Bioaerosols from Mouth-Breathing: Under-recognized Transmissible Mode in COVID-19?

The whole world has been affected by the coronavirus disease 2019 (COVID-19) pandemic, and many researchers are racing to understand the disease course and to undertake risk analyses to formulate effective treatment strategies. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highly transmissible through coughing and sneezing, and through breathing and talking which may account for viral transmission from asymptomatic carriers. Bioaerosols produced during mouth-breathing, an expiratory process in habitual mouth breathers, should be considered in addition to nasal bioparticles as a potential transmissible mode in COVID-19. Oral health professionals are justifiably apprehensive about the exposure risk due to close face-to-face contact and the mode of transmission. The aim of this commentary is to summarize the research conducted in this area and suggested strategies to limit the spread of COVID-19, especially in dental offices.