As cases and deaths from COVID-19 continue to rise across the country, evidence mounts about the potential long-term effects of the virus. In addition to chronic respiratory symptoms, brain fog and mental health symptoms, The New York Times recently highlighted one more potentially troubling chromic symptom that could long outlast the acute effects of COVID-19: tooth loss and other oral health problems. COVID-19 can weaken the circulatory system and cause inflammation, both of which have an effect on oral health outcomes. There may also be a connection between COVID-19 and worsening of existing oral health problems. While rigorous data and long-term studies will be needed to fully flesh out potential connections between COVID-19 and oral health, survivors of COVID-19 are beginning to report tooth loss and gum sensitivity, along with other oral health symptoms.
While we don’t yet know if or how COVID-19 is implicated in oral health issues, we do know for sure that oral health is deeply tied to systemic health. Research shows that oral health problems can exacerbate chronic illnesses, like cardiovascular disease, and could be a culprit for some acute conditions, including stroke, pneumonia and adverse pregnancy outcomes. Additionally, chronic conditions like diabetes and osteoporosis can worsen oral health outcomes. Poor oral health can also negatively affect nutrition, diet, emotional wellbeing, sleep and ability to work or study. Because of these deep connections, protecting oral health coverage and access to care is integral for supporting overall health. This is only more important during a public health crisis, when ensuring people avoid unnecessary hospital visits can be life-saving.
Unfortunately, COVID-19 has affected delivery of dental services, just as it has other aspects of the health care system. Early on, dental offices and clinics had to close to curb the spread of COVID-19 and many are still operating at reduced capacity. More than 4 million people have newly gained access to Medicaid coverage since the pandemic began, but adult dental benefits are optional in state Medicaid programs and less than 40% of U.S. dentists participate in Medicaid, leaving many without access.
Now more than ever, states must protect dental coverage and access to care and Congress must act to authorize federal aid. Delays in non-emergency dental care due to COVID-19 will mean pent-up demand and the need for greater access. If there is, in fact, a link between COVID-19 and oral health problems, the millions of people infected with COVID-19 may need even more dental care than before. There is already a demonstrated link between untreated oral health problems and chronic health conditions (e.g., diabetes, heart disease) that are known to put people at risk for worse COVID-19 outcomes. Additionally, being on a ventilator can cause bacteria in the mouth to enter the lungs and cause pneumonia. For COVID-19 patients who need ventilation, oral health problems could further complicate COVID-19 outcomes. Of particular concern is that Black people are significantly more likely to get ventilator-associated pneumonia than white people.
If the federal government doesn’t act fast to shore up state budgets and protect access to dental care, among other critical health care services, people’s health will continue to suffer, in the COVID-19 era and in its aftermath.