Implications of COVID-19 in the Oral Cavity

COVID-19

As research evolves, symptoms, treatments, and implications of COVID-19 are being studied. Through the evolving research, scientists and patients are trying to determine the link between COVID-19 and some dental symptoms that patients experience.

1. Loss of Taste - Dysgeusia

       A theory for the cause of loss of taste in patients is the following: On the epithelial cells of the tongue, there is a receptor. This receptor is for the angiotensin-converting enzyme 2. However, SARS-CoV-2 binds to this receptor as well. 1

2. Lesions and Ulcers

       A theory for the cause of the lesions and ulcers is that these are secondary causes of COVID-19, meaning they can be initially caused by opportunistic infections and due to the acute condition of COVID-19 the patient will then begin to express oral ulcers or red spots seen on the palate, gingiva (gums), lips, inside your cheeks and tongue. 2 Oral lesion presentation is varied but can include the following: “white and erythematous plaques, irregular ulcers, small blisters, petechiae, and desquamative gingivitisÉIn mild cases, oral mucosal lesions developed before or at the same time as the initial respiratory symptoms; however in those who required medication and hospitalization, the lesions developed approximately 7 to 24 days after onset symptoms.” 3 

A major impact the COVID-19 has had on the population's oral health is related to discontinuation and lack of care. For example, due to patients' dental anxiety of risk of transmission of COVID-19 patients have delayed treatment for restorative care including but not limited to cavities that needed fillings, teeth that needed crowns. Although patients have continued to present for dental emergencies that relate to tooth pain and abscesses, it is important to recognize that by not visiting the dentist for biannual exams patients have foregone screenings for oral cancer, in particular oral squamous cell carcinoma, malignant neoplasms, and immunologically mediated diseases.

As research evolves, there will be further clarity in the relation, prevalence, and impact of COVID-19 on the oral cavity. Due to the COVID-19 crisis causing dental offices and dental schools to be closed, the research on the connection between COVID-19 and dental implications has been limited.

If you feel that you experienced any of these symptoms, or see a lesion or sore in your mouth, please contact us immediately for evaluation and treatment. Teledentistry is possible for assessment of these lesions and we are available to our patients for virtual examinations.

 

This article has been based on research that is published and linked below.

1 Maciel, Panmella Pereira, Martelli Jœnior, Herc’lio, Martelli, Daniella Reis Barbosa, Machado, Renato Assis, Andrade, Priscila Victor de, Perez, Danyel Elias da Cruz, & Bonan, Paulo Rogério Ferreti. (2020). COVID-19 Pandemic: Oral Repercussions and its Possible Impact on Oral Health. Pesquisa Brasileira em Odontopediatria e Cl’nica Integrada, 20(Suppl. 1), e0138. Epub August 31, 2020. https://doi.org/10.1590/pboci.2020.135

2Maciel, Panmella Pereira, Martelli Jœnior, Herc’lio, Martelli, Daniella Reis Barbosa, Machado, Renato Assis, Andrade, Priscila Victor de, Perez, Danyel Elias da Cruz, & Bonan, Paulo Rogério Ferreti. (2020). COVID-19 Pandemic: Oral Repercussions and its Possible Impact on Oral Health. Pesquisa Brasileira em Odontopediatria e Cl’nica Integrada, 20(Suppl. 1), e0138. Epub August 31, 2020. https://doi.org/10.1590/pboci.2020.135

3Amorim dos Santos J, Normando AGC, Carvalho da Silva RL, et al. (2020) Oral Manifestations in Patients with COVID-19: A Living Systematic Review. Journal of Dental Research. Epub September 2020. doi:10.1177/0022034520957289

Author
Dr. Leelah Jaberi, DDS

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