• P-ISSN 2277-3525 E-ISSN 2582-7901

Journal of Multidisciplinary
Dental Research


Journal of Multidisciplinary Dental Research

Volume: 8, Issue: 2, Pages: 44-49

Invited Article

Oral Manifestations of Coronavirus Disease 2019 (COVID-19): An Overview

Received Date:22 December 2022, Accepted Date:22 December 2022, Published Date:26 December 2022


The grim milestone of three million deaths due to the global pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reached a few weeks ago. COVID-19 is a multi-system all-pervasive disease with protean manifestations, and its major signs and symptoms, such as the incessant dry cough, fever, and pneumonia, are well-known. Yet, its mucocutaneous manifestations, particularly those of the oral cavity, appear to be little recognized. This may be due either to the rarity of oral manifestations of COVID-19, or poor detection of such symptoms by attending physicians who may do only a cursory examination of the oral mucosa because of the overwhelming gravity of the other major systemic presentations. Nevertheless, there are now a considerable number of reports, including systematic reviews, on oral manifestations of COVID-19 in the literature. These, apart from the now well-known dysgeusia of COVID-19, range from ulcers, erosions, bullae, vesicles, mucosal pustules, macules, papules and pigmentations, as well as haemorrhagic manifestations including petechiae, crusts and spontaneous bleeding. Unfortunately, the majority of these reports are anecdotal in nature and remain to be substantiated. Here, we provide a brief overview of the reported oral manifestations of COVID-19, and their management protocols.

CPD/Clinical Relevance: To raise awareness of the currently reported major and minor oral manifestations of COVID-19 and their management protocols.


  1. Casas CG, Català A, Hernández GC, Rodríguez-Jiménez P, Fernández-Nieto D, Lario ARV, et al. Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 casesBr J Dermatol2020;183(1):7177. Available from: https://doi. org/https://doi.org/10.1111/bjd.19163
  2. Recalcati S. Cutaneous manifestations in COVID‐19: a first perspectiveJournal of the European Academy of Dermatology and Venereology2020;34(5):212213. Available from: https://doi.org/10.1111/jdv.16387
  3. Skroza N, Bernardini N, Balduzzi V, Mambrin A, Marchesiello A, Michelini S, et al. A late‐onset widespread skin rash in a previous COVID‐19‐infected patient: viral or multidrug effect? Journal of the European Academy of Dermatology and Venereology2020;34(9):438439. Available from: https:// doi.org/10.1111/jdv.16633
  4. Samaranayake LP, Fakhruddin KS, Panduwawala C. Sudden onset, acute loss of taste and smell in coronavirus disease 2019 (COVID-19): a systematic reviewActa Odontologica Scandinavica2020;78(6):467473. Available from: https:// doi.org/10.1080/00016357.2020.1787505
  5. Samaranayake LP, Fakhruddin KS, Bandara N. Chemosensory dysfunction in coronavirus disease 2019 (COVID-19) Dental Update2020;47(8):682684. Available from: https://www.dental-update.co.uk/issuesSingleIssueArticle.asp?aKey=2179
  6. Santos JAD, Normando AGC, Silva RLCD, Acevedo AC, Canto GDL, Sugaya N, et al. Oral Manifestations in Patients with COVID-19: A Living Systematic ReviewJournal of Dental Research2020;100(2):141154. Available from: https://doi.org/10.1177/0022034520957289
  7. Glezer I, Bruni‐cardoso A, Schechtman D, Malnic B. Viral infection and smell loss: The case of COVID‐19Journal of Neurochemistry2021;157(4):930943. Available from: https://doi. org/10.1111/jnc.15197
  8. Cooper KW, Brann DH, Farruggia MC, Bhutani S, Pellegrino R, Tsukahara T, et al. COVID-19 and the Chemical Senses: Supporting Players Take Center StageNeuron2020;107(2):219233. Available from: https://doi. org/10.1016/j.neuron.2020.06.032
  9. Biadsee A, Biadsee A, Kassem F, Dagan O, Masarwa S, Ormianer Z. Olfactory and Oral Manifestations of COVID-19: Sex-Related Symptoms—A Potential Pathway to Early DiagnosisOtolaryngology–Head and Neck Surgery2020;163(4):722728. Available from: https://doi. org/10.1177/0194599820934380
  10. Elkholi SMA, Abdelwahab MK, Abdelhafeez M. Impact of the smell loss on the quality of life and adopted coping strategies in COVID-19 patientsEuropean Archives of Oto-Rhino-Laryngology2021;278(9):33073314. Available from: https://doi. org/10.1007/s00405-020-06575-7
  11. Sinjari B, D’ardes D, Santilli M, Rexhepi I, D’addazio G, Carlo PD, et al. SARS-CoV-2 and Oral Manifestation: An Observational, Human StudyJournal of Clinical Medicine2020;9(10):3218. Available from: https://doi.org/10.3390/ jcm9103218
  12. Brandão TB, Gueiros LA, Melo TS, Prado-Ribeiro AC, Nesrallah ACFA, GVBP, et al. Oral lesions in patients with SARS-CoV-2 infection: could the oral cavity be a target organ? Oral Surg Oral Med Oral Pathol Oral Radiol 2021;131(2):4551. Available from: https://doi.org/https://doi.org/10.1016/j.oooo.2020.07.014
  13. Pedrosa MS, Sipert CR, Nogueira FN. Altered taste in patients with COVID‐19: The potential role of salivary glandsOral Diseases2021;27(S3):798800. Available from: https://doi.org/10.1111/odi.13496
  14. Sabino-Silva R, Jardim ACG, Siqueira WL. Coronavirus COVID-19 impacts to dentistry and potential salivary diagnosisClinical Oral Investigations2020;24(4):16191621. Available from: https://pubmed.ncbi.nlm.nih.gov/32078048/
  15. Carrouel F, Gonçalves LS, Conte MP, Campus G, Fisher J, Fraticelli L, et al. Antiviral Activity of Reagents in Mouth Rinses against SARS-CoV-2Journal of Dental Research2021;100(2):124132. Available from: https://doi.org/10.1177/0022034520967933
  16. Soares CD, Carvalho RAd, Carvalho KAd, Carvalho MGFd, Almeida OPd. Letter to Editor: Oral lesions in a patient with Covid-19Journal section: Oral Medicine and Pathology2020;25(4):e563e564. Available from: https://doi.org/10.4317/medoral.24044
  17. Jimenez-Cauhe J, Ortega-Quijano D, Carretero-Barrio I, Suarez-Valle A, Saceda-Corralo D, Real CMGD, et al. Erythema multiforme-like eruption in patients with COVID-19 infection: clinical and histological findingsClin Exp Dermatol.2020 ;45(7):892895. Available from: https://doi.org/10.1111/ced.14281
  18. Kahraman FC, Çaşkurlu H. Mucosal involvement in a COVID‐19‐positive patient: A case reportDermatologic Therapy2020;33(4):12. Available from: https://doi.org/10.1111%2Fdth.13797
  19. Malih N, Hajinasrollah G, Zare M, Taheri M. Unexpected Presentation of COVID-19 in a 38-Year-Old Male Patient: A Case ReportCase Reports in Dermatology2020;12(2):124131. Available from: https://doi.org/10.1159/000509994
  20. Tomo S, Miyahara GI, Simonato LE. Oral mucositis in a SARS‐CoV‐2‐infected patient: Secondary or truly associated condition? Oral Diseases2022;28(S1):963967. Available from: https://doi.org/10.1111/odi.13570
  21. Chaux-Bodard AG, Deneuve S, Desoutter A. Oral manifestation of Covid-19 as an inaugural symptom? J Oral Med Oral Surg2020;26(2):1. Available from: https://doi.org/10.1051/mbcb/2020011
  22. Sakaida T, Tanimoto I, Matsubara A, Nakamura M, Morita A. Unique skin manifestations of COVID-19: Is drug eruption specific to COVID-19? Journal of Dermatological Science2020;99(1):6264. Available from: https://doi.org/10.1016/j.jdermsci.2020.05.002
  23. Ciccarese G, Drago F, Boatti M, Porro A, Muzic SI, Parodi A. Oral erosions and petechiae during SARS‐CoV‐2 infectionJournal of Medical Virology2021;93(1):129132. Available from: https://doi.org/10.1002/jmv.26221
  24. Ansari R, Gheitani M, Heidari F, Heidari F. Oral cavity lesions as a manifestation of the novel virus (COVID-19) Oral Diseases2020;27(S3):771772. Available from: https://doi.org/10.1111/odi.13465
  25. Singh C, Tay J, Shoqirat N. Skin and Mucosal Damage in Patients Diagnosed With COVID-19Journal of Wound, Ostomy & Continence Nursing2020;47(5):435438. Available from: https://doi.org/10.1097%2FWON.0000000000000690
  26. Santos JAD, Normando AGC, Silva RLCD, Paula RMD, Cembranel AC, Santos-Silva AR, et al. Oral mucosal lesions in a COVID-19 patient: New signs or secondary manifestations? International Journal of Infectious Diseases2020;97:326328. Available from: https://doi.org/10.1016/j.ijid.2020.06.012
  27. Rodríguez MD, Romera AJ, Villarroel M. Oral manifestations associated with COVID‐19Oral Diseases2022;28(S1):960962. Available from: https://doi.org/10.1111/odi.13555
  28. Corchuelo J, Ulloa FC. Oral manifestations in a patient with a history of asymptomatic COVID-19: Case reportInternational Journal of Infectious Diseases2020;100:154157. Available from: https://doi.org/10.1016/j.ijid.2020.08.071
  29. Carreras-Presas CM, Sánchez JA, López-Sánchez AF, Jané-Salas E, Pérez MLS. Oral vesiculobullous lesions associated with SARS-CoV-2 infectionOral Dis2020;25(S3):710712. Available from: https://doi. org/10.1111/odi.13382
  30. Labé P, Ly A, Sin C, Nasser M, Chapelon‐fromont E, Saïd PB, et al. Erythema multiforme and Kawasaki disease associated with COVID‐19 infection in childrenJournal of the European Academy of Dermatology and Venereology2020;34(10):539541. Available from: https://doi.org/10.1111/jdv.16666
  31. Tapia ROC, AJPL, Guimaraes DM, Valdez LHM. Oral mucosal lesions in patients with SARS- CoV-2 infection. Report of four cases. Are they a true sign of COVID-19 disease? Spec Care Dentist2020;40(6):555560. Available from: https://doi.org/10.1111/scd.12520
  32. Santosh ABR, Muddana K. Viral infections of oral cavityJournal of Family Medicine and Primary Care2020;9(1):3642. Available from: https://doi.org/10.4103%2Fjfmpc.jfmpc_807_19
  33. Aghazadeh N, Homayouni M, Sartori‐valinotti JC. Oral vesicles and acral erythema: report of a cutaneous manifestation of COVID‐19International Journal of Dermatology2020;59(9):11531154. Available from: https://doi.org/ https://doi.org/10.1111/ijd.15047
  34. Patel J, Woolley J. Necrotizing periodontal disease: Oral manifestation of COVID‐19Oral Diseases2021;27(S3):768769. Available from: https://doi.org/10.1111/odi.13462
  35. Kämmerer T, Walch J, Flaig M, French LE. COVID-19-associated herpetic gingivostomatitisCOVID-19-associated herpetic2021;46(1):174176. Available from: https://doi.org/10.1111/ced.14402
  36. Indu S. Multiple oral ulcerations – An initial manifestation of COVID 19 infection: A personal experience!! Journal of Oral and Maxillofacial Pathology2020;24(2):227229. Available from: https://doi.org/10.4103/jomfp.jomfp_324_20
  37. Taşlıdere B, Mehmetaj L, Özcan AB, Gülen B, Taşlıdere N. Melkersson-Rosenthal Syndrome Induced by COVID-19The American Journal of Emergency Medicine2021;41(262):e5e7. Available from: https://doi.org/10.1016/j.ajem.2020.08.018
  38. Iranmanesh B, Khalili M, Amiri R, Zartab H, Aflatoonian M. Oral manifestations of COVID-19 disease: A review articleDermatologic Therapy2021;34(1):e14578. Available from: https://doi.org/10.1111/dth.14578
  39. Gianotti R, Zerbi P, Dodiuk-Gad RP. Clinical and histopathological study of skin dermatoses in patients affected by COVID-19 infection in the Northern part of ItalyJournal of Dermatological Science2020;98(2):141143. Available from: https://doi.org/10.1016/j.jdermsci.2020.04.007
  40. Yoon JG, Yoon JG, Song JY, Yoon SYG, Lim CS, Seong H, et al. Clinical Significance of a High SARS-CoV-2 Viral Load in the SalivaJournal of Korean Medical Science2020;35(20):e195. Available from: https://doi.org/10.3346/jkms.2020.35.e195


© 2022 Published by International Dental Educationists’ Association (IDEA). This is an open-access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/)


Subscribe now for latest articles, news.