Quite a lot of oral well being issues have been linked to COVID: ulcers and different kinds of lesions, erosions, plaque, unhealthy breath, swelling, and even necrosis. Based on case experiences and different medical communications, the tongue is the location affected most frequently, and circumstances are cut up fairly equally between women and men. Nonetheless, oral signs are stated to crop up extra usually in older adults and people with extra extreme circumstances of COVID.
Lack of oral hygiene, opportunistic infections, stress, immunosuppression, vasculitis, and hyper-inflammatory response secondary to COVID-19 are a very powerful predisposing components for onset of oral lesions in COVID-19 sufferers.
One kind of downside talked about within the above examine has not too long ago obtained a bit of additional consideration: geographic tongue.
Humorous identify, we all know, however it’s rather a lot simpler to pronounce than a number of the different names this inflammatory situation goes by, akin to erythema migrans or benign migratory glossitis.
It’s not unique to COVID sufferers, although.
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It’s one thing that turns up in wherever from 1 to three% of the inhabitants, and it makes areas of the tongue seem clean and purple, because of the lack of papillae (these little nubbly projections that usually cowl the tongue’s floor). The distinction between these patches and different areas can look form of like a map – therefore, the identify.
The causes of geographic tongue aren’t completely clear. A number of the candidates which were instructed through the years embrace stress, parafunctional habits like tongue biting, allergic reactions, and hormonal fluctuations. Though it will possibly look form of gross, the situation isn’t contagious and usually doesn’t even have to be handled, since there are seldom any signs past simply the tongue’s look.
“If a [geographic tongue] is of current onset, may it signify COVID-19?” asks Dr. Russell Hathway, of the division of oral and maxillofacial surgical procedure at Morriston Hospital in Swansea, UK, in a current letter to the BDJ. “Probably.”
There may be some proof to counsel that GT is perhaps related to elevated ranges of the inflammatory cytokine interleukin-6 (IL-6), the identical cytokine that’s upregulated in extreme COVID-19 illness. It is usually worthwhile remembering that angiotensin-converting enzyme 2 (ACE2) receptor expression is increased within the tongue relative to different oral tissues. ACE2 receptors are the entry level of the SARS-CoV-2 virus.
The suspected hyperlink, he notes, was recognized by way of affected person experiences submitted every day to the ZOE COVID-19 Symptom Examine app.
Professor Spector, the examine’s lead researcher from King’s Faculty London, has reported various person submissions that appear to be per GT, however to this point there are solely two communications within the literature reporting it as a part of COVID-19 sickness.
After all, rather more analysis is required to both verify or disprove the hyperlink. And it will possibly’t be emphasised sufficient that merely having geographic tongue doesn’t essentially imply you’ve got COVID.
However as Dr. Hathway’s letter suggests, in case your tongue has solely not too long ago taken on this look, it’s possible you’ll need to discuss it along with your dentist or doctor sooner fairly than later. And the identical goes with the looks of any unusual lesions or different modifications in your mouth. The earlier we will determine the issue and its significance, the earlier we will work with you to go about fixing it.
Picture by Bin im Garten
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