What is the relationship between oral health and covid-19?

Oral health and Covid-19 are closely related. On the one hand, there is increasing evidence of different symptoms that can appear in the oral cavity in people with Covid-19. On the other hand, it is known that poor oral health can worsen the prognosis in case of acquiring the virus. And not only that, but the oral cavity plays a fundamental role in the infection and transmission of the SARS-CoV-2 virus.

There is a study that concluded that patients with periodontitis (caused by the accumulation of bacterial plaque, along with other factors) and Covid-19 had a higher risk of developing serious complications of Covid-19 (including death) than people without periodontitis ( Marouf et al. 2021).

There are several hypotheses about this relationship, including that the accumulation of dental plaque causes inflammation at the gingival level, and that in cases of periodontitis, it can contribute to a systemic inflammatory state, which can trigger an increased risk of complications in patients with Covid. -19. Especially in people with diabetes, cardiovascular disease or immunocompromised.

The mouth is one of the main routes of entry for Covid-19. while good oral health can prevent complications from the virus.

At the same time, it has been proven that those with poor oral health are at greater risk of developing aspiration pneumonia if they require mechanical ventilation.

Advances in vaccination are very encouraging. Even so, it is still essential to be aware of the importance of good oral health as a preventive measure and to know the possible symptoms of Covid-19 in the mouth .

How Covid-19 affects the oral cavity

The oral mucosa is one of the main routes of entry of the SARS-CoV-2 coronavirus and it can manifest itself with different symptoms in the mouth .

• Loss of sense of taste . Distortion or loss of taste are considered less common symptoms of Covid-19, although more than 4 out of 10 people usually suffer from them according to the EneCOVID seroprevalence study of the Carlos III Health Institute. It is usually accompanied by loss of smell.

Complete loss of taste ( ageusia ) or changes in the perception of flavors ( dysgeusia ) appear more frequently in the first week of the disease and usually revert spontaneously after approximately one month in the vast majority of cases. persons. However, this symptom can last longer.

• Covid language . Changes in the tongue are other symptoms of Covid-19 in the mouth that can appear when contracting the disease.

Among the most frequent, transient lingual papillitis (inflammation or irritation of the taste buds), an enlarged tongue with teeth marks on the sides or a swollen tongue with patchy hair loss.

The manifestation of any of these symptoms among those infected with coronavirus has been renamed 'Covid language'.

• Mouth ulcers . Lesions in the oral mucosa and the appearance of canker sores or ulcers are also considered possible symptoms of Covid-19.

• Burning mouth syndrome . Burning, stinging or tingling sensations have also been described among people affected by Covid-19.

• dry mouth Many people also reported a feeling of dry mouth as a symptom of the disease. The hypotheses suggest that the virus could affect the salivary glands, which could cause a decrease in the production of this fluid.

It could also be a side effect of the medications used to mitigate the symptoms of Covid-19 and even, as a consequence of the prolonged use of masks, which encourages mouth breathing and can lead to xerostomia.

Oral hygiene as a preventive measure against Covid-19

Poor oral hygiene can be considered a risk factor for complications from Covid-19.

This makes improving tooth brushing and oral care take on a new dimension in today's context.

In this sense, it is advisable to wash your hands very well with soap and water before touching the brush to prevent the spread of viruses from the hand to the oral mucosa.

After brushing, rinse the brush well and preferably disinfect the head with an antiseptic mouthwash for 1 minute.

The next step would be to shake from right to left to remove excess water and moisture and store it head up.

The brush must be kept away from the toilet (at least 1 meter away) to avoid possible contamination, since the coronavirus can also be found in urine and feces.

The best thing would be not to have it in sight, but stored, and that it is not next to other brushes.

Another beneficial measure would be to incorporate into the brushing routine products with active ingredients that help prevent the formation of dental plaque and reduce its accumulation, such as Cetylpyridinium Chloride ( CPC ).

Likewise, we must remember the importance of completing oral hygiene with the use of dental floss or tape, tongue scrapers and mouthwashes that adapt to the needs of each person.

Specifically, mouthwashes acquire special importance in the current context, since the results of the latest laboratory studies show that some inactivate the SARS-CoV-2 virus, suggesting that they could reduce the viral load and the risk of transmission of the virus, as well as the risk of developing the infection with more severe manifestations.

In the case of mouthwashes with CPC, these inhibit the entry of the virus into susceptible cells, and are effective against different variants of the coronavirus. They act by breaking the membrane of SARS-CoV-2 and have been shown in in vitro studies to reduce the infectivity of the virus by 1,000 times.