The word Pandemic is described as a rapid spread of a disease in multiple countries and continents at the same time. Though, it refers only to the spread of the disease and not its deadliness, but human race had seen a pandemic at least once in a century. The ongoing pandemic of novel coronavirus has gripped the entire international community within no time. A single stranded RNA virus has shown one of the most catastrophic phase in the history of mankind. Covid 19 has crippled the lives and livelihood of many around the world. Since World Health organization in March 2020 declared coronavirus as a pandemic, everyone has witnessed the destruction caused by it. People have lost their lives, children their parents and the list goes on. The trouble that it has given to many while they were infected with the virus cannot be described in words. The infection remains a threat not only while the patient is infected but also long after he recovers from the disease. The Post-Covid (after the recovery from coronavirus infection) complications are a matter of concern for both the patients and the healthcare workers.
Fatigue, lethargy, difficulty in breathing, lung fibrosis, cardiac arrest, kidney failure, diabetes, cough, tonsillitis are the most common after effects of coronavirus infection. Besides these, there are many oral (mouth) issues that is bothering the people at large. The viral infection is mainly caused by droplet infection produced during coughing, talking etc. This may lead to an increased viral load in the mouth that can lead to some serious illness.
The experts have always warned to maintain good oral hygiene by brushing twice daily, flossing, using tongue scrapers and mouthwashes. The change of toothbrushes after the patient gets recovered from the infection has also been recommended. This is all because our mouth is most susceptible to the infections because of increased amount of Angiotensin converting enzyme (ACE2) receptor in various tissues of mouth and as is well known this receptor is the target site for the coronavirus.
The common post covid oral symptoms coming up include:
- Dry mouth (xerostomia): As the coronavirus is an air-borne infection, the people are forced to use the mask covering their face and nose. ‘Mask Mouth’ is where people develop some symptoms which is secondary to long term use of mask by them. At time, it is seen that people forget or avoid drinking water so that they don’t have to remove the mask. This leads to dessication of the oral tissues and people start developing the signs and symptoms secondary to the dry mouth condition like dental caries, oral malodor, gum infection, fungal, bacterial and viral infection to name a few.
- Bleeding gums: The complaint of bleeding gums is now commonly seen in patients recovered from the viral infection. In the event of COVID19 infection, the patient’s immune system is dysregulated leading to ‘cytokine storm’. An increased levels of cytokine in the the blood flow of gums leads to the complaint of bleeding gums.
- Oral ulcers: Many patients are turning up with typical ulcers seen in the viral infections called as herpetiform ulcers. Other ulcers are occurring due to increased inflammation in the mouth because of severe infection. This may get worsen if proper oral hygiene protocols have not been followed.
- Fungal infection: Fungal infection is explained as an opportunistic infection. The cytokine storm with an increase in IL-6 leads to the hindered oxygen supply in the tissues. In the absence of oxygen supply, the necrosis or the death of the tissues starts. As the coronavirus affects the upper respiratory tract and the surrounding structures, it is seen that the maxilla or the upper jaw bone shows of the signs of necrosis of the tissues. Initially, it is presented as a brown to blackish ulcer with some blackish discharge from nose. In the later stages, it can even perforate the bone leading to a more devastating infection. Such kind of deep fungal infection is termed as Mucormycosis, which is now commonly seen in patients suffering from coronavirus.
- COVID Tongue: This is a completely new term framed in a dermatology article from Spain. The “COVID TONGUE” is characterized by swelling or small bumps or ulcers on tongue accompanied with pain and burning sensation.
- Angular cheilitis: Long term use of masks covering face and nose leads to the collection or pooling of saliva near the corners of lips. The build up of micro-organisms in that area causes cracking and fissuring of corners of lips termed as angular cheilitis.
- Loss of taste: It has been suggested as one of the early indicators of COVID 19 infection. The virus is found to affect the function of the cranial nerves responsible for taste sensation that includes 1, 7, 9 and 10 with their supporting neurovascular bundles.
The dental surgeons must be aware of all the post covid symptoms and should always anticipate the conditions beforehand so as to prevent the major complications. The damage that COVID 19 peaks are making in terms of physical, mental, financial prospects cannot be denied but surely can be minimized by a team work and co-operation from all.