Oral Health Condition in COVID-19

Abstract

Aim: The outbreak of coronavirus disease (COVID-19) emerged in the Chinese city of Wuhan in late 2019 and has become a major public health problem not only in China but also in countries around the world. It is thought that SARS-CoV-2, which causes the disease, is transmitted through the mouth and nose and mostly affects the respiratory system. How oral health condition affects he infection process is not known. In this study, we aimed to examine and compare the oral health condition of people with and without COVID-19. Material and Methods: 101 patients diagnosed as COVID-19 and 72 patients without COVID-19 diagnosis were included in the study. After lung imaging, all patients were asked to complete a questionnaire and their oral health condition were scored. Groups with and without COVID-19 were compared in terms of total oral health scores and given parameters and radiolgical involvement. Results: The mean age of both groups were similar. The total scores of patients with COVID-19 were higher than the control group. In the COVID-19 positive group, the rate of tooth brushing and regular dentist visiting history were statistically significantly higher, and the presence of tooth loss and presence of halitosis were statistically significantly lower. Conclusion: It was thought that good oral health in those with COVID-19 may cause less anaerobic flora and less acid production in the mouth, and this high pH may make it easy for the virüs to attachment in the respiratory tract.

Keywords

• COVID-19
• oral health
• pneumonia

COVID-19’da Ağız Sağlığı Durumu

Abstract

Amaç: Çin'in Wuhan kentinde 2019 yılının sonlarında koronavirüs hastalığı salgını (COVID-19) ortaya çıkmış ve yalnızca Çin'de değil, tüm dünyadaki ülkelerde de büyük bir halk sağlığı sorunu haline gelmiştir. Ağır akut solunum hastalığı (Severe Acute Respiratory Syndrome causing Coronavirus) (SARS-CoV-2)’nin ağız ve burun yoluyla bulaştığı ve en çok solunum sistemini etkilediği düşünülmektedir. Ağız sağlığı durumunun enfeksiyon oluşumunu ne şekilde etkilediği ise bilinmemektedir. Bu amaçla bu çalışmada COVID-19 olan ve olmayan kişilerde ağız sağlığı durumunun incelenmesi amaçlandı. Gereç ve Yöntemler: Çalışmaya COVID-19 tanısı almış 101 hasta ile, COVID-19 tanısı almamış 72 gönüllü dahil edildi. Akciğer görüntülemeleri yapıldıktan sonra tüm hastalara ağız sağlığını değerlendirmek için hazırlanan anket soruları sorulup skorlandı. COVID-19 olan ve olmayan gruplar toplam ağız sağlığı skorları ve parametreleri ile radyolojik tutulum açısından karşılaştırıldı. Bulgular: Hasta ve kontrol gruplarının yaş ortalamaları benzer idi. COVID-19 olan hastaların toplam ağız sağlığı skor değerleri, kontrol grubuna göre olumlu yönde daha yüksekti (p=0,011). COVID-19 grubunda diş fırçalama (p=0,045) ve diş hekimine gitme (p=0,015) oranı istatistiksel olarak anlamlı derecede yüksek iken, diş kaybı (p=0,008) ve ağız kokusu varlığı (p<0,001) istatistiksel olarak anlamlı derecede düşük olarak saptandı. Sonuç: COVID-19 olanlarda ağız sağlığının iyi olmasının ağızda anaerobik florayı azaltabileceğini, bunun da asit üretiminin daha az olmasına neden olabileceği ve böylece ağızdaki yüksek pH’ın da virüsün solunum yoluna yerleşmesini kolaylaştırabileceği düşünüldü.

Keywords

• COVID-19
• ağız sağlığı
• pnömoni

References

1. Tanik A, Demirci F, Doğan MS. Kronik obstrüktif akciğer hastalığı ve periodontal hastalık ilişkisi. Dicle Med J. 2015; 42 (2): 274-8. https://doi.org/10.5798/diclemedj.0921.2015.02.0573.
2. Coulthwaite L, Verran J. Potential pathogenic aspects of denture plaque. British J Biomed Sci. 2007; 64: 180-9.
3. Scannapieco FA. Role of oral bacteria in respiratory infection. J Periodontal. 1999; 70: 793-802.
4. Scannapieco FA, Papandonatos GD, Dunford RG. Associations between oral conditions and respiratory disease in a national sample survey population. Ann Periodontal. 1999; 3: 251-6.
5. Finegold SM. Aspiration pnuemonia. Rev Infect Dis. 1991; 13: 737-42.
6. Morris JF, Sewell DL. necrotizing pnuemonia caused by mixed ınfection with actinobacillus actinomyces temcomitans and Actinomyces israeli: Case report and review. Clin Infect Dis. 1994; 18. 450-2.
7. Scannapieco FA, HoAW. Association of periodontal disease and chronic lung disease analysis of NHANES III. J Dent Res. 1999; 78: 1777-82.
8. Scannapieco FA, Bush RB, Paju S. associations between periodontal disease and risk for nasocomial bacterial pnuemonia and chronic obtructive pulmonary disease. A Sytemic Review. Ann Periodontal. 2003; 8: 54-69.

9. Scannapieco FA. Genco RJ. Association of periodontal ınfections with atherosclerotic and pulmonary disaeses. J Periodontal Res. 1999; 34: 340-5.
10. Bui FQ, Almeida-da-Silva CLC, Huynh B. Association between periodontal pathogens and systemic disease. Biomed J. 2019; 42(1): 27-35.
11. Weidlich P, Cimoes R, Pannuti CM. Association between periodontal diseases and systemic diseases. Braz Oral Res. 2008; 22: 32-43.
12. Paquette DW. The periodontal ınfection-systemic disease link: A review of the truth or myth. J Intern at Acad Periodontol. 2002; 4(3): 101-9.
13. Zhou X, Wang Z, Song Y. Periodontal health and quality of life in patients with chronic obstructive pulmonary disease. Respir Med. 2011; 105(1): 67-73.
14. Dar Odeh N, Babkair H, Abu-Hammad S, Borzangy S, Abu-Hammad A, Abu-Hammad O. COVID-19: Present and future challenges for dental practice. Int J Environ Res Public Health. 2020; 17(9): E3151.
15. Özçelik F and Sirin DA. Impact of COVID-19 on oral and dental health delivery and recommendations for continuation of oral and dental health services. https://doi.org//10.5772/intechopen.98522
16. Peng X, Xin X, Li Y, Cheng L, Zhou X, Ren B transmission routes of 2019-nCoV and controls in dental practice. Int J Oral Sci. 2020; 12(1): 9.
17. Başol ME, Karaağaçlıoğlu L, Yılmaz B. Ağız sağlığı etki ölçeğinin geliştirilmesi, Türkiye Klinikleri J Dental Sci. 2014; 20(2): 85-92.
18. Doğan BG. Temel ağız-diş sağlığı göstergeleri. Toplum Hekimliği Bülteni. 2007; 26(2): 40-6.
19. Gökalp S, Doğan BG, Ekçiçek M, Berberoğlu A, Ünlüer RŞ. Erişkin ve yaşlılarda ağız-diş sağlığı profili, Türkiye-2004. Hacettepe Diş hekimliği Fakültesi Dergisi. 2007; 31(4): 11-8.
20. Khumaedi AI, Purnamasari D, Wijaya IP. The relationship of diabetes, periodontitis and cardiovascular disease. Diabetes Metab Synd Clin Res Rev. 2019; 13(2): 1675-78.
21. Jepsen S, Stadlinger B, Terheyden H. Guest Editorial Ecience Transfer: Oral health and general health-the links between periodontitis, Atherosclerosis, and Diabetes. J Clin Periodontol. 2016; 42(12): 1071-3.
22. Wu Z, Nakanishi H. Connection between periodontitis and alzheimer’s disease: Possible roles of microglia and leptomeningeal cells. J Pharmacol Sci. 2014; 126(1): 8-13.
23. Az ZAA, Ak G. COVID-19 salgını sırasında ağız ve diş sağlığı uygulamaları. Anatol Clin. 2020; (25): 312-22.
24. Peng X, Xu X, Li Y, Cheng L, Zhou X, Ren B. Transmission routes of 2019-nCoV and controls in dental practice. Int J Oral Sci. 2020; 12(1): 1-6.
25. Ren YF, Rasubala L, Malmstrom H, Eliav E. Dental care and oral health under the clouds of COVID-19. JDR Clin Trans Res. 2020; 5(3): 202-10.
26. Xu H, Zhong L, Deng J, Peng J, Dan H, Zeng X, et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa.Int J Oral Sci. 2020; 12(1): 1-5.
27. Chen L, Zhao J, Peng J. Detection of 2019-nCoV in Saliva and characterization of oral symptoms in COVID-19 patients. SSRN. 2020. https://doi.org/10.2139/ssrn.3556665.
28. Giacomelli A, Pezzati L, Conti F, Bernacchia D, Siano M, Oreni L, et al. Self-reported olfactory and taste disorders in patients with severe acute respiratory coronavirus 2 infection: a Cross-sectional study. Clin Infect Dis. 28; 889-90. https://doi.org/10.1093/cid/ciaa330
29. Guo T, Fan Y, Chen M. Cardiovascular ımplications of fatal outcomes of patients with Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. 2020; 5(7): 1-8.
30. Sabino-Silva R, Jardim ACG, Siqueira WL. Coronavirus COVID-19. Impacts to dentistry and potential salivary diagnosis. Clin Oral Investig. 2020; 24(4): 1619-21.
31. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: Implications for virus origins and receptor binding. Lancet. 2020; 395(10224): 565-74.
32. Niessen LC, Jones JA. Oral health changes in the elderly: Their relationship to nutrition. Postgraduate Med. 1984; 75(5): 231-37.
33. Chandra RK. Nutrition and the ımmune system: An introduction. Am J Clin Nutr. 1997; 66(2): 460-63.
34. Childs CE, Calder PC, Miles EA. Diet and immune function. Nutrients. 2019;11(8):1933.
35. Murthy S, Gomersall CD, Fowler RA. Care for critically ill patients with Covid-19. JAMA. 2020; 323(15): 1499-500.
36. Pedersen SF, Ho YC. SARS-CoV-2: A Storm is raging. J Clin Invest. 2020; 130(5): 2202-5.
37. Zhang C, Wu Z, Li JW. The Cytokine Release Syndrome (CRS) of SAevere Covid-19 and Interleukin-6 Receptor (IL-6R) Antagonist Tocilizumab May be the Key to Reduce the Mortality. Int J Antimicrob Agents. 2020; 55(5): 1059-64.
38. Sirin DA,Ozcelik F. The relationship between Covid-19 and the dental damage stage determined by radiological examination. Oral Radiol. 2021; 37(4): 600-9. https://doi.org/10.1007/s11282-020- 00497-0