Oral Hygiene and COVID-19: Importance of Good Oral Health

Since the World Health Organization declared the coronavirus disease (COVID-19) a pandemic in March 2020, over 760 million cases have been recorded worldwide.¹ In the following years, scientific literature has suggested a link between oral health status and COVID-19.^2-3,6

This article covers current information about COVID-19 and oral health, including risk factors for diseases and the importance of good oral hygiene.

Importance of Oral Health During the COVID-19 Pandemic

Maintaining good oral health is fundamental for overall health and well-being, and this is especially true during the COVID-19 pandemic. 

Research shows that poor oral hygiene habits can contribute to COVID-19 transmission.⁴ Science also suggests a link between poor oral health and increased risk for COVID-19 complications.^2-3,6  

Adopting good oral hygiene habits can protect your dental health and overall health.

What Is the Link Between COVID-19 and Oral Health?

A wealth of scientific evidence has established a relationship between oral health conditions and systemic diseases.² Scientists believe this applies to COVID-19, though more research is needed to understand the relationship.

Oral Hygiene and COVID-19 Severity

The human oral cavity is home to a diverse microbiome (biofilm) of more than 700 types of bacteria.² Scientists suspect that an unhealthy oral microbiome increases the risk for COVID-19 complications, including pneumonia, sepsis, and death.⁶

COVID-19 complications are more common in people with other health conditions, including:

• Diabetes
• High blood pressure (hypertension)
• Cardiovascular disease

These conditions are also associated with unhealthy oral biofilms and periodontal disease (gum disease). 

COVID-19 and Oral Health Status

Recent research has found that oral health conditions are present in many people with COVID-19. Additionally, gum (periodontal) disease symptoms are linked to greater disease severity.² 

One study identified the oral health conditions most likely to occur in people with COVID-19.² These oral health issues include:

• Dry mouth — Also called xerostomia, this was the most prevalent oral health condition in people with COVID-19.
• Oral mucosal lesions — These include mouth ulcers, blisters, rashes, tiny spots on the tongue and oral tissues, bumps on the surface of the tongue, and canker sores. 
• Periodontal diseases and symptoms — Periodontal disease symptoms, including bleeding gums, gum pain, and loose teeth, are associated with COVID-19 disease severity.
• Orofacial pain — This includes jaw pain, dental pain, oral pain, temporomandibular joint (TMJ) pain, and facial tingling.

Future research is needed to determine whether these oral diseases are a result of COVID-19 or if they are risk factors that were present before infection.

Does COVID-19 Make Your Teeth Sensitive?

Dental (tooth) pain is one of the oral health conditions found to occur in people with COVID-19. However, it’s unclear whether orofacial pain is caused by COVID-19, or if it’s one of the risk factors for infection.

Oral Hygiene Tips to Prevent COVID-19 Spread

The virus that causes COVID-19 thrives in the mucous membranes of the oral cavity (oral mucosa). Poor oral hygiene can cause the virus to easily spread.

The American Dental Association (ADA) recommends following these oral hygiene guidelines:

1. Don’t Touch Your Face or Mouth

Avoid touching your face, lips, mouth, eyes, and ears with dirty hands. If you bite your nails, refrain from doing so as much as possible to prevent contracting COVID-19. 

2. Practice Good Oral Hygiene At Home

Essential tips for practicing good oral hygiene at home include:

• Use an antiseptic mouth rinse often to kill germs and bacteria in your mouth
• Drink water to prevent dry mouth
• Brush your teeth with fluoridated toothpaste twice per day
• Floss your teeth daily to remove plaque buildup
• Reduce or eliminate common risk factors, such as alcohol, sugary drinks, and tobacco

Maintaining good oral hygiene at home is always necessary to prevent cavities, gum disease, and other oral diseases. It’s especially important to take care of your teeth and mouth during the COVID-19 pandemic to prevent the spread of disease.

3. Replace Your Toothbrush or Toothbrush Head Often

Everyone is supposed to replace their electric toothbrush head or disposable toothbrush every 3 to 4 months.

During the coronavirus pandemic, dentists recommend replacing them more often. Or, at the very least, every 3 months. 

4. Clean and Disinfect Your Toothbrush

Many people don’t realize that their toothbrushes can harbor bacteria, blood, and saliva. Improper toothbrush care results in poor oral hygiene and can spread diseases, such as COVID-19.⁴

You can disinfect your toothbrush daily by rinsing it in 0.5 percent hydrogen peroxide for up to 15 minutes. This solution can kill COVID-19 bacteria in about one minute. Make sure you rinse off your toothbrush before brushing. 

Other Ways to Keep Your Toothbrush Clean

• If you don’t have hydrogen peroxide, you can rinse your toothbrush under hot water for a few minutes or boil it (disposable toothbrushes only, NOT electric toothbrushes)
• Never share your toothbrushes
• Make sure it gets fresh air
• When the tips become frayed or discolored, throw it out

5. Properly Store Your Toothbrush

Allow your toothbrush to dry after each use by keeping it upright. This helps prevent the spread and growth of bacteria.

6. Reschedule Non-Urgent Dental Services

The virus that causes COVID-19 flourishes on the oral tissues and easily spreads via saliva and respiratory droplets. This is why the American Dental Association (ADA) recommended rescheduling non-emergency dental procedures during the COVID-19 pandemic.

General Guidelines to Complement Good Oral Health

In addition to maintaining oral health and hygiene practices, the Centers for Disease Control and Prevention (CDC) recommends:

• Frequent hand washing — Wash your hands for at least 20 seconds a few times each day to prevent the spread of COVID-19. If you have to leave your house for any reason, you should wash your hands directly after returning home. 
• Hand sanitizers — If hand washing isn’t available, hand sanitizers that contain at least 60 percent alcohol are also capable of killing the COVID-19 virus.
• Disinfecting surfaces —  Clean hard surfaces, soft surfaces, and electronics with a disinfectant cleaner containing at least 70 percent alcohol.

Has the COVID-19 Pandemic Changed Oral Health Care?

COVID-19 has had a tremendous impact on oral healthcare systems across the globe. One study found the following changes to oral health care:³

• Decreased use of oral health care services — Lockdowns and fear of disease transmission led people to delay dental procedures.
• Increase in teledentistry — More people chose to access oral health services from home via telehealth

Summary

Good oral health is essential for overall health, and poor oral health is associated with issues like systemic diseases and increased COVID-19 severity. 

Research shows a link between oral health status and COVID-19. More research is needed to determine if oral disease is a risk factor for or a result of COVID-19 infection.

Good oral hygiene can help promote oral health and reduce the risk for and severity of COVID-19.