Impact on oral health of the post-COVID-19 infections: a systematic review

Abstract

Introduction: The COVID-19 pandemic has been associated with a diverse range of oral health implications, including mucosal lesions, periodontitis, and disruptions of the oral microbiota. Since airborne particles primarily transmit COVID-19, understanding its potential impact on oral health is crucial for dental care and infection control. Objectives: This systematic review aimed to evaluate the effects of post-COVID-19 infections on oral health, highlighting clinical manifestations, periodontal disease associations, and microbiota disturbances. Methods: Electronic literature searches were conducted between January 2020 and July 2024 by one author across several databases, including PubMed/MEDLINE, Scopus, Cochrane Library, EMBASE, ScienceDirect, Google Scholar, and Web of Science. A total of 3,642 publications were screened. Two reviewers analyzed the articles and extracted the data. Of these, 25 studies met the inclusion criteria. Results: A total of 25 studies were included in this systematic review, addressing oral manifestations, the link between periodontal disease and COVID-19, and broader oral health impacts. Lesions such as ulcers, candidiasis, and taste disorders were reported, with causes attributed to viral effects or secondary inflammation. Evidence suggests a bidirectional relationship between periodontitis and COVID-19, potentially mediated by elevated cytokines (IL-6, TNF-α). Conclusions: Post-COVID-19 conditions are associated with a range of oral health issues, including opportunistic infections, a potential bidirectional link with periodontitis mediated by inflammation, and altered oral microbiota. However, the evidence is heterogeneous, and the quality of many studies is limited, underscoring the need for more rigorous research to establish causality.