28/11/2020
Shared By Dr Nehal Patel
Oral and Maxillofacial surgeon
Increase in fungal Osteomyelitis of maxilla & Mandible in patients recovered from COVID
1. This is serious matter and during your routine dental practice you will come across patients who have been recovered from covid and have multiple mobile teeth.
2. Kindly investigate these pts before doing extractions. I have seen 3 such cases in last one month who were recovered from COVID and all 3 pts were given heavy dose of steroid to treat covid.
3. All 3 were young pts without prior history of diabetic and they all reported with mobile teeth. Usual antibiotic treatment was given to all of them.
4. All 3 developed fungal (Mucor Mycosis) osteomyelitis and ended up losing their one side of entire maxilla
5. High dosage of steroid given for treatment can cause permanent hyperglycemia in previously non diabetic pt this along with suppressed immunity due to COVID can cause fungal osteomyelitis
6. Mucor mycosis is very serious fungal disease and it is very aggressive, reported mortality is almost 30%-40% and it requires immediate attention and injectable antifungal therapy for long time.
7. Proper history of patient is of upmost important in this post covid era. If you come across any patients with multiple mobile teeth who has history of COVID and received steroid in heavy dose kindly investigate properly before doing any dental treatment.
8. Early diagnosis & aggressive surgical treatment with proper antifungal therapy can reduce morbidity & mortality.
9. Request all to investigate your pts properly who has history of COVID and if require take opinion of your Oral surgeon.
One such case of 35 yes lady who lost entire one side of her maxilla...She was non diabetic precovid...Her sugar shoots up and she developed fungal osteomyelitis...No of such cases have increased...So be careful and investigate before proceeding for dental treatment