The correlation between COVID-19, periodontal disease, and diet

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You might read the title of this article and then start scratching your head, asking yourself, "What is he talking about? Is he just trying to catch my attention? Maybe even confuse me?"

Well, here's why I am talking about the correlation between COVID-19, gum disease, and diet. The connection is our immune system. And, yes, I want your attention so I can share my thoughts about this association, your overall health, and your well-being. I certainly don't want to confuse you.


Alvin Danenberg, DDS.Alvin Danenberg, DDS.

New research suggests that the SARS-CoV-2 virus, which leads to the development of COVID-19, could be life-threatening by initially damaging red blood cells and causing hypoxia. The theory goes like this:

  • The virus attacks red blood cells by attaching to the iron portion of the cells' hemoglobin.
  • The virus oxidizes the iron and releases it into the bloodstream.
  • The virus then replaces the iron with itself in the red blood cell.
  • The virus controls the red blood cell, which is now unable to carry necessary oxygen to other cells and organ systems. This results in hypoxia.
  • The oxidized iron pours into the bloodstream causing severe oxidative stress, which causes systemic inflammation initiated by the immune system.
  • Zinc in the body mobilizes itself to offset the damage from the free-floating oxidized iron, thereby depleting the body of its necessary levels of zinc. This can cause a loss of smell and taste, among other effects.
  • The oxidative stress from excessive iron, severe systemic inflammation as a result of the immune system's overproduction of inflammatory chemicals (cytokines), and hypoxia can cause the lungs and other organs to fail, possibly leading to death from COVID-19.

As of this writing, this is still just a theory. So much is being learned about the virus day by day. However, this theory makes sense. It could result in the clinical signs and symptoms of this pandemic that are being observed and documented throughout the world.

Gum disease

The gum tissues in your mouth are susceptible to chronic systemic inflammation. The oxidative stress occurring from an excess of unhealthy oxidized iron causes the immune system to create acute and chronic systemic inflammation. These physiological changes cause dysfunction in the immune system, especially if the immune system was already weakened or dysfunctional from emotional stress, environmental toxic substances, an unhealthy gut, or poor diet choices.

Active gum disease will increase as the immune system fails to control the overgrowth of harmful bacteria in the mouth. Periodontal infection will release virulent bacteria and inflammatory elements into the bloodstream, complicating the already spreading systemic inflammation. Inflamed and bleeding gums will increase the potential for increasingly destructive forces occurring from SARS-CoV-2.


A diet including inflammatory foods and lacking nutrient-dense foods will damage the gut's garden of bacteria, its mucous layer, and its epithelial barrier. The result will be the leakage of toxic substances into the bloodstream from the lumen of the gut. The immune system attempts to gobble up these toxic substances by releasing various chemicals and cells to fight the invasion. These immune system actions create inflammation that spreads throughout the circulatory system to all organ systems. However, if you have periodontal disease and if the novel coronavirus is present, then your immune system already could be overwhelmed.

A vicious cycle

A weakened immune system, active periodontal disease, and unhealthy food choices continue to promote chronic systemic inflammation. If SARS-CoV-2 invades the body, the existing chronic systemic inflammation will exacerbate the potential virulence of the virus. This could lead to a vicious cycle escalating exponentially.

Fortunately, the vast majority of infected people will not die from COVID-19. Their body's immune system will overcome the virus at a point where the virus is inactivated by the antibodies that are naturally produced by the adaptive immune system. Other negative feedback pathways will go into effect and reduce the immune system's production of inflammatory chemicals. But there are proactive precautions that uninfected individuals could take to enhance their immune system.

I've talked about how to improve the immune system in some of my previous blogs. In summary, a nutrient-dense, anti-inflammatory diet, along with lifestyle changes, will enhance the health of the gut and provide the immune system with many of the necessary ingredients to defend your body.

Supplements of vitamin C, vitamin D, glutathione, and zinc have been suggested to help prevent or possibly treat SARS-CoV-2 infection. However, along with lifestyle changes, the nutrient-dense, anti-inflammatory diets I have recommended will provide most of these nutrients in their natural states as they exist in real, unprocessed foods.

Medical research will come up with an adequate treatment protocol to deal with the acute and life-threatening manifestations of the novel coronavirus. Scientists also may develop an effective vaccine or an array of vaccines to protect people prior to the invasion of the virus. But your proactive efforts to support your immune system will also help in fighting the virus, preventing periodontal disease, and avoiding other chronic diseases. A healthy immune system will go a long way in maintaining your well-being.

Alvin Danenberg, DDS, has retired from the private practice of periodontics in Bluffton, SC. He continues to be on the faculty of the College of Integrative Medicine and created its integrative periodontal teaching module. He also spent two years as chief of periodontics at Charleston Air Force Base earlier in his career. His website is

The comments and observations expressed herein do not necessarily reflect the opinions of, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

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