Essays

The COVID-19 pandemic, triggered by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), represented a significant global health crisis. Initially identified in December 2019 in Wuhan, China, COVID-19 was characterized as a novel pneumonia of unknown origin, quickly spreading across the globe. Various theories regarding its origins have been proposed, including zoonotic transmission from bat coronaviruses; however, the precise source and transmission pathways remain unclear.

Consequences of Lockdowns on Dental Care

The lockdowns implemented during the COVID-19 pandemic had a profound impact on healthcare systems, particularly for patients needing urgent dental care. During these periods, access to dental services was severely restricted, as dental professionals faced heightened risks of contracting COVID-19 and other respiratory infections while performing their duties. Procedures that generated aerosols posed especially significant risks to dental staff, along with potential exposure from patients and their companions.

Delays in Treatment and Long-Term Outcomes

The pandemic not only caused immediate disruptions but also delayed long-term treatment plans that typically require multiple visits over several years. In March 2020, the American Dental Association recommended postponing all non-urgent dental procedures. This guideline was lifted at the end of April 2020, allowing both general dentists and specialists to resume practice, albeit under stringent safety protocols.

Opportunistic Infections During COVID-19

Throughout the pandemic, there was a notable rise in bacterial, viral, and fungal coinfections and superinfections among patients with COVID-19. Coinfection refers to the simultaneous presence of a secondary infection alongside the primary SARS-CoV-2 infection, while superinfection occurs later. Depending on when and where they were diagnosed, these infections could be classified as community-acquired or hospital-acquired, contributing to increased morbidity among affected individuals.

Oral Manifestations Related to COVID-19

Oral manifestations were observed in over 70% of COVID-19 cases, often appearing four days prior to systemic symptoms and persisting for up to 12 weeks after their onset. These manifestations were observed across genders and were symptomatic in 68% of cases. Notably, 13% of patients developed oral lesions before receiving a positive test for SARS-CoV-2. Common oral symptoms included ulcerations (the most prevalent at over 50%), erosions, blisters, vesicles, pustules, and changes to the tongue's appearance.

Bruxism and Temporomandibular Disorders (TMDs)

The COVID-19 pandemic has also significantly impacted the prevalence of temporomandibular disorders (TMDs) and both awake and sleep bruxism. A questionnaire study conducted among medical students during the isolation period revealed that 77% reported TMD symptoms, while self-reported rates of awake bruxism and sleep bruxism were 48% and 59%, respectively. Comparatively, dental patients experienced a 3.3-fold increase in painful TMD diagnoses compared to pre-pandemic levels.

Symptoms Related to Olfactory and Taste Dysfunction

Olfactory and taste dysfunction are recognized symptoms associated with COVID-19 infection. These neurological presentations can vary in severity from mild anosmia to complete loss of smell (total anosmia), alongside taste disorders such as hypogeusia, dysgeusia, and ageusia. Interestingly, chemosensory dysfunction may serve as an early indication of COVID-19 infection, with varying patterns of olfactory dysfunction reported among affected individuals.

In summary, the COVID-19 pandemic has had far-reaching effects on dentistry, influencing treatment access, patient outcomes, and the prevalence of various oral health issues. As the world continues to navigate the aftermath of this crisis, understanding these impacts will be crucial for improving dental care practices in the future.