Periodontal disease and targeted prevention using aMMP-8 point-of-care oral fluid analytics in the COVID-19 era

Ismo T Räisänen,Kehinde A Umeizudike,Pirjo Pärnänen,Pia Heikkilä,Taina Tervahartiala,Solomon O Nwhator,Andreas Grigoriadis,Dimitra Sakellari,Timo Sorsa

doi:10.1016/j.mehy.2020.110276

Abstract

Periodontal disease is a chronic multifactorial infectious and inflammatory disease associated with several chronic systemic diseases, such as diabetes, cardiovascular diseases (CVD), chronic obstructive pulmonary disease, hypertension, Alzheimer’s disease and so on. These same systemic diseases have been associated with severe COVID-19 infections. Several recent studies have suggested hypotheses for the potential association between periodontal disease and severe COVID-19. Periodontal disease is also one of the most prevalent diseases globally. All this supports the importance of good oral health, also in the COVID-19 era. Thus, new strategies and approaches to identify patients at risk of periodontal disease could be beneficial to enhance secondary prevention, especially if targeted to COVID-19 risk groups. Diagnostic biomarkers for periodontal disease have been researched extensively. Potential biomarkers in oral fluid with currently available rapid non-invasive point-of-care technology, such as aMMP-8, could help to extend screening and identification of patients at risk for periodontal disease also to situations and places where professional dental expertise and equipment are limited or unavailable. i.e., nursing and care homes, and rural and distant places. The oral fluid point-of-care technologies could also be useful in the hands of medical professionals (diabetes, CVD, etc.) to identify patients at risk for undiagnosed periodontal disease and to refer them to a dentist for examination and evaluation. Finally, if there is a causality between periodontal disease and severe COVID-19 infections, these point-of-care oral fluid biomarker technologies could possibly also help in the assessment of the risk of deterioration and complications.

Highlights

Oral diseases, including periodontitis, are one of the most prevalent diseases globally [1,2]
This study proposes to evaluate if non-invasive oral fluid point-ofcare tests based on biomarkers, such as active matrix metalloproteinase8, could be beneficial for interdisciplinary screening and identification of individuals with severe periodontitis and active periodontal breakdown during COVID-19 pandemic to refer them to targeted periodontal disease prevention (Fig. 1)
Periodontitis is one of the most prevalent diseases globally, which underscores the need for new approaches to identify patients at risk to enhance secondary prevention for periodontitis

Summary

Introduction

Oral diseases, including periodontitis (gum disease), are one of the most prevalent diseases globally [1,2]. This study proposes to evaluate if non-invasive oral fluid point-ofcare tests based on biomarkers, such as active matrix metalloproteinase8 (aMMP-8), could be beneficial for interdisciplinary screening and identification of individuals with severe periodontitis and active periodontal breakdown during COVID-19 pandemic to refer them to targeted periodontal disease prevention (Fig. 1). The proposed preventive oral health strategy with point-of-care testing could mitigate the risk of adverse systemic effects of periodontitis and possibly the risk of severe COVID-19 infections, especially among older patients and those with underlying health conditions.

Results

Conclusion