Covid-19 and its impacts on dental health
Are you concerned about Covid-19? Maybe you currently have contracted the virus or have recently recovered from COVID-19. Are you concerned about the dental implications that your outbreak has had on your dental health? Please read below for more information
Background
COVID-19 is an infectious disease caused by the SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2) and is 75 to 80% identical to severe acute respiratory syndrome coronavirus (SARS-CoV) and several bat coronaviruses. This coronavirus was discovered in 2019 in Wuhan, China and has caused an international disease outbreak leading to millions of infections and millions of deaths worldwide. This devastating virus has touched all of our lives in one way or another.
Covid-19 (Coronavirus disease) has many different symptoms and implications. These symptoms appear 2-14 days after exposure and include (but are not limited to) fever, chills, cough, fatigue, sore throat, congestion, loss of taste/smell, headache and muscle aches, trouble breathing, and diarrhea/vomiting.
According to an article published January 3, 2021 in the Journal Oral Radiology: The relationship between COVID-19 and the dental damage stage determined by radiological examination[CM1] , the mouth can act as an entry point for the COVID-19 coronavirus because epithelial cells in your cheeks, floor of mouth, tongue and gums, have angiotensin converting enzyme (ACE2). There are also receptors present in salivary gland epithelial cells. ACE2 is the protein receptor that allows the virus to enter cells. In people with poor oral health, the presence of ACE2 appears to be higher. This means that people with poor oral health (think periodontal disease) can be more susceptible to contracting COVID-19 and having more severe infections.
This is especially true for the elderly population who struggle to maintain good oral health. In general, the elderly population is at risk of developing serious complications related to COVID-19. One in ten pneumonia-related deaths may be prevented by improving oral hygiene in the elderly according to a systematic review published in the Journal of American Geriatric Society 2008[CM2] : A systematic review of the preventive effect of oral hygiene on pneumonia and respiratory tract infection in elderly people in hospitals and nursing homes: effect estimates and methodological quality of randomized controlled trials
There are several ways COVID-19 can affect your dental health. Some of these ways include: gingivitis and periodontitis (gum disease), altered sense of taste, dry mouth, mouth sores, dry mouth and Covid tongue.
Let’s explore these in more detail.
Gingivitis and Periodontitis (Gum Disease)
People with Covid-19 may have a lot of congestion. This can lead to mouth breathing. Mouth breathing can increase dental plaque formation because it dries out the mouth enabling dental plaque to grow more profusely. When dental plaque (which is comprised of bacteria) is allowed to stay on the teeth, the plaque bacteria produce toxins that can irritate the gums and cause them to bleed and become red, inflamed, and puffy. Also, people who are ill with COVID-19 are also less likely to practice good oral hygiene which can lead to an overgrowth of dental plaque. When dental plaque is allowed to stay on the teeth, over time it can become calcified and become impossible to remove yourself with brushing and flossing alone. And remember: overgrowth of dental plaque leads to gingivitis (which is reversible) and bleeding gums which leads to periodontal disease and bone loss (and is largely irreversible). According to the American Academy of Periodontology, “patients with periodontitis are at least 3 times more likely to experience Covid-19 complications including death, ICU admission, and the need for assisted ventilation.” Make sure to stay on top of your oral hygiene schedule and get your teeth examined and cleaned at least every six months at Salt Creek Family Dental!
Altered sense of smell or taste
Have you heard about people losing their sense of smell or taste for an extended period of time after contracting COVID-19? Why is that?
It appears that taste receptor cells become damaged by the virus. ACE receptors, which are viral points of entry, are not only near the olfactory nerves (nerves related to sense of smell) but may also be related to some taste receptors. So you can actually have a loss of taste even if your sense of smell comes back. Sometimes this lingers long after the acute phase of the disease.
If you have lost your sense of smell, there is hope! 95% of people can expect improvement in taste or smell in less than one year. However, you may need to retrain your olfactory senses. According to Dr. Greg Vanichkaachorn, a Mayo Clinic occupational medicine specialist, you will need to smell specific substances. “Those substances are clove, lemon, eucalyptus, and rose. He recommends that patients smell the substances for 15 seconds, twice a day for several weeks or several months. This has been associated with significant improvements in the ability to taste and smell.”
Covid Tongue
Covid tongue is when you have Covid and you notice that your tongue is white and patchy.Covid tongue could be from a direct effect of the viral infection, or it could be a more general response to being ill.Another possibility is that people with COVID-19 may be more susceptible to fungal infections in their mouth.
If you notice any strange changes to your tongue or unusual ulcers in your mouth after your acute phase of COVID-19 has resolved, please contact our office. We may be able to write you a prescription for medication that may help your fungal infection or we can write a prescription for a palliative mouth rinse that may ease your mouth pain. Help is just a call away in Hinsdale, IL at 630-323-0060!
Dry Mouth
Dry mouth, also known as xerostomia, is caused by insufficient saliva secretion or salivary gland disfunction. Dry mouth is one of the many symptoms of COVID-19 and in fact, it may be one of the first symptoms to appear. Saliva in your mouth is one of your first lines of defense against invading my microorganisms such as Covid-19. Dry mouth can lead to bad breath, a dry or sore throat, a grooved fissured tongue, altered or metallic taste, and an increase in formation of cavities in your teeth! Saliva contains minerals such as calcium and phosphate that help keep teeth healthy. It also contains antibodies that keep us healthy and stop tooth decay.
How can you help treat dry mouth? You can increase the amount of water you drink, use a humidifier in your room, stop smoking, reduce caffeine intake, and avoid alcohol, including alcohol-based mouthwash. For palliative care of dry mouth, you can use a specific mouth rinse or throat lozenges that help with dry mouth. Please contact our office for ideas on how to help your dry mouth. We have a number of different remedies and we are just a call away!
Covid Mouth Sores
For some people, COVID-19 can cause mouth ulcers and canker sores from the virus itself, and also from our own immune response. Mouth sores can appear as early as two days before other COVID-19 symptoms appear or as late as three weeks afterward. Redness and ulcers can be found throughout the mouth but commonly begin more on the roof of the mouth as red pin prick lesions. If you notice any mouth sores in your mouth, we recommend that you avoid acidic foods and drinks and rinse several times a day with warm salty water. Also avoid alcohol or mouthwash that has alcohol. If these sores do not resolve after your COVID-19 infection has cleared, please contact our office for an evaluation by one of our caring dentists. Either call (630)323-0060 or email us at office@saltcreekfamilydental.com We are here to help!
Summary
Unfortunately, it seems that at some point, all of us will personally experience contracting Covid-19. Practicing good oral hygiene can reduce your susceptibility to contracting the disease and may also help to lessen your disease severity. All of us at Salt Creek Family Dental look forward to helping you stay healthy during this pandemic so we can eventually put this behind us! See you soon!
Citations-
[CM1]Sirin DA, Ozcelik F. The relationship between COVID-19 and the dental damage stage determined by radiological examination. Oral Radiol. 2021 Oct;37(4):600-609. doi: 10.1007/s11282-020-00497-0. Epub 2021 Jan 3. Erratum in: Oral Radiol. 2021 Feb 3;: PMID: 33389600; PMCID: PMC7778567.
[CM2]Sjögren P, Nilsson E, Forsell M, Johansson O, Hoogstraate J. A systematic review of the preventive effect of oral hygiene on pneumonia and respiratory tract infection in elderly people in hospitals and nursing homes: effect estimates and methodological quality of randomized controlled trials. J Am Geriatr Soc. 2008 Nov;56(11):2124-30. doi: 10.1111/j.1532-5415.2008.01926.x. Epub 2008 Sep 15. PMID: 18795989.