key: cord-0025196-t3cq7298
authors: Kumar, Purnima S.
title: Authors’ response
date: 2021-11-12
journal: J Am Dent Assoc
DOI: 10.1016/j.adaj.2021.11.002
sha: cc8a602be24fd42423b7079e9966d5c427b6d1ad
doc_id: 25196
cord_uid: t3cq7298

nan

Letters 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). 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. 1 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%). 1 Not only this, but SARS CoV-2 has been detected in plaque and calculus samples. 2, 3 There is also evidence in literature to support the relationship between periodontal disease and worse COVID-19 related outcomes. 4 In light of this knowledge, it would then seem logical to argue that periodontal disease might not only affect COVID-19erelated 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. 

SARS-CoV-2 detection in gingival crevicular fluid

Dental biofilm of symptomatic COVID-19 patients harbours SARS-CoV-2

Dental calculus: a reservoir for detection of past SARS-CoV-2 infection

The clinical association between periodontitis and COVID-19

We thank Dr. Sahni for his letter to the editor commending our manuscript. As he points out, emergent evidence links periodontal disease to COVID -19 incidence and severity, and various oral niches are emerging as potential reservoirs for the SARS-CoV2 virus. These lines of evidence highlight the role of the dental professional in preventing community spread of infectious diseases. They also reinforce the importance of at-source mitigation and elimination through mouthrinsing, high-volume evacuation, and so forth, and eliminating viral reservoirs through oral hygiene, professionally administered oral prophylaxis, and other means. n