b'It dawned on me that if this is happening in the mucosa of the lungs, its probably also happening in the mucosa of the oral cavity.Building a dream team cautioned that much follow-up research is necessary. He pointed out The two doctors contacted Dr. Sarah Teichmann,that more saliva tests are now being given to kids because the samples head of cellular genetics at the Cambridge,are easier to collect than with other tests, and some feel that saliva England-based Wellcome Sanger Institute, whotests could ultimately be the gold standard for COVID-19 tests for all.was leading a project to create comprehensiveToday the medical community might still think of the nose or the lungs reference maps of all human cells to furtherfirst when it comes to diagnosing COVID-19. As the advantages of understand health and disease. We emailedsalivary diagnostics become better understood and appreciated, so too Dr. Teichmann saying, If you think you mightwill the narrative that the oral cavity is a vitally important part of the be able to use this data to help human health,body, he said. We hope that well continue to see increasingly more well donate it to your team, said Dr. Byrd. Shedentistry in medicine and more medicine in dentistry.responded almost immediately saying, Lets do this project together. Importantly, Dr. TeichmannA remarkable virusalso confirmed Dr. Byrd and Dr. Warners intuition that the front doors are available to the SARS- Using all the toolkits at the teams disposal to look at all of the individual CoV-2 virus in both the gingival and glandularcells of a healthy mouth, they found that the oral cavity is broadly sites. With Dr. Richard Boucher and the Marsicoavailable to be infected by a wide range of viruses. They also found Lung Institute at UNC, we were able to verify thatthat SARS-CoV-2 stands apart from most other coronaviruses. For these findings were similar across the entire oralexample, MERS is also a coronavirus, but it didnt lead to a pandemic, tissues, said Dr. Byrd. he said. In contrast, SARS-CoV-2 is much more naturally adapted for infection and transmission. It infects the barrier tissues, which are the Revelation #1 tissues facing the external environment, he said. Unfortunately, all of these tissues cells are open doors to the virus. In that respect, its a The oral cavitys role in COVID-19 infectionsremarkable virus.started becoming clearer to Dr. Byrd and Dr. Warner by the spring of 2020 when they wereThe power of collaborationseeing cases in JAMA Dermatology and other journals reporting on taste loss. If loss of taste isDr. Byrd credited the success of the project to the amazingly fruitful caused by how parts of the brain are respondingcollaboration among Dr. Warner, Dr. Teichmann, Dr. Boucher and to taste, it would be considered a secondaryhimself, among the NIDCR, the Wellcome Sanger Institute and UNC, manifestation, Dr. Byrd explained. But if the lossand among other teams in the U.S. and teams in the U.K. Everyone of taste is caused by the virus being inside thewas dedicating their best selves, he said.oral cells and making more of itself, you have aFor future pandemics, it will be important for the international direct infection. Our toolkits enabled us to verifyconsortiums studying any disease to make their data available so it can that the virus was in fact inside the oral cells andbe determined if the oral cavity is a site that clinicians should be looking replicating. at for possible infection. If we know what the viruss front doors are, Revelation #2 we can make better informed clinical judgments, said Dr. Byrd. This will require widespread collaboration among industry, government, One particularly important aspect of this discoveryacademia, and practitioners. We cant just rely on individual labs was the fact that some of the cells that getanymore; there is just too much expertise thats required. Only a team infected in the glands help produce saliva. Thescience approach will work. teams toolkits confirmed that those cells were pumping the virus directly into the saliva. Dr. Byrd AAP Periospectives| 35'