SARS CoV-2 load in periodontal disease.

JADA welcomes letters from readers on articles that have been published in an issue of JADA within the previous 2 months. Accepted letters will be forwarded to the article’s authors for comment. By sending a letter to the editor, the letter writers acknowledge and agree that the letter and all rights of the letter writers in the letter become the property of JADA. Letter writers must disclose any personal or professional affiliations or conflicts of interest so readers can take that into account when assessing the letter writers’ opinions. The views expressed are those of the letter writers and do not necessarily reflect the opinion or official policy of the ADA.JADA reserves the right to edit all letters into a publishable format (up to 550 words and 5 citations and no illustrations) and requires all letters to be signed. You may submit a letter via Editorial Manager by going to https://www.editorialmanager.com/jada/default.aspx (clicking the “Register” link on the Editorial Manager home page and follow the step-by-step process to create an account if needed).

I read with interest the November JADA article entitled “Estimating Salivary Carriage of Severe Acute Respiratory Syndrome Coronavirus 2 in Nonsymptomatic People and Efficacy of Mouthrinse in Reducing Viral Load: A Randomized Controlled Trial” (Chaudhary PP, Melkonyan A, Meethil A, et al. JADA. 152[11]:903-908). The authors indeed provide important information regarding the utility of commonly available mouthrinses in reducing salivary loads of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) to reduce the possibility of infection transfer.

It would be worth mentioning that saliva is not just saliva itself but can have in it gingival crevicular fluid (GCF) as well, along with sputum or other expectorate. The authors did note the possibility of patients with episodes of cough exhibiting greater viral load.

SARS CoV-2 has not only been detected in GCF, but these levels have been found to be correlated with viral recovery from saliva and nasopharyngeal swab sampling. In fact, the sensitivity of GCF (63.64%) to detect SARS CoV-2 has been found to be comparable to that of saliva (64.52%).

Not only this, but SARS CoV-2 has been detected in plaque and calculus samples. , There is also evidence in literature to support the relationship between periodontal disease and worse COVID-19 related outcomes.

In light of this knowledge, it would then seem logical to argue that periodontal disease might not only affect COVID-19–related adverse outcomes but could influence the cumulative viral load of the oral cavity by virtue of greater plaque accumulation, calculus formation, and GCF flow, all of which have been shown to harbor the SARS CoV-2.