Author: Alex Johnson

Patients with Periodontitis Nine Times more likely to Die after Contracting COVID-19

The alarming headline above is one of the findings of a recent study published in the Journal of Clinical Periodontology1. The study adds to research establishing a strong link between periodontitis and COVID-19 complications including ICU admission, the need for ventilator use, and death. The global pandemic has so many people fearful, uncertain, and eager for competent medical advice. So, how do we interpret this information?  Should we share this information with our patients? Lastly, how do we educate our patients about the risks without using fear tactics? Below are my thoughts on how to answer these questions.

First, to understand why there is such a strong link between periodontal disease and COVID-19 we need to consider what we already know about periodontal disease and systemic health. The link between periodontal disease and other chronic inflammatory conditions, such as diabetes, cardiovascular disease, respiratory disease, and rheumatoid arthritis is now well established. Because of the link to systemic health, those with periodontitis are also the patients most at risk for COVID-19 complications. A healthy individual may be asymptomatic or only experience mild COVID-19 symptoms. In contrast, a patient with underlying chronic health conditions can find themselves in the ICU in respiratory distress. Studies also propose that when a patient is on a ventilator, the bacteria causing periodontal disease can be aspirated into the lungs2, making it a contributing mechanism in the rapid respiratory decline of COVID-19 patients.
Examining the numbers can provide insight into who would benefit from a discussion about this information. While 50% of the US adult population has some form of periodontal disease, 10% present with severe periodontitis. As you know, periodontitis is an infection damaging the soft tissue and bone that supports the teeth, which can eventually result in tooth loss. On the COVID-19 side of the equation, around 14% of COVID-19 patients require hospitalization and oxygen support, 5% will land in the ICU, and 2% will die. Considering the numbers, a significant portion of the population is at risk for COVID-19 complications in association with their periodontal disease. Since we don’t know who will contract the disease, we should discuss this issue with the majority of our patients, particularly those with systemic health issues.
To communicate this information to patients, I recommend making it part of a broader discussion of the association between periodontal disease and systemic health using the following talking points:
  • Periodontal disease is a chronic inflammatory condition that shares common risk factors with most chronic inflammatory diseases such as diabetes, cardiovascular disease, respiratory disease, and rheumatoid arthritis.
  • Studies have shown that those most at risk for COVID-19 complications are those with these same conditions.
  • The link between periodontal disease and other chronic inflammatory conditions adds another layer of risk for patients who are hospitalized with COVID-19.
  • Minimize your risk of COVID-19 complications by taking care of your mouth, including good home care and regular visits with your dentist and hygienist.

To help explain the link between periodontal disease and the rest of the body, our team has developed the chairside patient-education tool below. If you would like laminated copies to use with your patients, please contact us at smile@counciloakperio.com.

Dr. Christopher M. Bingham
  1. https://dentistry.co.uk/2020/07/06/poor-oral-hygiene-risk-covid-infection/

 

Why I became a Periodontist

My Dad and me. This picture was taken in 2011 when I was awarded the Richard G. Lazara Implant Fellowship Award, the largest monetary award given by the American Academy of Periodontology Foundation.
 

Asking someone why they chose their profession usually comes with a story that includes some discussion about their interests, an influential teacher, or an individual who introduced them to their vocation. In this article, I would like to share my story with you about how I came to be a periodontist. This story is just as much about my family as it is about my profession and begins before I was even born.

My grandfather was raised on a farm in southern Alberta, Canada. I don’t know why he chose to become a dentist, but he broke with the farming tradition and became the first dentist in my family. After completing dental school in Edmonton, he returned to a town close to home and worked in private practice from the 1950s to the 1980s.

One of the stories I love about my grandfather is how he was able to provide same-day dentistry. For example, crown preparation was often completed in the morning. He would then wax up the crown in the patient’s mouth, cast the crown over lunch, and finally deliver the crown at the end of the day. The goal today is still the same as in my grandfather’s time, just achieved with modern technology.

My father chose to follow in his father’s footsteps. I am the oldest of seven children, and I was born in Canada during the summer between college and dental school. At six weeks of age, my parents put me in a box (there were no car seats back then) and drove to Chicago so my dad could attend Northwestern Dental School. Periodontology was a fairly new specialty back then, and after dental school, my dad chose to complete a two-year residency. After his residency, he worked in Chicago for a couple of years before moving our family back to Canada to start his own practice.

Growing up, I loved being around my dad’s practice. As a teenager, I was allowed to watch my dad perform the occasional surgery. I liked what I saw, and so began my journey to dental school. After completing dental school at the University of Illinois at Chicago, I worked as a general dentist for two years in Canada. I realized during this time that I wanted to be a periodontist just like my dad. I soon returned to complete a three-year periodontal residency at the Medical College of Georgia.

My dad and I love to talk “shop” as it is referred to in our family. I also have a brother who is a general dentist. Put the three of us into a room together and we can keep each other entertained for hours exchanging dental stories and ideas. During these discussions, I often get animated and excited. There is so much I love about being a periodontist!

I feel so fortunate to be able to go to work each day and do something I love! My family’s deep connection to dentistry also deepens my love for my profession. In the future, I hope one of my children will choose to follow in my footsteps and find joy in their career as a dentist too.

Dr. Christopher M. Bingham