Dr Najat Abdrabbo Alyafei
World Health Organization has been advocating several measures like the use of mouth masks, hand hygiene, social distancing, and quarantine to limit the spread of coronavirus, which has propagated unanticipatedly across the globe.
With many distinct variant strains of the virus emerging, the world is off late, facing new waves of this pandemic and a serious threat to human health due to the unavailability of a conclusive preventive vaccine, strategies to control the pandemic focus on preventing the spread of the virus. Diligent measures adopted at the individual and community level are the essential approaches to curb the spread of this pandemic.
Mouth is one of the main portals for the entry of corona virus into a person, as well as it is a route for the transmission of the disease from an infected person, when he coughs, sneezes or even talks, through the droplets which carry the virus in the air. Significant viral loads have been detected in the saliva of the COVID-19 patients. A recent collaborative study between Hamad Medical Corporation - Department of Dentistry and the College of Dental at Qatar University, published in Journal of Clinical Periodontology investigated the prevalence of severe COVID- 19 complications (death, ICU admissions and need for artificial assistance) and compared it to COVID-19 patients who were discharged without experiencing any severe complications.
Dental records of both these groups of patients were evaluated. The outcome of this research revealed that complications were significantly higher among the patients with preexisting gum disease (Periodontitis). Periodontitis is a disease that occurs in the mouth when harmful bacteria infect the gums and create gaps between the gums and teeth. In advanced cases, periodontitis will result in bone loss, and ultimately the teeth may become loose and fall off.
Most often, periodontal disease is caused due to improper oral hygiene, and in other cases, it has been associated with systemic diseases. Effective cleaning of the teeth with a toothbrush and fluoridated toothpaste twice daily and using dental floss are simple means to prevent gum diseases and preserve a healthy foundation for the teeth and gums. People with systemic diseases need additional care and management of the underlying conditions. Given the new findings of severe complications in COVID-19 patients with gum diseases, we cannot afford to continue to neglect our oral health.
Mouthwashes of Listerine, Chlorhexidine, Peroxal and Povidone Iodine also have the potential to stop the COVID-19 transmission by reducing the viral load in the mouth and saliva. It is recommended COVID-19 patients regularly disinfect their toothbrushes and replace their toothbrushes with new ones regularly if they wish or after recovering from the infection. Using a disposable toothbrush is an option. Mouthwashes can additionally be used to disinfect the toothbrushes also.
It is recommended to leave the toothbrush head immersed in the solution for 20 minutes to kill the virus. In addition, a new Laboratory study’s results propose that some toothpaste and mouthwashes may help reduce the spread of amount virus in the mouth; thus, the spread of SARS-CoV-2 that causes COVID-19 will reduce. In summary, it can be inferred that poor oral hygiene leads to gum disease (periodontitis) and creates a preexistent environment of increased inflammatory biomarkers in the body.
Suppose this is coupled with coronavirus co- infection. In that case, it will result in an exaggerated systemic immune response in the body, referred to as a “cytokine storm,” which may terminate in severe outcomes like death. Promoting and encouraging good oral hygiene maintenance is an important determinant for controlling transmission and reducing the oral load of coronavirus.
