Epidemiological Association between Oral Diseases and COVID-19: Pulpitis as a Key Risk Factor

Abstract

Aims: To establish a possible association between pulpitis and COVID-19. Study Design:  A descriptive, cross-sectional and retrospective study with an analytical approach was designed. Place and Duration of Study: Ambulatory Care Medical Unit. The study was conducted from January 1st to July 31st, 2024, with Mexican patients attending outpatient consultations in the Dentistry, and the Family Medicine Specialty and General Medicine departments at the "División del Norte" Family Medicine Clinic, ISSSTE, in Mexico City, Mexico. The data was collected from January to December, 2022. Methodology: Data on health and sociodemographic variables were collected through a retrospective design, using medical records from the Medical Financial Information System “SIMEF system”. Results: We included 13,359 adult patients, mainly females (n=8,510; 63.7%) and people in their sixties (n=3,637; 27.3%). The average age was 61.76 years old (SD=12.65, median age=61 [IQR=52-71]). The most prevalent diseases were: hypertension (4,682; 35.0%), type 2 diabetes (3,502; 26.2%), COVID-19 virus identified (1,970; 14.7%), hyperlipidaemia (1,255; 9.4%), and obesity due to excess of calories (1,222; 9.1%). The average age of the 48 patients with irreversible pulpitis was 57.33 years old (SD=9.99 years, median age= 57 [IQR=49.25-62]). The majority of patients were females (n=29, 60.4%) and older adults between 50 and 59 years old (n=15, 31%). The logistic regression models showed associations with: sex (female) OR=1.196 (1.080-1.323), p=0.001; age (years) OR=0.920 (0.915-0.925), p<0.001; anomalies of dental arch relationship OR=0.399 (0.185-0.859), p=0.019; dentofacial functional anomalies OR=0.486 (0.262-0.902), p=0.022; temporomandibular joint disorders OR=0.620 (0.386-0.998), p=0.049; retained dental root OR=0.273 (0.111-0.672), p=0.005; disorders of teeth and supporting structures OR=0.407 (0.189-0.877), p=0.022; jaws’ alveolitis OR=11.573 (1.049-127.692), p=0.046; and pulpitis OR=2.198 (1.047-4.614), p=0.037. Conclusion: These findings have shown epidemiological associations between oral conditions and COVID-19, and indicated that pulpitis is an associated risk factor. This supports the notion that oral conditions may play a significant role in modulating the risk of SARS-CoV-2 infection and the development of COVID-19, potentially through genetic and epigenetic mechanisms related to inflammatory and immunological processes.