The Connection Between COVID-19 and Oral Health
Chest pain, difficulty breathing and fever are three signs of COVID-19 that are frequently discussed, but there is evidence that COVID-19 could have oral symptoms as well.
Oral Symptoms of COVID-19 as Reported by Patients
- Dry Mouth
- Loss of Taste and Smell
- Excessive Salivation
- Bad Breath
- Oral Ulcers and Mouth Rashes. (4)
Dry mouth and loss of taste and smell are two symptoms reported by many COVID-19 patients. These can be some of the first and only symptoms exhibited in some cases. (1)
Excessive salivation is also a potential symptom. It can contribute to issues like angular cheilitis (inflammation of the corners of the mouth), since the salivary enzymes in excess saliva can irritate the skin. (2)
The SARS-CoV-2 virus can cause changes to the surface of the tongue and the chemicals in saliva. these changes may lead to the development of bad breath. However, more research needs to be done, since there are a variety of factors that can contribute to more noticeable bad breath. For example, wearing a mask may make a patient more aware of the smell of his or her breath or encourage mouth breathing, which can contribute to bad breath. Bad breath is also a common side effect of several over-the-counter medicines used to treat COVID-19 at home. (3)
Several patients who have tested positive for COVID-19 were also diagnosed with oral ulcers. Another potential symptom is a rash on the upper palate of the mouth. Certain rash patterns are more commonly associated with viral infections, and the rashes found in COVID-19 patients are consistent with those patterns. (4)
Gum Disease and the Severity of COVID-19
Periodontal pockets could be a favorable place to harbor the virus that causes COVID-19. (5) There is also some evidence that inflammation caused by periodontal disease could contribute to the severity of a patient’s COVID-19 symptoms or quicker progression. (6)
Problems With Diagnosis
Oral complications because of COVID-19 infection have been poorly described and potentially underreported, likely due to the fact that most oral symptoms are unlikely to be fatal or dangerous. This has left gaps in the early diagnosis of the onset and characterization of such symptoms, as well as their associations with COVID-19 outcomes.
One of the problems with treating COVID-19 is that two people rarely have the exact same symptoms. Some people infected with the disease may only experience loss of smell, while others experience many other symptoms. Further research will provide a greater understanding of how the coronavirus interacts with the body. As dentists become aware of the variety or oral symptoms associated with COVID-19, they may even be able to use that information to detect otherwise asymptomatic cases in their patients.
(1) American Journal of Otolaryngology
(2) Oral Diseases, October 2020
(4) Oral Diseases, July 2020
(5) Oral Diseases, May 2020
(6) CDA Journal, October 2020
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