Page 19 - Bulletin Vol 27 No 1 - Jan. - April 2022 FINAL

Research Article |COVID-19 & the Oral Cavity (Cont.)

The questionnaire first addressed the severity of the virus by inquiring about the need for supplemental oxygen, hos-
pital stay, intubation, and common systemic symptoms reported from current literature. The next subset of questions
looked to see the progression of symptoms, the emergence of new oral symptoms, and resolution of symptoms. A
wide variety of oral symptoms were deliberately included to account for the current absence of information re-
lating to Covid-19 related symptoms of the oral cavity. The last subset of questions inquired about Covid-19 screening
requirements and regulations for office appointments with a dental professional

Statistical Analysis
Descriptive statistics such as frequency (percentage) is employed to summarize results. A variety of commonly
reported systemic and oral symptoms from literature were compiled to formulate the survey. The authors looked to
determine if any meaningful, numbers permitting, clinical associations existed amongst specific systemic symptoms,
new oral symptoms and worsening oral symptoms (Table 1). The prevalence of each systemic and oral symptom was
computed amongst survey respondents. An exact 95% confidence interval was computed for selected / noteworthy
symptoms

Questions 4, 7, and 9 inquired about systemic symptoms, new oral manifestations, and worsening oral symptoms
experienced, respectively. A Monte Carlo estimation of the exact test based on 10,000 runs was conducted in assessing
associations as most of the reported symptoms among systemic and oral symptoms were sparse.
Results:

Demographics of Reported of Survey Participants
A total of 6218 persons who visited a Montefiore Health System location were sent the survey, of which 395 were
bounced due to invalid addresses. A total of 973 opened the questionnaire, and 556 completed the survey.
Systemic Symptom Distribution

Seven of the most common systemic symptoms from current research and literature were listed in our questionnaire.
In our study sample, the most reported systemic symptoms were body aches (73.9%), fever (69%) and loss of taste
(62.3%) (Table 2).

Oral Symptom Distribution
Fifteen different oral symptoms were listed in our questionnaire to observe and investigate a wide range of possible
outcomes that the Covid-19 infection may have on the oral cavity. Of the study participants, the most reported oral
symptoms were dry mouth (19.5%, 95% CI: 16.2% – 23.2%), tooth pain (13.1%, 95% CI: 10.3% – 16.3%), and bleeding
gums (8.0%, 95% CI: 5.8% – 10.6%). The majority of patients with Covid-19 infection in the study did not experience
any oral symptoms (58.1%, 95% CI: 53.7% – 62.3%) (Table 3).
Systemic Symptoms v. Oral Symptoms Clinical Correlation

A statistically significant association was found showing patients who experienced two or more systemic symptoms
were found to have experienced multiple new oral symptoms (p<0.0001) (Table 4). Similarly, patients who experienced
two or more systemic symptoms experienced multiple worsening oral symptoms (p=0.0034) (Table 5).
Additional Findings

Comparing patients who experienced systemic symptoms to those who experienced oral symptoms, 64.9%
(95% CI: 60.7% - 68.8%) and 65.9% (95% CI: 61.3% - 69.8%) of respondents claimed resolution of such symptoms,
respectively. About 25.5% of respondents (95% CI: 22.0% - 29.4%) required assistance with breathing while only 3.4%

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