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COVID-19 and Oral Health: Is There a Connection?

A lady wearing a mask

COVID-19 has changed the world ever since it was discovered in late 2019. Extensive studies have been carried out showing how the virus behaves and what it does to different organs. However, there is almost nothing about how SARS-CoV-2 affects the oral cavity.

As you know by now, the virus replicates in the salivary gland and oral mucosal cells. Saliva is the primary source of transmission of the virus. With this being said, it stands to reason that there must be some effect that the virus has on the oral cavity.

Thanks to a study published on March 3 in the Sage Journals, we get to see that oral diseases can actually arise after COVID-19.

Dr. Enrico Gherlone and his team conducted the study on 122 patients hospitalized at San Raffaele University between July 23 and September 7, 2020, for COVID-19 and were evaluated three months after being discharged. Over 80% of the patients had issues with their oral cavity or nearby structures.

What We Know So Far

In any case, viral diseases are known to affect your oral cavity. Let’s say someone has HIV (human immunodeficiency virus); the disease normally presents itself in oral lesions. Or in the case of the human papillomavirus (HPV) infection that often leads to oral squamous cell cancer.

However, there is limited data on how acute respiratory infections impact the oral cavity. In fact, there isn’t much to go by since there wasn’t much research done in the case of Middle East Respiratory Syndrome (MERS) and the Severe Acute Respiratory Syndrome (SARS).

In your oral cavity, an enzyme known as the angiotensin-converting enzyme 2 (ACE2) is produced by the epithelial cells and salivary glands, which is an entry receptor for the SARS-CoV2 virus.

Even in most cases, the virus has been detected in the saliva of most patients who have COVID-19. Therefore, the oral cavity has a wealth of data when it comes to studying the impact of the virus.

Is There a Connection?

When most people get infected, the body responds through the antiviral inflammatory response. What this does is that your body will stage a defense strategy that aims to fight the infection. This normally happens in two stages: the immune mechanisms, which happen within the first seven days, and the antigen-specific phase, which occurs later.

When this happens, it increases the risk of worsening the effects of any underlying oral disorders, especially the ones caused by immune deficiencies or autoimmune diseases.

At times, drugs administered during treatment seemed to increase the chances of causing oral issues. Most people who are given corticosteroids have a higher chance of increasing fungal infections. This means that you can be at risk of getting oral candidiasis. In case you take antiviral drugs, you may get stomatitis, mouth ulcers, and dry mouth.

Intubation, tracheostomy, and assisted external ventilation are normally done when a patient is exhibiting severe symptoms. When this is done, most patients will have hyposalivation, which can worsen any previous oral injuries.

Also, according to the study, the most prevalent issues that were discovered were:

  • Dry mouth
  • Salivary gland ectasia

Salivary gland ectasia was surprisingly high and was most common in older patients. According to the study, most patients who had salivary gland ectasia were given antibiotics during their hospitalization. Receiving the antibiotics increased the odds of getting salivary gland ectasia.

Most patients who had dry mouth also had other underlying issues such as diabetes and COPD.

Also, a considerable number of patients exhibited other oral abnormalities such as:

  • TMJ abnormalities
  • Masticatory muscle weakness
  • Facial tingling
  • Facial pain linked to reduced facial muscle tone

Facial pain was also observed in some patients, possibly because of the reported SARS-CoV-2’s neurological effects. Additionally, there was a small percentage of the population that exhibited other oral issues such as:

  • Oral ulcers
  • Altered sense of smell and taste
  • White tongue

However, no lesions were seen on the cheeks or lips.

The Bottom Line

The study has brought to light that the oral cavity seems to be a good environment for the interaction of the virus with the oral cells. However, the researchers reiterate that there is no conclusive evidence at the moment that shows the direct involvement of the virus in causing oral diseases.

In any case, the research shows that there is the presence of oral conditions in COVID-19 survivors. Also, it reveals that dentists can contribute to the prevention and treatment of COVID-19 since we are specialists in oral care. Contact our dentist near you at Designer Smiles, FL, if you need any dental service. Call us now to book an appointment with our dentist.