COVID-19 Pandemic and Periodontal Practice: The Immunological, Clinical, and Economic Points of View

Abstract

The recent global health problem, COVID-19, has had far-reaching impacts on lifestyles. Although many effective WHO-approved vaccines have been produced that have reduced the spread and severity of the disease, it appears to persist in humans for a long time and possibly forever as everyday it turns out to have new mutations. COVID-19 involves the lungs and other organs primarily through cytokine storms, which have been implicated in many other inflammatory disorders, including periodontal diseases. COVID-19 is in a close association with dental and periodontal practice from two respects: first, repeated mandatory lockdowns have reduced patient referrals to dentists and limited the dental and periodontal procedures to emergency treatments, whereas it is important to recognize the oral manifestations of COVID-19 as well as the influence of oral and periodontal disease on the severity of COVID-19. Second, dentistry is one of the high-risk professions in terms of close contact with unmasked individuals, necessitating redefining the principles of infection control. The pressures of the economic recession on patients as well as dentists add to the difficulty of resuming elective dental services. Therefore, this study is divided into two parts corresponding to what mentioned above: the first part examines the clinical and immunological associations between COVID-19 and periodontal and oral diseases, and the second part delineates the measures needed to control the disease transmission in dental clinics as well as the economic impact of the pandemic era on dental services.

Sergančiųjų Covid-19 Burnos Pakitimų Ypatumai

“…Daugelis autorių nurodė, kad opiniai pažeidimai atsirasdavo 21-28 COVID-19 ligos dieną, buvo skausmingi, pavieniai ar dauginiai [15,17,18,20,21]. Dažniausiai buvo stebimos į aftą panašios opos, apsuptos eritemine aureole ir padengtos fibrinine pseudomembrana [6,3,18,22]. T. Brandão ir kt.…”

“…Skonio ir uoslės pokyčiai buvo dažniausi, o kartais ir vieninteliai COVID-19 simptomai, įprastai nebūdingi viršutinių kvėpavimo takų infekcijoms ir netipiški daugeliui pacientų ir gydytojų. M. Darestani ir kiti [22] nurodo, jog SARS-CoV-2 virusas gali paveikti skonio funkciją keliais būdais. Prisijungęs prie AKF2 receptorių, kurie aptinkami liežuvio ir seilių liaukų epitelyje, sukelia uždegimines reakcijas.…”

“…COVID-19 sergančiųjų kserostomijos dažnio pasireiškimo intervalas buvo nuo 0,3% iki 83,9% [2, 6,10,11,13,15,16,20]. Keletas autorių nurodė, kad kai kuriais atvejais kserostomija pasireiškė likus keletui dienų iki bet kokių kitų simptomų atsiradimo, kartu su kitais simptomais arba 1-2 dienos po jų atsiradimo [11,22]. Taigi, burnos sausumas, skonio ir uoslės pokyčiai galėtų būti identifikuojami kaip ankstyvi ar vieni pirmųjų galimų ligos simptomų, dar prieš diagnozuojant COVID-19.…”

Associations between Periodontitis, COVID-19, and Cardiometabolic Complications: Molecular Mechanisms and Clinical Evidence

“…In addition, as described by two review articles, COVID-19 was associated with several oral manifestations, including oral lesions (in both keratinized and non-keratinized mucosa), taste dysfunction (dysgeusia), and xerostomia [ 48 , 49 ]. Dysgeusia was the first recognized oral symptom of COVID-19, whereas aphthous-like lesions, herpetiform lesions, candidiasis, and oral lesions of Kawasaki-like disease were the most common oral manifestations.…”