“Many dental surgeries are closed or are only seeing patients for emergencies, it is even more important than ever to brush properly and carry out inter-dental brushing or flossing regularly.”
Everyone is trying to manage this uncertain and trying times in different ways. Brushing your teeth and gums or keeping a good dental hygiene might not be on the top of the list of the things to do in the middle of the COVID-19 pandemic.
That view will change very quickly if you have a painful gum abscess or your teeth became loose, and you can’t get in to see a periodontist (gum specialist).
Preventative measures, eating habits and having a regular brushing routine should be built into your daily routine especially for patients with periodontitis (gum disease). Gum disease is common and if left untreated, may lead to bone loss around the teeth. This may lead to loose teeth and teeth being lost.
How do I know if I have gum disease?
Gum disease is caused by the bacteria in plaque which is not removed during brushing. Plaque is a thin and sticky film which forms on your teeth. If the plaque is not removed by brushing, it can harden into tartar or calculus. As the calculus forms near the gumline, the plaque underneath releases harmful poisons causing the gums to become irritated, inflamed and present as bleeding gums. Clinically, this is presented as a condition called gingivitis.
The gums start to pull away from the teeth when it becomes inflamed and the gaps between the gums and the teeth called pockets deepened and become infected. In susceptible individuals, the bone supporting the teeth is destroyed, and healthy teeth can become loose and fall out. This disease is called periodontitis.
Gum disease (gingivitis) will usually presents with red, swollen gums that bleed when you brush or clean between your teeth. If the gum disease progresses to periodontitis, the bone supporting the teeth will be destroyed and teeth will become loose or wobbly, look longer (gum recession), bigger gaps will form between teeth, bad breath and the teeth may move or misalign over time. Sometimes, your teeth may become sensitive. However, more often than not, it is usually painless unless there is an acute infection such as gum abscess (gum boil or “pimple” containing pus). There has been suggestions of a link between periodontitis and health problems such as heart disease, strokes, preterm and still born births. It is therefore sometimes known as “The Silent Killer.”
How do I take care of my gums?
- Oral care routine
It is important to remove plaque and food from around your teeth and gums in order to stop your gums from becoming inflamed, swollen and infected (and teeth from getting decay). Once the plaque harden into calculus, this would need to be removed by a dental professional.
Maintaining your usual brushing regime with fluoride toothpaste and interdental brushing/flossing daily to keep in mind the followings:
a. Brush regularly twice a day. Last thing at night and one other time during the day. It is important to brush your teeth as well as the gum level. An electric toothbrush can be more effective in plaque removal but both manual and electric toothbrush would work providing that you spent time to brush thoroughly. A toothbrush with a small sized head would be useful to reach all parts of the mouth. Soft bristles would be better for your gums and you must ensure that the head of the brush is not worn or the bristles are not splayed. In general, change to a fresh brush once every 3 months. In patients with untreated gum disease, gum bleeding may be a presenting sign, it is crucial that patients continue to brush regularly and thoroughly both the teeth and gums rather than avoid brushing due to concern with gum bleeding. If the gum bleeding does not stop after 1 to 2 weeks, you should seek advise from a dental professional.
b. Use a fluoride toothpaste. Current recommedation would be to spit out after brushing and do not rinse, so that the fluoride stays on your teeth longer.
c. Flossing or interdental brushes (e.g. Tepe brushes or piksters) of different sizes are essential for brushing in between your teeth for patients with gum disease. Cleaning in between your teeth removes plaque and food particles that are stuck between your teeth and the gumline. These are the areas which a toothbrush can’t reach. This regime would need to be carried out once a day and without the need to put toothpaste on the interdental brushes. This is an effective way to remove the bacteria contained in the plaque. Interdental brushing is usually carried out prior to normal tooth brushing but can be carried out at any time of the day.
d. The use of mouthwash is not essential but may be helpful. Anecdotal evidence would suggest that the use of mouthwash with 1% Peroxide or 0.2% Chlorhexidine Gluconate for 30 seconds to 1 minute works well against reducing the viral load. Since COVID-19 is a virus, this may help to reduce the risk of spreading a virus.
e. For patients who may be concerned with bad breath. Tongue brushing or cleaning to remove the sulphur-producing bacteria may help to improve a patient’s breath.
f. Remember to wash your hands with soap for 20 seconds and dry them with a towel.
Don’t forget: 3 to 6 monthly check-ups and cleans are important for gum maintenance for patients with periodontitis. If you are unable to see a Periodontist due to the COVID-19 pandemic, ensure that you reschedule to the next available appointment. In the meantime, patients who have concerns, should approach our Periodontist for a virtual consultation.
2. Diet or eating habit matters
During this “Stay Home” period, don’t let yourself go by feasting on snacks and junk food and neglecting your health. Most people think that eating high level of sweets and sugar in your diet causes decay. This is partly true, however, it is how often you have sugar in your diet, not necessarily the amount, that causes most of the problems. It takes an hour for your mouth to neutralise the acid caused by eating and drinking sugar. It is therefore important to limit the number of attacks by having sugary foods and drinks just at mealtimes. Drinking water and chewing sugar-free gum would also help to neutralise the acid more quickly.
Limit fizzy drinks, fruit juices, energy drinks or even excessive Vitamin C supplements (capsules or tablets are preferred in comparison to chewable tablets or dissolvable tablets) because they can cause dental erosion (acid in food and drinks wears away the enamel of the teeth) and may lead to sensitivity.
3. Stay hydrated by drinking plenty of water
Stay hydrated is important for both your oral and general health. Lack of fluids may lead to dry mouth. A reduction of saliva in your mouth also increases tooth decay and gum inflammation as the all important saliva which normally helps to remove food particles and acid that keeps the oral bacteria at bay.
How to avoid catching or spreading the coronavirus (COVID-19)
- Never share a toothbrush
No matter how close you are to the people you live with, sharing your toothbrush is not hygienic. That is one way that viruses can spread to other people. The toothbrush heads should be stored and kept apart from other toothbrushes in your household.
2. Clean your bathroom regularly and close the toilet lid before you flush
There has been some studies to suggest that virus can be spread by faecal matter. It is important to keep your toothbrush away from your toilet.
3. Change your toothbrush regularly
To ensure the effectiveness of your brushing, your toothbrush should be changed regularly. If you have had the coronavirus or suspect that you may have, get a new toothbrush after your isolation period.
4. Visiting your Periodontist and stay connected
Maintaining regular visits with your periodontist will always be important. However, during this period of uncertainty in order to limit the transmission risk of COVID-19, dentists are subject to restrictions and are only able to provide dental treatment on an urgent basis. Nevertheless, you can still reach out to your periodontist or stay connected via virtual or online consultation.
Lastly, stay safe and stay strong. Always be kind!