Can Periodontal Pockets House SARS-Cov-2?

By Laura Ibarrola

Supervised and Edited by Dr. Levy Do

Periodontal disease, commonly known as gum disease, is a result of poor oral hygiene. Our mouths are home to millions of bacteria. These bacteria excrete waste, which is able to form a sticky substance known as plaque. When people fail to brush and floss properly, plaque can build up on the gum line. This build-up can mineralize into Tatar, which releases toxins into the gums. In severe cases, this can lead to the formation of deep spaces around the teeth known as periodontal pockets. These pockets provide ideal conditions for various microbes, including viruses.

Several dental experts believe that periodontal pockets could be a potential reservoir for SARS-Cov-2, which is the novel coronavirus responsible for the current COVID-19 pandemic. As of August, the virus has infected over 17 million people. The virus is well known to infect the upper respiratory tract. However, research indicates the virus may have several targets within the body, including the mouth. 

High levels of SARS-Cov-2 receptors in the oral cavity may lead to viral infection. Oral epithelial cells have been found to express high levels of angiotensin-converting enzyme-2, otherwise known as ACE-2. ACE-2 is the primary receptor that coronaviruses use to enter the body. In addition, a recent study found that the virus may also be able to use a receptor known as CD 147 to infect cells. Epithelial cells located in periodontal pockets have been found to have high expression of these receptors. 

Further research needs to be conducted to determine if there is a correlation between periodontal pockets and COVID-19 infection. However, based on previous findings, it is plausible that periodontal pockets could possibly house SARS-Cov-2.

Sources

Pitones-Rubio, Viviana et al. “Is periodontal disease a risk factor for severe COVID-19 illness?.” Medical hypotheses, vol. 144 109969. 19 Jun. 2020, doi:10.1016/j.mehy.2020.109969

Badran, Zahi, et al. “Periodontal Pockets: A Potential Reservoir for SARS-CoV-2?” Medical Hypotheses, vol. 143, 2020, p. 109907., doi:10.1016/j.mehy.2020.109907.