COVID-19 and COVID-19-related illness is, unfortunately, the disease that has swept across the entire world for the past two years. News outlets have devoted nearly 24/7 hour coverage to the minute-by-minute developments of this pandemic. Simultaneously, while these tragic events are unfolding – we continue to see cases of heart attacks, obesity, cancer, and cavities. 

Cavities?! Okay, okay - I get it – most people wouldn’t put that on the same list as life-threatening diseases like cancer…but maybe they should. Your mouth is connected to the rest of your body. So, what happens to your oral health can have far-reaching ramifications for systemic health and productivity. Even California state representative Tony Cárdenas, D-Calif.(1) has gone on record to state that “oral health illness results in tens of millions of lost workdays each year.” One should take this statistic seriously, because even if you don’t, the bacteria on calculus will. Some of the most prevalent bacteria in your mouth can bind with platelets, small cells in the blood. Once this occurs, normal blood flow can be interrupted leading to blockages in arteries and a higher risk of cardiac events.(2) Given roughly 50 percent of individuals over age 30 have some form of gum disease and heart disease is one of the leading causes of death in America – we must take oral health seriously.

Bacterium from your gums has a secondary target as well - your mind! An infection in your gums can kill off brain cells, leading to memory loss and dementia. To this end, a study published in 2020 showed that participants with gum inflammation were nine times more likely to score lower on cognitive tests.(3) Also, it is important to consider that bacteria in our mouths can fester leading to active infections, which in turn, can lead to dramatic swings in blood sugar levels.(4) This, invariably, can make managing pre-diabetes or diabetes that much harder! Heart issues, Alzheimer's disease, and diabetes have all been correlated to an unhealthy mouth.

I’d be remiss if I did not mention that all of this is further complicated by the fact that COVID-19 has likely had a significant impact on oral healthcare in America. While we have yet to discover and experience the true ramifications of COVID-19’s long-term side effects concerning oral health, they likely go beyond physical changes to the mouth.(5) For example, due to fear of infection and social distancing measures, many people neglected dental visits for routine cleanings and even necessary care to maintain their oral health. For many people transitioning to staying home more and spending hours on screens for remote work and school, mindless eating became routine. As for brushing, who cares? I’m wearing a mask!

This cycle of neglecting oral health caused scores of decay and dental emergencies that have not been discussed on the national stage. We have even gotten to the point where many individuals have now developed severe bruxism or grinding habits that have ravaged existing teeth.(6) So much so that where nightguards were once the anomaly, they have now become the norm. Personally, 2021 has been a record-setting year for the number of crowns that I performed to save fractured teeth.

Now that we are largely unmasked and teeth can be seen again, will healthy teeth become in vogue and the subject of the next Hollywood blockbuster? Most likely not. But maybe - just maybe, if we can change the national conversation to discuss the importance of oral health - then maybe we can make America smile again!

1. House passes Oral Health Literacy and Awareness Act. US Representative Aumua Amata Coleman Radewagen. https://radewagen.house.gov/media-center/press-releases/house-passes-oral-health-literacy-and-awareness-act#:~:text=%E2%80%9CI%20appreciate%20the%20leadership%20on,Congressman%20C%C3%A1rdenas%20and%20Congressman%20Bilirakis.%E2%80%9D&text=According%20to%20HHS%2C%20illnesses%20related,million%20lost%20workdays%20each%20year. Published December 9, 2021. Accessed April 12, 2022.  
2. Carrizales-Sepúlveda EF, Ordaz-Farías A, Vera-Pineda R, Flores-Ramírez R. Periodontal disease, systemic inflammation and the risk of cardiovascular disease. Heart, Lung and Circulation. 2018;27(11):1327-1334. doi:10.1016/j.hlc.2018.05.102
3. Dioguardi M, Crincoli V, Laino L, et al. The role of periodontitis and periodontal bacteria in the onset and progression of alzheimer’s disease: A systematic review. Journal of Clinical Medicine. 2020;9(2):495. doi:10.3390/jcm9020495
4. Genco RJ, Graziani F, Hasturk H. Effects of periodontal disease on glycemic control, complications, and incidence of diabetes mellitus. Periodontology 2000. 2020;83(1):59-65. doi:10.1111/prd.12271
5. Farid H, Khan M, Jamal S, Ghafoor R. Oral manifestations of covid‐19‐a literature review. Reviews in Medical Virology. 2021;32(1). doi:10.1002/rmv.2248
6. Emodi-Perlman A, Eli I, Smardz J, et al. Temporomandibular disorders and bruxism outbreak as a possible factor of orofacial pain worsening during the COVID-19 pandemic—concomitant research in two countries. Journal of Clinical Medicine. 2020;9(10):3250. doi:10.3390/jcm9103250

Dr. Amir Kazim is a General Dentist in Long Beach, California, who wears many hats from working in private practice to providing tele-dentistry to serving as adjunct faculty at Cypress College. He takes a unique holistic view of the dental landscape and is a strong advocate for oral health on a regional and national level, serving as a California Dental Association Foundation Board Member, Harbor Dental Society Board Member, and American Dental Association Delegate.