2017. 88(12):1329-1338.
25. Centers for Disease Control and Prevention. How to Protect Yourself & Others. 2022 Jan. 20; https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html.
26. 질병관리청. 예방조치안내. 국민 행동수칙 준수 2021 Jan. 25; http://ncov.mohw.go.kr/baroView4.do?brdId=4&brdGubun=44.
27. 질병관리청. 코로나바이러스감염증-19 치과의료기관 감염예방관리. 2020 Aug. 3]; http://ncov.mohw.go.kr/shBoardView.do?brdId=2&brdGubun=24&ncvContSeq=3421.
28. 질병관리청. 호흡기 감염병 예방을 위한 환기 지침. 2021 Oct. 27;http://ncov.mohw.go.kr/tcmBoardView.do?brdId=3&brdGubun=31&dataGubun=&ncvContSeq=6044&contSeq=6044&board_id=312&gubun=ALL.
29. Lindsley WG, Derk RC, Coyle JP, Martin SB, Jr., Mead KR, Blachere FM, et al., Efficacy of Portable Air Cleaners and Masking for Reducing Indoor Exposure to Simulated Exhaled SARSCoV-2 Aerosols - United States, 2021. MMWR Morb Mortal Wkly Rep, 2021. 70(27):972-976.
30. Conway Morris A, Sharrocks K, Bousfield R, Kermack L, Maes M, Higginson E, et al., The removal of airborne SARS-CoV-2and other microbial bioaerosols by air filtration on COVID-19surge units. Clin Infect Dis, 2021.
31. Abe S, Ishihara K, Adachi M, Sasaki H, Tanaka K, and Okuda K, Professional oral care reduces influenza infection in elderly. Arch Gerontol Geriatr, 2006. 43(2):157-64.
32. Okuda K, Kimizuka R, Abe S, Kato T, and Ishihara K, Involvement of periodontopathic anaerobes in aspiration pneumonia. J Periodontol, 2005. 76(11 Suppl):2154-60.
33. Roberts N and Moule P, Chlorhexidine and tooth-brushing as prevention strategies in reducing ventilator-associated pneumonia rates. Nurs Crit Care, 2011. 16(6):295-302.
34. Roy T, Damoulakis G, Komperda J, Mashayek F, Cooper LF, Rowan SA, et al., Effect of H(2)O(2) Antiseptic on Dispersal of Cavitation-Induced Microdroplets. J Dent Res, 2021. 100(11):1258-1264.
35. Chaudhary P, Melkonyan A, Meethil A, Saraswat S, Hall DL, Cottle J, et al., Estimating salivary carriage of severe acute respiratory syndrome coronavirus 2 in nonsymptomatic people and efficacy of mouthrinse in reducing viral load: A randomized controlled trial. J Am Dent Assoc, 2021. 152(11):903-908.
36. 보건복지부. 코로나19 시대, 슬기로운 구강 관리- 감염과 구취를 예방하는 「생활 속 구강 관리 수칙」안내. 2020 Sept. 4; https://www.khealth.or.kr/board/view?pageNum=9&rowCnt=10&no1=538&linkId=1001266&menuId=MENU00907&schType=0&schText=&boardStyle=&categoryId=&continent=&country=&contents1=.