The importance of managing oral health during the COVID-19 pandemic

With COVID-19 limiting clinicians’ interaction with patients, Rohini Bansal lists the advice she’s giving to her patients so they can stay on top of their oral health.

As clinical research and science regarding the nature and management of the coronavirus continues, it is imperative we promote and practise preventative oral care.

Government protocols within the UK have led society to help prevent the spread of infection via regular hand washing with gels, wearing of face masks and social distancing ourselves from others.

With these limitations in place we are anticipating a growing reduction in the number of positive COVID cases. As changes on the functionality of the coronavirus are occurring spontaneously, it is crucial we take all the necessary steps to stay healthy.

Oral health is significant

There is increasing evidence to support detection of coronavirus within saliva.

Clarity in the spread of infection and whether there is ability to break down the walls of the virus within the mouth remain questionable.

Barriers surrounding dental access are also having a huge impact. Individuals are in a position where they may suffer in pain for a longer duration. With it being near impossible and difficult to reach a dental surgery in time, the management of dental pain is pivotal.

With the ongoing restricted dental guidelines that are now in full swing, our scope of practice is limited. Currently, we are unable to carry out routine dentistry so freely.

An integral part of my role is to give personalised oral hygiene advice to my patients for them to improve their brushing regime on their own. I have been looking at ways to help encourage individuals to practise better brushing methods during these quarantine times, and sustain both their oral and overall health.

My top brushing tips

• Brush twice daily for at least two minutes using firm pressure and a fluoridated toothpaste
• After brushing, spit out rather than rinsing out with water
• Adopt a good brushing technique as oppose to scrubbing away at your teeth and gums
• Try to clean in between your teeth. These areas can hold food, debris and bacteria
• Avoid brushing straight after eating. Ideally wait 45 minutes to allow extra time for the saliva components to break down the food in your mouth
• Don’t neglect brushing the tongue. The tongue is a strong active muscle that can release strong potent smells if it is not cleaned effectively. Remember to clean the tongue after brushing using a toothbrush or a tongue scraper
• Regularly check everything in the mouth looks and feels normal. Look out for random bleeding and texture differences.

Diet plans

• Always stay hydrated. Hydration is key to keep your saliva active in keeping the oral tissues moist and healthy
• When consuming fizzy drinks or beverages, try to use a straw to avoid direct contact with the teeth. Direct contact can gradually lead to acid wear and sensitivity, which is uncomfortable
• Avoid snacking throughout the day. This can disrupt the saliva levels in the mouth, which will affect the health of the tissues in the mouth
• Be careful and take caution when eating hard foods and fruits
• Keep sugar consumption confined to mealtimes only.

Denture care

• Make sure dentures are cleaned daily. To make them last longer, clean them after eating each meal
• If you feel pain when wearing dentures, it is okay to remove them. Let your gums rest and relieve the soreness for a few hours
• Avoid sleeping with your dentures
• When cleaning and managing dentures, remember to handle with care as they can be fragile and break easily.

My formulated five-step routine for maintaining good oral health during restricted times

• Brush all the surfaces of each tooth for two minutes (use a timer)
• Use interdental brushes to clean between the teeth
• Clean the tongue using soft vertical brush strokes
• Check for any abnormalities (bleeding gums, ulcers and cavities)
• Spit after brushing, no rinsing out with water.

What does the future hold?

Despite the lack of profound evidence supporting oral health aspects of COVID-19, encouraging dental care advice at this time can only act as a benefit to individual’s overall health.

It could be some time before the dental world reaches some level of normality. We are still in the early days of learning about the virus’s association with the world.

In the meantime, let’s buckle up for the ride. Stay positive, remain safe and – most importantly – don’t forget to remind our patients to continue brushing.