ARTICLE TOPIC:EFFECT OF COVID 19 ON ORAL HEALTH

COVID-19 Impacts Oral Health—Even If You

Don’t Acquire the Viral Infection
Only history will be able to fully measure the impact of the COVID-19 pandemic. But many
dental professionals are already seeing a direct or indirect impact of increased stressors with
patients seeking routine care. Among the obvious evidence:
 Increased accumulations of hard and soft deposits on patients’ teeth due to longer than ideal
timeframes between preventive care
 Increased evidence of wear facets
 Abfraction lesions and fractured teeth due to stress-related bruxism
 Increased xerostomia due to mask-wearing throughout the day, which tends to decrease
hydration and increases mouth-breathing
 Increased evidence of demineralized surfaces due to increased snacking and consumption of
alcohol and sugary products as a result of a work environment at home
Indirect evidence clinicians are seeing of the impact of COVID-19 on oral health includes
increased inflammatory response due to heightened life stressors and decreased oral hygiene
related to isolation-induced depression.
Also, increased pro-inflammatory food consumption and increased xerostomia raise the risks
for dental caries and periodontal disease alike. Tooth sensitivity appears to be at an all-time
high as well, likely as an indirect response to increases in acidic dietary choices, bruxism, and
alcohol consumption.
How Can You Assist Your Patients?
Patients may or may not be aware of all of the direct and indirect impacts of COVID-19 on
their oral health. Therefore, clinicians need to become private detectives during routine
examinations to identify all of the direct and indirect impacts the pandemic may have already
had. Intervention can help relieve hypersensitivity, increase oral hydration, remineralize tooth
structure, and decrease inflammatory response.
Prior to each visit, review each patient’s records to find previously identified increased risks
for periodontal diseases and dental caries. Prioritize thorough screenings and risk assessments
for these patients as well as for all patients with underlying health concerns such as cancer,
heart disease, diabetes, obesity, and autoimmune diseases as well as for any patient who is
immunosuppressed.
Depending on how long the interval has been between dental hygiene visits, and on
contributing risk factors that influence oral health, some patients who had been at low risk of
disease prior to the pandemic may receive an unexpected diagnosis of gingivitis,
periodontitis, or dental caries. Adequate time for education and information on risk reduction
is imperative for these patients. Many will need to return for additional therapy or treatments
they have not experienced in the past.
Dental professionals should be equipped to provide as indicated:
  Wise counsel to reduce pro-inflammatory dietary food and beverage choices such as sugary or
acidic beverages and starchy carb snacks
 Coaching to adopt simple but thorough oral hygiene routines to offset increased risks from
pandemic stressors
 Identification of decreased salivary flow and evidence of xerostomic tissues
 Identification of demineralized surfaces and/or hard and soft tissue evidence of bruxism
 Identification of inflammatory responses and diagnosis of gingivitis and/or periodontitis for
early diagnosis and treatment
 Product recommendations specific to each patient’s needs to offset xerostomia, remineralize
tooth structure, increase salivation, prevent sensitivity, and reduce plaque biofilm
Dental professionals should be utilizing teledentistry and social media to communicate
prevention and intervention messages to alert patients that increased attention to their oral
health is critical during a pandemic.
Also, periodontal disease may be an influencing factor contributing to a more severe COVID-
19 outcome, once infected, primarily due to the increase in pro-inflammatory cytokines based
upon recent published data from the British Dental Journal. This is of particular importance
with some patients experiencing longer intervals between dental care during the pandemic.
What Can Your Patients Do?

Knowledge is power regarding choices we make for our health. Once your patients are
equipped with knowledge that risks may be higher than they have previously experienced for
oral disease, they can proactively take steps to reduce risks and prevent adverse outcomes in
their oral health.
First, advise your patients to drink more water than they think they need. The more a person
is masked, the easier it is to reduce hydration. Patients should be intentional about drinking
water, through a straw, if necessary, to maintain adequate hydration. No one should wait until
they are thirsty to hydrate.
Next, patients should be told to increase their antioxidant consumption daily with multiple
servings of green leafy vegetables and bright colored fruits and vegetables to provide
necessary nutrients and minerals to oral tissues.
Third, tell each patient to become a label detective, intentionally avoiding or limiting
products with high sugar content and/or high acidic content. They should revamp how they
snack, for example, choosing carrot sticks with almond butter instead of chips or candies.
Also, patients should be advised to select a convenient time to devote at least two minutes to
thorough brushing and another minute for cleaning in between their teeth daily. They should
maximize use of power brushes such as the Philips Sonicare for optimal results and power
devices such as the AirFloss for ease and effectiveness of cleaning between teeth.
Patients additionally should experiment with over-the-counter products to alleviate dry
mouth. Products that contain Xylitol such as Spry mints, gum and spray, or Xylimelts can be
very beneficial in stimulating saliva and hydrating tissues. So can antioxidant products such
as Periosciences AO Provantage gel, toothpaste, and mouth rinse, as well as products that
contain arginine and calcium carbonate such as Basic Bites. Oral probiotics such as Probiora
Pro can help repopulate the oral cavity with beneficial bacteria during sleep when salivary
flow is reduced.
Furthermore, xylitol nasal sprays such as XLEAR can help maintain clear nasal passages and
potentially could be preventive against variants of the SARS-CoV-2 virus that have been
shown to reside at higher viral counts in nasal passages.
Of course, patients should be told to utilize fluoridated toothpaste daily to offset acidic
attacks to the enamel and help strengthen it, but they should also avoid rinsing immediately
after brushing. Patients should simply spit out excess toothpaste, but allow a bit of the residue
paste to coat and remain on the tooth surfaces for maximum protection.
Finally, patients should not delay in seeking preventive dental care. Increased protective
layering of infection control strategies due to the pandemic make dental offices a safe place
to receive preventive and therapeutic treatments.
Our patients may not be aware of potential adverse effects to their oral health related to the
COVID-19 pandemic. But with simple strategies, we can assist them in protecting their
beautiful smiles and preserving their oral health.
Karen Davis, RDH, BSDH, practices clinically in Dallas, Texas and is founder and owner of
a continuing education company named Cutting Edge Concepts. Her background as a
clinician, consultant, and speaker enable her to identify with challenges facing dentistry and
offer innovative solutions vital to success in today’s marketplace. Dentistry Today has
recognized Karen as a “Leader in Continuing Education” since 2006. She is an independent
consultant to Philips Oral Healthcare.
REFRENCE:
https://www.dentistrytoday.com/news/todays-dental-news/item/7778-
covid-19-impacts-oral-health-even-if-you-don-t-acquire-the-viral-infection
Submitted to;
Dr shazia
COMMUNITY DENTISTRY