Can periodontal pockets and caries lesions act as reservoirs for coronavirus?

Abstract

The periodontal pocket and likely caries lesions may act as a reservoir and source of dissemination and development of systemic infections. While periodontal pockets have been found to harbor several viral species, there is no information on its ability to serve as a reservoir for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We have used a real-time polymerase chain reaction (RT-PCR) approach to evaluate SARS-CoV-2 in periodontal pockets and cavitated caries lesions in a crosssectional study of 72 participants who were divided into six groups: symptomatic positive COVID-19 cases with periodontal pockets, symptomatic positive with cavitated caries lesions, asymptomatic positive with periodontal pockets, asymptomatic positive with cavitated caries lesions, positive control, and negative control. A total of 180 samples were interrogated by RT-PCR to amplify the SARS-CoV-2 E and S genes. SARS-CoV-2 was present in 41.7% of symptomatic positive COVID-19 cases with periodontal pockets and 16.7% of symptomatic positive with cavitated caries lesions. The mean Ct value of E and S genes in periodontal pockets patients were 36.06±0.46 and 30.06±6.73, respectively, and the mean Ct value for both genes in caries lesions patients were 35.73±4.14, and 34.78±1.93, respectively. The sensitivity, specificity, and accuracy to detect SARS-CoV-2 among periodontal pockets were 20.8% (95% CI 7.13-42.15), 100% (95% CI 73.54-100.0), and 47.2% (95% CI 30.22-64.51), respectively. Among cavitated caries lesions patients, they were 8.3% (95% CI 1.03-27.0), 100% (95% CI 73.54-100.0), and 38.9% (95% CI 23.14-56.54), respectively. SARS-CoV-2 can be detected in periodontal pockets and caries lesions, and these sites may act as reservoirs for the virus. However, the sensitivity of SARS-CoV-2 detection is low compared with other methods. To our knowledge, this report is the first to investigate the relationship between SARS-CoV-2 and periodontal pockets and caries.

The short-term effect of different chlorhexidine forms versus povidone iodine mouth rinse in minimizing the oral SARS-CoV-2 viral load: An open label randomized controlled clinical trial study

“…[20] Its effect was found to extend up to at least three hours, and it can be used safely for up to 6 months in the oral cavity and 5 months in the nasal cavity. [21–34] Our study supports the potential effect of PVP-I mouth rinse in helping with the virus reduction in the oropharyngeal area. This can prevent the spread of infection from patients’ mouths and protect dentists as well as all medical field workers.…”

The Oral Cavity Potentially Serving as a Reservoir for SARS-CoV-2 but Not Necessarily Facilitating the Spread of COVID-19 in Dental Practice

“…Natto et al 37 Dental pulp ACE2 and TMPRSS2 are coexpressed in dental pulp, which would be infected with SARS-CoV-2…”

“…Gingival crevicular fluid containing SARS-CoV-2 flows into gingival sulcus and periodontal pocket, which could provide SARS-CoV-2 with a habitat Kheur et al 35 Elisetti 36 Natto et al 37 Badran et al 38…”

COVID-19 in Dental Practice Is Prevented by Eugenol Responsible for the Ambient Odor Specific to Dental Offices: Possibility and Speculation

“…In addition to the risk of infection associated with dental treatments, the oral cavity also serves as a reservoir for SARS-CoV-2 [ 2 ]. SARS-CoV-2 is present in and replicates in saliva [ 3 ], minor and major salivary glands [ 4 ], gingival crevicular fluid and gingival sulcus [ 5 ], periodontal tissue [ 6 ], periodontal pocket [ 7 ], dental plaque [ 8 ], and dental biofilm [ 9 ]. Higher viral loads are found in such oral secretions and tissues even after recovery from COVID-19 [ 4 ].…”