The Role of Oral Health in the Acquisition and Progression of SARS-CoV-2
Studies have shown that the oral cavity may be a main route of entry for the SARS-CoV-2 virus, suggesting that its health may be a significant factor in the acquisition and progression of COVID-19. This study aimed to investigate whether certain indicators of oral health are related to the likelihood of acquiring the disease or its severity. A retrospective analysis using electronic health record data was performed on charts dated 12/01/2019 to 08/24/2020 from the Columbia University College of Dental Medicine. 387 COVID-19 positive cases were matched to COVID-19 negative controls based on 1:1 age, sex, and race. Demographic data, number of missing teeth, and alveolar crest height were determined from medical and dental charts and radiographs, and a conditional logistic regression model was used to assess their association with COVID-19 status and hospitalization status. Results showed that COVID-19 cases were found to have increased alveolar bone loss (OR=4.302), fewer missing teeth (OR-0.897), and lack of smoking history compared to controls. COVID-19 cases with increased number of missing teeth were also significantly associated with hospitalization (OR=2.1871). After adjusting for time between examinations, cases with COVID-19 had greater alveolar bone loss compared to controls (0.641+/- 0.613 mm vs 0.260 +/- 0.631 mm, p<0.01.) Our data demonstrated that COVID-19 and alveolar bone loss may have a bi-directional relationship where patients with alveolar bone loss may be more susceptible to COVID-19 infection and may also experience increased alveolar bone loss after infection.