Dentists, Inflammation, and COVID-19 Risks

Charles Whitney, MD


COVID-19 is unequivocally the most stealthy yet serious virus I have encountered in 30 years of medicine. It is extremely contagious and completely asymptomatic in many patients. It causes mild illness in most. Even in people who end up on a ventilator, it is usually mild for the first six to eight days until they are hit with a raging cytokine storm!

I’m an official a card-carrying COVID-19 survivor. Fortunately, mine was a mild illness with fever for three days and muscle/bone pain for an additional two days. I never had shortness of breath. I did have loss of taste and smell and a couple episodes of diarrhea that I believe are very specific for this virus. This is how the immune system is supposed to respond.

Surprising to me was a very prominent “energy sucking” fatigue that lingered for about two weeks, forcing me to pace myself. Otherwise, I paid for it in the afternoon and evening. I am not a very patient patient. I am not very good at slowing down!

Thank goodness for telehealth. Because of it, I was able to stay connected with my patients throughout my two-week quarantine and with physician backup for hands-on needs.

I’m certain I got the virus from my receptionist, who developed symptoms on a Saturday. The prior day, we shared a computer mouse and prepared food together in the kitchen immediately after I had washed my hands. My symptoms began seven days later.

The good news is that both of us and a third team member who contracted COVID-19 during a weekend in New York City have all tested antibody positive, so we are safe to each other and our patients.

The Immune System and Inflammation

Most of America won’t be as fortunate as we are to have mild disease and develop immunity. Eventually everyone is going to come out of hibernation from our extreme social distancing efforts, which are effectively diminishing the spread of COVID-19. How and when we end social distancing is still uncertain.

One certainty is that when we do reintegrate with society, the virus will still be out there, just as contagious, and just as dangerous. Our best protection will be a strong immune system that is able to respond briskly and efficiently when we are exposed. Impactful efforts include sleep, fasting, exercise, promoting oral and gut health, detoxification, and more.

A high-functioning immune system lies quietly, ready to attack enemies like infections, cancer cells, and toxicity from our environment. It mounts a vicious attack on the invaders through a process called inflammation. Therefore, acute inflammation is actually a good thing, created to protect us. The cytokines you hear about in discussions about COVID-19 are the bullets of inflammation that kill our enemies.

The reason that people with underlying high blood pressure, elevated blood sugar, obesity, and autoimmune conditions are at increased risk of COVID-19 complications is that each of these conditions causes chronic inflammation. With these conditions, your immune system is constantly turned on and does not react appropriately when true invaders enter your world.

This immune dysregulation makes it more difficult for your body to respond when needed. More so, with COVID-19, our immune system appears to react overzealously when eliciting the needed inflammation to fight coronavirus. That’s the “cytokine storm” that occurs in high-risk individuals several days into the illness and leads to rapid worsening. It’s like putting gasoline on a fire. The cytokine storm of COVID-19 fills lungs with fluid, leading to pneumonia and respiratory failure.

I strongly believe that the reason some young and middle-aged people who are seemingly “healthy” experience severe complications of COVID-19 is that they have an unrecognized chronic inflammation not yet causing significant symptoms or testing abnormalities.

Therefore, pharmaceutical medications alone are not adequate to treat chronic diseases like high blood pressure and high blood sugar. Medications might improve your numbers, but do not address the underlying inflammation causing your blood pressure and blood sugar to rise in the first place.

The key to nurturing a high-functioning immune system is to address the underlying causes of inflammation like inflammatory fat, a poor oral and gut microbiome, and toxicities from food and our environment.

What Dentists Can Do

Do not tolerate any blood in the sink! This is where dental professionals have an opportunity to educate their patients that periodontal and endodontic infections weaken their immune systems and put them at increased risk for COVID-19 complications as well as other serious diseases like dementia, heart attacks and strokes, some cancers, and pregnancy complications.

The time to act is now. The exciting news is that it does not take long to turn around the ship of inflammation. In my motivated patients who diligently launch into lifestyle improvements, I frequently need to reduce blood pressure medication, sometimes within two weeks. They have quickly reduced their inflammatory burden, and so can you!

Perfection is not necessary. Every effort helps, but there is no single magic bullet. A comprehensive effort is optimal. To learn how you can start to tune up your immune system today, see my COVID-19 post-hibernation survival guide.

Lastly, protect yourself! Dental offices are obviously essential businesses. You need to be available for urgent dental needs, and I would argue that periodontal and endodontic treatments are high on the list of urgent dental needs.

Any procedure that aerosolizes oral fluids will contaminate your airspace. Perform these procedures in an enclosed space if possible, and everyone involved should wear N95 masks to protect themselves. Call your physician colleagues if you have difficulty finding masks. Unfortunately, some dental suppliers offer them to physician clients, but not dentists. This makes absolutely no sense, but is a reality of the situation.

Dental professionals must join the integrated healthcare team. Change occurs during times of crisis, and this is an opportunity for you to show your patients and community your expertise as an integrated healthcare professional!

Dr. Whitney is double-board-certified in family medicine and sports medicine. He served as a physician in the United States Air Force before joining the University of Pennsylvania Health System. In 2004, he established his current private medical practice, Revolutionary Health Services, where his focus is on preventive medicine, emphasizing preventive cardiology and dementia prevention. A speaker and writer, he is a leading national advocate of bridging the oral-systemic gap between dentistry and medicine. He served on the board of directors and was vice president of the American Academy of Private Physicians. He was twice named a “Top Doc” in concierge medicine by Concierge Medicine Today. And, he was four times named “Top Doc” in Philadelphia by Philadelphia Magazine.

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