Is There A Connection Between Oral Health And COVID-19?
Gillian D'Souza | June 2021
Doctors and researchers are investigating the many effects of COVID-19 and its possible impact on the teeth, gums, and oral cavity.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes the new coronavirus disease 2019 (COVID-19).
This article will discuss the possible links between COVID-19 and oral health.
Is there a link?
There does not appear to be much research suggesting that COVID-19 can lead to poor oral health.
However, one 2021 study suggests that poor oral health can play a part in contracting SARS-CoV-2.
The study notes that the mouth can act as an entry point for SARS-CoV-2 because cells in the tongue, gums, and teeth have angiotensin-converting enzyme-2 (ACE2). This is the protein receptor that allows the virus to enter cells.
In those with poor oral health, the presence of ACE2 receptors appears to be higher.
notes that there may be a connection between gum disease and changes in dental plaque with an increased risk of complications from COVID-19.
The researchers suggest that a lack of oral hygiene can increase the chance of bacteria traveling from the mouth to the lungs. This may then increase the risk of developing a bacterial infection in addition to COVID-19.
COVID-19 and access to oral healthcare
According to the Centers for Disease Control and Prevention (CDC), oral health is an important part of a person’s overall health and well-being.
Access to dental care is important in reducing the early stages of oral disease.
The COVID-19 pandemic led to reduced opening hours and the closure of dental practices, except in the case of emergency procedures. This has limited people’s ability to access routine care.
The CDC also notes that this lack of access to dental care disproportionately affects those who are from low income households and who rely on dental benefits under Medicaid.
Only 20% of dentists accept Medicaid. Additionally, people who rely on Medicaid dental benefits have experienced restrictions and reductions in their coverage.
COVID-19 and gingivitis
Gingivitis refers to inflammation of the gums.
Some symptoms of gingivitis include:
- red, swollen gums
- bleeding gums when brushing or flossing
- bad breath
- an unpleasant taste in the mouth
Poor oral hygiene can lead to the accumulation of bacteria that stick to the teeth and form dental plaque. This is a common cause of gingivitis.
The authors of one 2021 case report speculate that having a debilitating disease such as COVID-19 may mean that a person is less likely to practice good oral hygiene. This enables dental plaque to grow, which increases the risk of gingivitis.
The researchers also suggest that bleeding gums may be a symptom of COVID-19. They observed that symptoms of gingivitis reduced after COVID-19 subsided.
However, these findings are based on a study of three people. More research in a wider population is necessary to confirm them.
Can COVID-19 cause tooth sensitivity?
There does not appear to be any research suggesting that there is a direct link between COVID-19 and tooth sensitivity.
A person experiences tooth sensitivity when the enamel, which is the hard outer layer that protects the teeth, becomes damaged or weakened.
Some symptoms of tooth sensitivity include:
- pain or discomfort while chewing
- sensitivity to hot or cold foods
- pain after exposure to cold air
- sensitivity to sweet or acidic foods and drinks
For mild cases of tooth sensitivity, a person can use desensitizing toothpaste. They can also try using extra soft toothbrushes.
If the symptoms persist, a person may wish to consult a dentist.
COVID-19 and dry mouth
Dry mouth, or xerostomia, occurs when there is inadequate saliva to keep the mouth moist. This makes it difficult to break down food, wash food particles away from the mouth, and swallow food.
Dry mouth may be an early symptom of COVID-19, and it was one of the most common oral symptoms reported by 108 people in a study in The Lancet. However, the reasons for this are still unclear.
The study authors say that dry mouth may be a direct effect of the SARS-CoV-2 virus infecting and damaging the salivary glands. It may also occur due to poor oral hygiene or as a side effect of COVID-19 treatment.
Without treatment, dry mouth can increase the risk of tooth decay and infection in the mouth.
COVID-19 and oral ulcers
Like other viral infections, SARS-CoV-2 impairs the immune system and makes a person susceptible to other secondary conditions.
recovering from this infection have observed ulcers in their mouth. For some, doctors have found these ulcers to be thrush-like, while others have seemed fairly unspecific.
An ulcer may develop as a white patch on the tongue, gums, or roof of the mouth.
Some other symptoms include:
- white or red bumps in the mouth
- dull pain
- discomfort while eating and drinking
- a burning sensation
According to the National Health Service (NHS), mouth ulcers tend to resolve on their own in 1–2 weeks. A person should consult a doctor if ulcers persist for longer than 3 weeks, as this could indicate another opportunistic infection.
Alternatively, a local pharmacist can recommend some simple measures to treat an ulcer a home. These measures could take the form of an antimicrobial mouthwash, a topical gel or cream, medicated lozenges, or a mouth spray.
Can COVID-19 cause cracked teeth?
According to the American Dental Association, dentists have noted a 59% increase in teeth grinding, or bruxism, and a 53% increase in chipped and cracked teeth since the start of the COVID-19 pandemic.
They suggest that this can occur as a result of higher anxiety levels during the pandemic and poor posture resulting from a work-from-home environment.
The dentists explain that anxiety and poor posture can cause people to clench their jaw and grind their teeth. These are involuntary behaviors that stem from added stress. The result is increased pressure on the teeth that weakens them and makes them more prone to crack.
Cases of chipped or cracked teeth have also occurred in people with severe COVID-19. One study
suggests that people in critical care, such as those who need ventilators, experience a range of complications, including chipped teeth.
Amid the rise in oral diseases during the pandemic, researchers are trying to determine whether they are due to COVID-19 or secondary factors such as stress, poor posture, or other conditions.
Although there is no concrete evidence yet to definitively link COVID-19 to oral health, people should try to practice good personal and oral hygiene as a form of disease prevention.