With the emergence of Covid19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (Sars -Cov- 2 ) ,insights in to the relationship between Sars-Cov-2 and oral diseases are urgently needed to elucidate the oral manifestations of coronavirus disease.
Gingival inflammation:
Bleeding and inflammation in oral tissue have been suggested to be a result of generalized increase in inflammation due to elevated levels of cytokines and interleukins initiated by Sarscov-2 .
Periodontal disease can increase levels of circulating cytokines , particularly interleukin 6 which has been implicated as one of major interleukins leading to cytokine storm.
Treatment:
- Scaling and root planning : It is a deep cleaning procedure that can treat and help to reverse gum disease.
- Medications and mouth rinses: these can help infected gums to heal and combat bacteria in mouth.
- Bone grafts: these can help to rebuild bone lost to gum disease
Xerostomia:
Covid 19 has been suggested to cause dry mouth for variety of reasons. The most common is mouth breathing by an individual due to use of mask. This can desiccate oral tissue especially without frequent hydration
Another reason is viral entry in to salivary glands which are known to be abundant in ACE2 Inhibitors
Treatment :
Stimulating saliva production: Medications prescribed to stimulate production of saliva such as pilocarpine or cevimiline
Symptomatic treatment include :
Increasing the flow of saliva
Controlling dental caries
Treating infections
Oral ulceration:
Covid 19 has been associated with vascular anomalies due to viral damage of blood vessels.the virus gains entry in to the endothelial cells that line blood vessels via ACE2 receptor and damages them leading to situation of oxygen deprivation. Tissue necrosis including oral ulceration can be result of vessel damage. Most covid 19 patients has oral ulceration s that were suspected to be caused by Sara Cov2 virus.
Treatment:
For people with more painful or frequent recurrence of mouth ulcers dentist may prescribe an anesthetic solution to reduce swelling and lessen pain. Dentists also prescribe antimicrobial mouth wash to be applied directly to the ulcer .
Cracked teeth.
Psychological stress-related factors from covid 19 pandemic plays a major role in stress-related tooth fracture .another one is sleep deprivation could also result in bruxism and cracked teeth
Treatment:
Treatment for cracked teeth include
Treating the crack with composite resin in a process called bonding
Using a filling
Using a crown which is cap that entirely covers the cracked teeth.
Loss of taste and smell
Sudden onset in loss of taste and smell are two symptoms that can be the earliest indicators of Covid19. The main reason behind this loss is suspected to be viral disruption of cranial nerves.
It is very necessary that doctors advise patients who have recovered from Covid19 to go for regular dental checkups. The need to do is more pressing in case of people who have diabetes because an infection in mouth can increase the viral load of disease.
Symptoms are usually temporary. And taste and smell should significantly improve or return within 4 weeks. However, in some cases, it may take up to 6 months.
