Back to basics – improving oral hygiene at home during the COVID-19 crisis

oral hygieneColgate explains how you can help improve patients’ oral hygiene at home and maintain a high standard of quality care during the COVID-19 crisis.

The FDI World Dental Federation states: ‘A good oral hygiene routine, regular dental check-ups and a healthy lifestyle are crucial for protecting oral health and maintaining general health’. Oral diseases, if left untreated, not only impact the mouth, but can also impact every aspect of life.

‘The COVID-19 pandemic has severely affected oral health around the globe. In addition to fuelling unhealthy eating and drinking habits (Abbas, 2020), the pandemic has severely disrupted dentistry services and access to care.’

Keeping patients protected, not only from the virus but from dental disease where possible, is key to maintaining a high standard of quality care. Supporting patients in maintaining good oral hygiene at home is therefore more important than ever. Dental teams can reach out to proactively advise, educate, and motivate patients to improve their daily oral hygiene routines.

The pandemic has been a catalyst for many people to become more aware of their own physical health along with the importance of self care. Oral hygiene is also important to general health and wellbeing. So this situation is an opportunity to proactively advise patients on how they can better maintain or improve their oral health at home.

An effective oral hygiene routine should be evidence based and ideally tailored to patients’ specific needs. Dentists can deliver this advice to the patient whilst chair side or remotely through digital media. What is important is the patient is both aware and understands how they can help themselves to maintain their own oral health at home. 

Although largely preventable, dental caries and periodontal disease continue to be the two largest threats to oral health. Research has indicated possible associations between chronic oral infections and diabetes, heart and lung disease, stroke, and low birth weight or premature births (Benjamin, 2010). In other words, whilst oral health refers to the health of our mouth it ultimately supports and reflects the health of the entire body. So, what is the best advice we can pass on to patients at this time to support them? 

Optimising toothbrushing advice

We know that optimising daily toothbrushing can help to prevent dental caries and periodontal disease. But we should not assume that patients always know how best to achieve this.

Another important factor to consider is the benefit of the entire dental team delivering consistent and evidence-based messages. This consistency in messaging can help support behaviour change in patients to help improve oral hygiene outcomes. 

Manual toothbrushes are accessible for most patients, easy to use and can be effective at plaque control. The way we use the toothbrush is as important as the toothbrush itself.

Make patients aware that the effectiveness of their toothbrush reduces. So they should replace it every three months, or before, if the bristles become worn and splayed.

Another reason to change their toothbrush is if they have had a cold or a virus. Once an infection has passed, together with the typical symptoms such as a cough, sneezing, or fever, they should replace their toothbrush.

In terms of toothbrushing technique, no particular technique is better than another. The patient’s existing method of brushing may need modifying to maximise plaque removal, emphasising the need to systematically clean all tooth surfaces.

To control caries, it is the fluoride in toothpaste that is the important element of toothbrushing in preventing, controlling, and arresting caries. Higher concentration of fluoride in toothpaste leads to better caries control.

To help control gum disease, the physical removal of plaque is an important element of toothbrushing. It reduces the inflammatory response of the gingiva and its sequelae. Unfortunately, many patients are unable to achieve optimum plaque control from brushing alone. This means using an appropriate toothpaste technology containing an antibacterial agent.

Managing the oral biofilm

In seeking a truly innovative approach to support everyday prevention, Colgate has leveraged the recent change in focus of the dental profession from treatment of disease to proactive prevention. Harnessing the trend to more health-conscious and educated patients. Building upon a new understanding of oral biology and oral health. As a result, Colgate has developed the next generation of Colgate Total toothpaste. It embraces a contemporary approach to everyday prevention by delivering superior biofilm control (Manus et al, 2018; Colgate data on file),* for whole mouth health.** 

As we consider biofilms, it is important to highlight their relative distribution in the oral cavity. Hard tissue surfaces make up for only 20% of oral surfaces. The remaining 80% are soft tissue surfaces – mainly on tongue, cheeks and gums. Colgate Total, with 1,450 ppm sodium fluoride and dual-zinc and arginine, enables superior biofilm (Manus et al, 2018; Colgate data on file)* control. It delivers comprehensive benefits for the whole mouth.**

There is also evidence to support optimising toothbrushing by brushing for two minutes and discouraging patients from rinsing immediately after toothbrushing (Chestnutt et al, 1998). The ‘spit don’t rinse’ message prevents washing away the fluoride protection in the toothpaste.

If a fluoride mouthwash is indicated, this should be used at a different time to toothbrushing (Marinho et al, 2003). Colgate Fluorigard 0.05% daily rinse is medicinally licensed and clinically proven to prevent caries.

Finally, with all oral hygiene advice, it is also important to remember to reinforce diet messages to support oral health. Remind patients to reduce the frequency and amount of sugary food and drinks and, when consumed, limit to mealtimes (Moynihan and Kelly, 2013).

Keep in touch – keep oral hygiene top of mind

These oral care messages may seem rather simple; however, their impact will be far reaching in supporting patients whilst they are outside your direct care.

Many patients are now especially open to these types of messages at a time when there has also been an increased use of digital media replacing face to face contact. A number of digital tools have been developed during this time to allow dental teams to engage remotely to raise the importance of oral hygiene and educate and motivate their patients to keep oral health top of mind.

Visit www.Colgatecommunication.co.uk/educational-resources today to see the range of educational resources available to share with your patients.             

For additional information please visit www.Colgateprofessional.co.uk or www.colgatetalks.com.

References

Abbas AM (2020) Dietary habits in adults during quarantine in the context of COVID-19 pandemic. Obes Med 19

Benjamin RM (2010) Oral Health: The Silent Epidemic Public Health Rep 125(2): 158-9 

Chestnutt IG, Schäfer F, Jacobson AP and Stephen KW (1998) The influence of toothbrushing frequency and post-brushing rinsing on caries experience in a caries clinical trial. Community Dent Oral Epidemiol 26(6): 406-11

Manus LM, Daep CA, Begum-Gafur R, Makwana E, Won B, Yang Y, Huang XY, Maloney V, Trivedi HM, Wu D and Masters JG (2018) Enhanced In Vitro Zinc Bioavailability through Rational Design of a Dual Zinc plus Arginine Dentifrice. J Clin Dent 29 (Spec Iss A): A10-19

Marinho VCC, Chong L, Worthington HV and Walsh T (2003) Fluoride mouthrinses for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews 2003 3: CD002284

Moynihan PJ and Kelly SAM (2013) Effect on caries of restricting sugars intake: systematic review to inform WHO guidelines. J Dent Res 93(1): 8-18


* Colgate Total provides superior in vitro delivery, penetration, and retention of zinc through arginine technology for biomass reductions versus zinc control toothpaste.

** Whole mouth health defined as teeth, tongue, cheeks and gums.

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