Illustration by Daria Krikunova.
These days, the evolving Coronavirus outbreak is causing an unprecedented degree of anxiety regarding health. Most of it is focused on the possibility of contracting or spreading COVID-19, and of overcoming the illness without major complications.
This shouldn’t drive oral health to the backseat, though: oral health is an important component of our general wellbeing, and it can impact our immunity and the speed of our recovery. Many studies have established a link between our overall health status and the presence of oral infections (1). If you have been infected with Coronavirus, then you will need to take your preexisting oral conditions into account.
Plus, many of the temporary restrictions we are facing will impact our ongoing oral treatments; and the infection itself can also affect your dental problems.
This means that any specific actions you take during the coming days must take into account whether you already have the virus, the rest of your medical history, and the area where you live.
COVID-19, respiratory illnesses, and oral health
Recurrent or frequent oral health problems include gingivitis (inflamed gums), periodontitis (gum disease), cavities, and tooth abscesses or infection. These conditions are common in general, but they’re especially frequent among the elderly and those with any conditions that affect immunity, like such as diabetes, heart problems, or autoimmune conditions.
Does that description sound familiar? Unfortunately, this group crosses over a lot with those who are regarded as most vulnerable from COVID-19 or upper respiratory infections in general (2). There are several reasons for this, but one that has been extensively studied is the link between oral bacteria and pneumonia.
Cavities, gum disease, and oral infections can all create pockets where bacteria can thrive. Occasionally, that bacteria can travel from the mouth into the lungs and cause an infection in the lungs – pneumonia. Never a pleasant disease, pneumonia is one of the most frequent reasons why those with respiratory infections end up requiring hospitalization or help with respiration.
Therefore, if you have any recurrent oral conditions (like gum disease), or have recently had cavities, it will be best to take extra precautions to prevent bacterial respiratory infection.
How can I prevent complications?
There are two main pillars to base your prevention strategies: preventing Coronavirus itself and preventing any new bacterial infections arising from the oral cavity.
To prevent contracting or spreading the virus, your best bet is to follow the guidelines provided by the World Health Organization.
Meanwhile, oral hygiene is supposed to be a regular activity – but it never hurts to review the basics. A recent review of pneumonia rates at nursing homes showed that effective, thorough oral cleaning can reduce your chance of pneumonia by 10% (3). Try to make sure you check all the boxes:
Brush your teeth conscientiously with fluoridated toothpaste
Floss every day
Remember to scrub your tongue – its soft and moist texture can give bacteria a hidden nest (4).
Inspect your cavity or bridge sites to spot any new developments
Can I still see my dentist?
All over the world, people of all ages have been advised to stay home and cancel non-essential appointments – and in many places, that includes any non-urgent dental appointments. It’s natural to wonder if that applies to you as well, but you should consider your circumstances before making a final decision.
Is visiting the dentist worth the risk?
For the most part, dental offices are regarded as safe and aseptic – and the staff at the clinic takes great care to keep them that way.
The main form of transmission for the Coronavirus is through droplets of saliva. Even under normal circumstances, you will be asked to stay home if you are showing signs of an active infection, such as sneezing or productive coughing (that’s the kind with phlegm). This rule is still valid!
Unfortunately, we still don’t have a lot of information regarding how the Coronavirus can spread from asymptomatic patients. At this time, it’s best to take extra precautions.
If you are over 65 or have any condition that could affect your immunity, then you are at the at-risk group. It’s best to only go to the dentist if you absolutely have to. This includes:
If you recently had a dental procedure, such as endodontics, that requires a follow-up
If you are in pain
If you are in the middle of an ongoing treatment that cannot be postponed
If you notice any sign of active infection, pus, or develop a fever, please call your general health practitioner and follow the local protocol.
If you are scheduled for a non-urgent appointment such as a routine cleaning or whitening treatment, please postpone it. If you are worried about developing an infection or cavity, you can monitor your dental health at home using our app.
At this time, it is also very important to think of others. Please notify your dentist about any cancelled appointments. That slot could be useful for someone else!
What should I do if I must go?
Despite your dentist’s best efforts, you may still be at risk of contracting or spreading the virus while on the way to your appointment or in the waiting area. Keep your distance from others, and remember to keep your hands, especially after touching doorknobs or chairs.
If you already have Coronavirus or suspect you may have
The COVID-19 infection is somewhat similar to seasonal influenza. This means that the early symptoms are likely to include sneezing, coughing, and difficulty breathing. Your sinuses may also feel clogged or swollen, which may tempt you to breathe through your mouth. This may increase the discomfort from any pre-existing oral problems, such as gingivitis and a dry mouth. If you are prone to frequent oral infections, you may also have a slightly higher risk of a flare-up.
It’s best if your body does not have to fight two battles at once. Be extra vigilant about your daily oral hygiene, and use our app to monitor any symptoms.
The current Coronavirus outbreak has affected routines and habits for people all over the world. Whether sick or healthy, we all have a responsibility to care for ourselves right now and prevent further burdens on the healthcare system. Your protection and that of your community go hand in hand!
1. Williams RC, Barnett AH, Claffey N, Davis M, Gadsby R, Kellett M, Lip GY, Thackray S. (2008) The potential impact of periodontal disease on general health: a consensus view. Current Medical Research and Opinion. 2008 Jun;24(6):1635-43. doi: 10.1185/03007990802131215. Available online: https://www.ncbi.nlm.nih.gov/pubmed/18452645
2. Loeb M, McGeer A, McArthur M, Walter S, Simor AE. (1999). Risk Factors for Pneumonia and Other Lower Respiratory Tract Infections in Elderly Residents of Long-term Care Facilities. Archives of Internal Medicine. 1999;159(17):2058–2064. doi:10.1001/archinte.159.17.2058 Available online: https://www.ncbi.nlm.nih.gov/pubmed/10510992
3. Hede B, Poulsen JE, Christophersen R, Christensen LB. (2014) Shared Oral Care – evaluering af et mundhygiejneprogram på fem plejecentre. Tandlægebladet 2014;118:980-6 Available online: https://www.tandlaegebladet.dk/sites/default/files/articles-pdf/TB122014-980-987.pdf
4. Danser MM, Mantilla Gomez S, Van der Weijden GA. (2003). Tongue coating and tongue brushing: a literature review. International Journal of Dental Hygiene 1, 2003; 151-158 Available online: https://onlinelibrary.wiley.com/doi/full/10.1034/j.1601-5037.2003.00034.x