Untreated periodontitis and COVID-19: What is the evidence? Part 1 of 3

By Casey Hein, MBA, BSDH, RDH

If only the periodontal microbiota could talk. While there is currently no definitive evidence that untreated periodontitis exacerbates COVID-19, the connection is biologically plausible. Here’s what we do know.

Prioritizing the health of the immune system has never been more important than during a viral pandemic such as COVID-19, the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients know this, and they’re well primed to hear about ways they can boost their immunity. Of course, there are recommendations such as dietary supplements, good nutrition, adequate sleep, increased physical activity, and stress management. But how about addressing chronic infections that compromise immunity?

Could this include untreated periodontitis? If only the periodontal microbiota could whisper the answer. Like so many things in this pandemic, we just don’t know. That said, my answer is “maybe.” I realize there will be those who disagree with my reasoning here. As in any scholarly debate, I welcome their alternative views.

No one has investigated whether treatment of periodontitis specifically enhances immunity. However, what we do have is mounting evidence that many persistent infections can alter immunity to unrelated pathogens. These are referred to as chronic bystander infections, which may also exert another negative impact—vaccines for unrelated illnesses may not be as effective in people who have persistent infections.


Originally published in RDH, Oct. 20, 2020


Casey Hein, MBA, BSDH, RDH, is an internationally recognized speaker and extensively published author with over 40 years’ experience as a dental hygienist in private practice, public health, education, and government. She first began speaking about periodontal-systemic links in 2003 and founded the first publication on oral-systemic science, called Grand Rounds in Oral-Systemic Medicine. She is a pioneer in implementation of periodontal-systemic science, medical-dental collaboration, and providing primary-care services traditionally delivered by physicians and nurses in dental offices.

View Casey’s full bio