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

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.

Keywords: COVID-19; Periodontitis; Point-of-care testing; Prevention; Teledentistry; aMMP-8.

Fig. 1

A) Periodontal disease diagnostics and B) related preventive oral health strategy.

Fig. 2

aMMP-8 levels measured from 69 Greek patients by aMMP-8 point-of-care mouth rinse test (PerioSafe® with the ORALyzer®), test cut-off 20 ng/ml. Patients classified by their stage of periodontitis and HbA1c levels. Calculated from the data in Grigoriadis et al. (2019) .