Page 20 - Bulletin Vol 27 No 1 - Jan. - April 2022 FINAL

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

(95% CI: 2.1% - 5.3%) required intubation. Furthermore, 38.6% (95% CI: 34.6% - 42.8%) of Covid-19 patients required
an overnight stay in the hospital.

In regards to screening protocols, of those who had a clinical appointment with a dental professional, only 46.6%
(95% CI: 42.1% - 51.2%) of respondents acquired a negative Covid19 test prior and only 23.8% (95% CI: 19.1% -
26.8%) reported being required to receive a negative test for the visit (Table 6).
Discussion:

The purpose of the study was to investigate the oral manifestations of the Covid-19 infection, explore possible
correlations between systemic and oral symptoms associated with Covid-19, and ultimately gain knowledge
regarding Covid-19’s effect on oral health for our medical and dental communities. A wide distribution of oral
symptoms was established by this study. The most common oral symptoms experienced were dry mouth and tooth
pain, while most respondents reported no oral symptoms. Although no significant associated oral manifestations
with Covid-19 were drawn, the investigators believed that by encompassing all possible symptoms, the study would
be a gateway reference to increase awareness and invite further investigation based on the study findings.
In line with current research and literature, the systemic symptoms reported in this study were body aches, fever,
and loss of taste. Although the prevalence of partial or complete ageusia invited optimism of possible correlations
between systemic and oral symptoms, no direct correlation amongst clinical symptoms, systemic or oral, were drawn
from this study.

The main conclusion of the study was that patients who experienced multiple systemic Covid-19 symptoms also
experienced multiple new and worsening oral symptoms. The study alludes that increased severity and progression
of the Covid-19 infection, as demonstrated by increased number of systemic symptoms, may correlate with a
deteriorated oral health status. Whether this finding is due to immunosuppression secondary to Covid-19 inviting
opportunistic oral manifestations, or if there truly is a direct impact of Covid-19 within the oral cavity, cannot be
determined by this study.
Despite the relative uncertainty of transmission and progression of the Covid-19 infection, less than half of
participants (46.6%) received a negative PCR result prior to visiting an outpatient clinic appointment. Furthermore,
less than a quarter of respondents (23.8%) were required to have a negative result prior to their appointment.
Although the distribution of the vaccine has greatly curtailed transmission, the study suggests a lack of stringent
screening protocols at the height of the Covid-19 outbreak.

All individuals who received a positive Covid-19 PCR result in the Montefiore Health system with a documented email
address were sent the study questionnaire. However, patients without email addresses and those with more severe
symptoms, such as those hospitalized, intubated, or expired, that could not have responded to the survey are not
accounted for in this study. An additional limitation is the small percentage of respondents to the survey. Thus, the
possible correlation between oral and systemic manifestations of the Covid-19 infection cannot be entirely
dismissed.
Conclusion:

The study’s investigation into oral and systemic symptoms offers the medical and dental communities insight into
potential manifestations of Covid-19 seen in their patients. The prevalence of symptoms such as dry mouth and
tooth pain seen in the study should encourage practitioners to potentially consider screening for Covid-19 infection
in patients showing these manifestations. Furthermore the study urges clinicians to have increased periodic
evaluations of patients who had Covid-19, as those experiencing multiple systemic symptoms were found to have
multiple new and worsening oral symptoms. In lines with screening, the study encourages more stringent regulations
and screening guidelines for patient appointments to minimize the spread of Covid-19 amongst their communities.

20 | Nassau County Dental Society ⬧ www.nassaudental.org