Document Type : original article


1 Dentist

2 Assistant Professor of the Department of Pediatric, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran. Iran

3 department of pediatric dentistry, school of dentistry, islamic azad university



Background: This study aimed to assess the frequency of asymptomatic coronavirus disease-2019 (COVID-19) carriers and related oral manifestations in child dental patients.
Methods: This cross-sectional study was conducted on 215 asymptomatic pediatric dental patients aged 4-12 years. Clinical examination was performed by one calibrated examiner to determine oral signs and symptoms between October 2021 to July 2022. After completing clinical examination, the participants underwent a COVID-19 polymerase chain reaction (PCR) test. Data were analyzed by Chi-Square, T- test, and Fisher’s exact test (α<0.05).
Results: The mean age of the patients was 7.71±1.74 years; 102 (47.4%) were males and 113 (56.6%) were females. Thirty-two patients (14.9%) had a positive PCR result for COVID-19. Out of 32 positive subjects, 7(3.3%) had oral lesions including aphthous and herpetic ulcers. Impairment in the sense of taste was not observed in any of the patients. Association between oral symptoms, and age (P=0.432) or gender (P=0.539) was not significant.
Conclusion: The prevalence of COVID-19 asymptomatic carriers in the study population was 14.9%; and 3.3% of them had oral manifestations, which emphasizes the need for personal protective equipment to prevent infection transmission.


  1. 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.
  2. WHO Coronavirus (COVID-19) Dashboard. ( Accessed 5 August 2022
  3. Sayampanathan AA, Heng CS, Pin PH, Pang J, Leong TY, Lee VJ. Infectivity of asymptomatic versus symptomatic COVID-19. Lancet. 2021 Jan 9; 397(10269):93-94.
  4. Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C, Zimmer T, Thiel V, Janke C, Guggemos W, Seilmaier M, Drosten C, Vollmar P, Zwirglmaier K, Zange S, Wölfel R, Hoelscher M. Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. N Engl J Med. 2020 Mar 5; 382(10):970-1.
  5. Darvish S, Salman BN. General Considerations for the Practice of Pediatric Dentistry in the Period of COVID-19 pandemic: A Review. J Biosci Med. 2021 Aug 2; 9(8):29-42.
  6. Karbuz A, Akkoc G, Demirdag TB, Ciftdogan DY, Ozer A, Cakir D, Torun SH, Kepenekli E, Erat T, Dalgic N, Ilbay S, et al. Epidemiological, Clinical, and Laboratory Features of Children With COVID-19 in Turkey. Front Pediatr. 2021 May 7; 9:631547.
  7. Gao M, Yang L, Chen X, Deng Y, Yang S, Xu H, Chen Z, Gao X. A study on infectivity of asymptomatic SARS-CoV-2 carriers. Respir Med. 2020 Aug; 169:106026.
  8. Ludvigsson JF. Children are unlikely to be the main drivers of the COVID-19 pandemic - A systematic review. Acta Paediatr. 2020 Aug; 109(8):1525-30.
  9. Coronavirus disease 2019 (COVID-19): Caring for children. U.S. Centers for Disease Control and Prevention. Accessed 2021 Feb 19.
  10. Candan M, Yildirim S. Prevalence of asymptomatic SARS-CoV-2 infection in children in Sivas province, Central Anatolia. Eur J Res. 2022 Apr 11; 8(6):771-6.
  11. Lamberghini F, Trifan G, Testai FD. Severe acute respiratory syndrome coronavirus 2 infection in asymptomatic pediatric dental patients. J Am Dent Assoc. 2021 Apr; 152(4):277-83.
  12. Atsawasuwan P, Del Campo DM, Del Campo LM, Viana G, Ravindran S, Allareddy V, Kadkol S. Positivity rates of SAR-CoV-2 infection in orthodontic patients at the orthodontic clinic, University of Illinois Chicago. PLoS One. 2022 June 23; 17(6):e0270311.
  13. Iranmanesh B, Khalili M, Amiri R, Zartab H, Aflatoonian M. Oral manifestations of COVID-19 disease: A review article. Dermatol Ther. 2021 Jan; 34(1):e14578.
  14. Nasiri K, Tehrani S, Mohannadikhah M, Banakar M, Alaeddini M, Etemad-Moghadam Sh, V.O.Fernandes G, Heboyan A, Imannezhad S, Abbasi F. Oral manifestations of COVID-19 and its management in pediatric patients:A systematic review and practical guideline. Clin Exp Dent Res. 2023; 9: 922-934.
  15. Candan M, Yildirim S. Prevalence of asymptomatic SARS-COV-2 infection in children in Sivas province, Central Anatolia. Eur Res J. 2022; 8(6):771-776.