Good general health begins with good oral health

The mouth is not an isolated system, but rather a gateway for oral and systemic infectious diseases.

It is known that the oral cavity plays an important role in SARS-CoV-2 infection.

SARS-CoV-2, the virus that causes the disease known as COVID19, can be spread from person to person through droplets that are released when an infected person coughs, sneezes or exhales.


How is the infection produced?

SARS-CoV-2 coronavirus infects human cells through ACE2 receptors1,2

The infectious process of the virus begins when SARS-CoV-2 interacts with a receptor called ACE2 which is present on the surface of some cells of our body.





The viral load and its relation to disease severity?

This receptor has been identified in several organs:

Intestine, Heart, Kidneys, Lungs and ORAL CAVITY

High density of ACE2 receptors in the oral cavity,
particularly on the tongue1


Presence of this receptor in cells of the oral mucosal epithelium,and special mention of the high concentration thereof in the tongue epithelium and in lymphocytes of the oral mucosa1.


Over the first 10 days, in which those affected are asymptomatic and highly contagious, the infection is located in the upper respiratory tract (mouth, nose, throat). Then, as the disease progresses, the virus moves to the lower respiratory tract (lungs)3.


Hallmarks of viral shedding in aggregated samples

The viral load of SARS-CoV-2 is directly related to the severity of COVID-194.


Viral dynamics in patients with mild and severe COVID-19

(A) DCT values (Ctsample-Ctref) from patients with mild and severe COVID-19 at different stages of disease onset. Median, quartile 1, and quartile
3 are shown. (B) DCT values of serial samples from patients with mild and severe COVID-19. COVID-19=coronavirus disease 2019. *p<0·005.

Reduction of the pathogenic load in the oral cavity may help to reduce the severity of the
COVID19 disease and to temporarily reduce the transmission of SARS-CoV-2 to healthy people.

Transmission routes of SARS-CoV-2 in dental clinics and hospitals

The possibility of saliva and aerolisation from infected patients being a route of transmission, special relevance in the dental field5



The oral cavity must be considered a route of entry and place for sustaining the virus in our body and a potentially high risk for developing infectious disease.


The oral cavity is a high risk site for SARS-CoV-2 infection1,2


It is advisable to use products containing
Cetylpyridinium Chloride as an active ingredient.


1. Xu H, Zhong L, Deng J, Peng J, Dan H, Zeng X, et al.High expression of ACE2
receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci. 2020
Feb 24;12(1):8.
2. Rabi FA, Al Zoubi MS, Kasasbeh GA, Salameh DM, Al-Nasser AD. SARS-CoV-2 and
Coronavirus Disease 2019: What We Know So Far. Pathogens. 2020 Mar 20;9(3)
3. Wölfel R. Corman VM, Guggemos W, Seilmaier M, Zange S, Müller MA, et al.
Virological assessment of hospitalized patients with COVID-2019. Nature https://- (2020).
4. Peng X, Xu X, Li Y, Cheng L, Zhou X, Ren B. Transmission routes of 2019-nCoV
and controls in dental practice. Int J Oral Sci. 2020 Mar 3;12(1):9
5. Liu Y, Yan LM, Wan L, Xiang TX, Le A, Liu JM, Peiris M, Poon LLM, Zhang W. Viral
dynamics in mild and severe cases of COVID-19. Lancet Infect Dis. 2020 Mar 19.
pii: S1473-3099(20)30232-

6. Popkin DL,ZilkaS,DimaanoM, Fujioka H, Rackley C,SalataR et al.Cetylpyridinium
chloride (CPC) exhibits potent, rapid activitygainstinfluenza viruses in
vitro and in vivo.PathogensandImmunity. 2017;2(2):253-69.
7. Mukherjee PK, Esper F, Buchheit K, Arters K, Adkins I, Ghannoum MAet al.
Randomized, double-blind, placebo-controlled clinical trial to assess the safety
and effectiveness of a novel dual-action oral topical formulation against upper
respiratory infections. BMC Infect Dis. 2017 Jan 14;17(1):74
8. Liang Shen, Junwei Niu, Chunhua Wang, Baoying Huang, Wenling Wang, Na
Zhu, Yao Deng, Huijuan Wang, Fei Ye, Shan Cen, Wenjie Tan. 2019. High-Throughput
Screening and Identification of Potent Broad-Spectrum Inhibitors of Coronaviruses.
Journal of Virology. doi: 10.1128/JVI.00023-19 93 (12)
9. Quirynen M, Avontroodt P, Soers C, Zhao H, Pauwels M, van Steenberghe D.
Impact of tongue cleansers on microbial load and taste. J Clin Periodontol 2004;
31: 506–510.

Transmission of SARS-CoV-2 in the dental clinic?