Exploring the relationship between COVID-19 and oral health by radiographic examination.

Design Analytical retrospective study aimed at revealing the relationship between dental damage stage (DD Stg) and the severity of COVID-19 disease. This study was conducted over four months between 10 March 2020 and 15 July 2020 at the University of Health Sciences department at the Abdulhamid Han Training and Research Hospital Dental Services in Turkey.Sample selection A total of 137 patients were included in this study taken from a cohort of 1,516 patients with a positive polymerase chain reaction (PCR) COVID-19 test. In order to meet the inclusion criteria, patients must have been referred to the dental outpatient department and have a dental panoramic tomogram available for examination.Data analysis A new radiographic staging tool was developed by the authors, informed by previous tools. Following radiographic analysis, participants were allocated to a DD Stg (0-3). Multiple statistical analyses were conducted on the data including Pearson correlation analysis, Spearman correlation analysis and a multiple regression analysis.Results Those participants in DD Stg 3 were significantly older than the other groups; those in DD Stg 2 and 3 had significantly higher presence of chronic disease and evidence of more carious teeth. Those in DD Stg 2 and 3 had a statistically higher number of hospitalisations due to COVID-19 when compared to those in DD Stg 0 and 1, with DD Stg 3 having the highest number overall as well as having a significantly higher mortality rate. Furthermore, those in DD Stg 0 had fewer symptoms associated with COVID-19 compared to the other groups.Conclusions The results show there may be a remarkable association between severity of COVID-19 symptoms and oral health; however, care must be taken when interpreting these results as age is clearly a serious confounding factor and no clinical examination was undertaken.