Most dentist offices are closed for routine procedures during the COVID-19 outbreak.
Dentists are urging people to brush twice a day and floss once a day to take care of their teeth.
They say keeping your toothbrush clean is also important for good dental health.

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Good dental hygiene might not be in the front of your mind in the middle of the COVID-19 pandemic.

That could change quickly if you develop a painful cavity and can’t get in to see a dentist.

“I understand that this isn’t the most normal of times, but it’s very important to control the things we can right now,” H. Dieu Luong, DDS, a New Jersey-based dentist, told Healthline. “On a long list of things in these trying times is oral care.”

Generally speaking, dentists’ advice is to maintain a daily routine of brushing teeth and flossing to prevent tooth decay.

“The main objective is very simple: plaque control,” Daniel Rodda, DDS, owner of Oasis Dental Care in Flagstaff, Arizona, told Healthline.

He advises brushing teeth twice daily and flossing once per day.

“If you haven’t already, make the switch to an electric toothbrush — and brush your teeth for 2 minutes,” Faraj Edher, DDS, a prosthodontist in Vancouver, British Columbia, Canada, told Healthline. “This has shown to offer the highest levels of oral hygiene, which is crucial at a time when you aren’t seeing your dentist or hygienist for cleanings and checkups.”

Rinsing with a non-alcohol-based mouthwash twice a day also can help reduce plaque buildup leading to inflammation of the gums (gingivitis).

“The oral microbiome is a key component of the immune system,” Mark Burhenne, DDS, founder of AsktheDentist.com, told Healthline. “Mouthwashes high in alcohol or toothpastes with bactericidal components in them, like triclosan or other antibacterial ingredients, can greatly disrupt the health of the oral microbiome.”

“During this time, it’s best not to use any mouthwash or toothpaste that is meant to kill oral bacteria,” Burhenne said. “Your best bet is to use a hydroxyapatite toothpaste, which is less bactericidal than fluoride but rebuilds tooth enamel equally as well.”

Other dentists also recommend the use of fluoride-based toothpaste.
Diet matters

What you eat is also important.

Chris Strandburg, DDS, a spokesperson for Waterpik, advised avoiding excessive snacking — a habit that’s all too easy to adopt when dealing with the stress and boredom inherent in self-quarantining.

“Starchy foods or drinks lead to acid in our mouths, which dissolves tooth surfaces,” Strandburg told Healthline. “The more often our teeth are bathed in these acids, the weaker and softer they become.”

Burhenne also recommended avoiding non-fiber carbohydrates — “which act just like straight sugar and contribute to plaque buildup” — as well as adopting a Paleo-type diet and avoiding processed foods, if possible, to protect oral health.

Good hydration also is important for oral health, dentists agree.

“Resist turning to unhealthy habits to manage your stress,” Jared Cox, DDS, owner of Today’s Family Dentistry in Searcy, Arkansas. “Overindulging in smoking and drinking can be detrimental to oral health. Smoking inhibits the blood supply to your gums and increases your risk for gum infections. High exposure to alcohol can dry out the cells in your cheeks and gums. Chewing on ice, pen caps, or fingernails as a means of stress management can cause the teeth to chip or break.”

Dentists also recommend avoiding hard foods that can crack a tooth or damage fillings as well as popcorn, peanut brittle, and sticky candy.

“Be careful not to pull out a filling while flossing,” Mike Koumaras, DMD, told Healthline. “Pull the floss through the area side-to-side instead of up through the tooth contact.”

Keep your toothbrush clean

If you suspect that COVID-19 is present in your home, disinfect your toothbrush, advises Mike Golpa, DDS, the chief executive officer of the G4byGolpa dental implant centers.

“Take good care of your toothbrush,” he told Healthline. “It’s very sensitive for transmitting viruses.”

Fecal matter has been shown to contain coronavirus.

“Every time we flush the toilet, we generate an aerosol spray,” Kartik Antani, DDS, a dentist at Napa Family Dental in Albuquerque, New Mexico. “Most people leave their brushes and other toiletries merely inches away from commodes. Try to flush with the lid closed. Keep your floss pics, brushes, and tongue cleaners covered. Soaking them in a mixture of mouthwash and hydrogen peroxide also keeps them safe.”

Healthy gums can better prepare you to fight a coronavirus infection.

“There is established scientific evidence that the immune response in your body is closely related to the health of your gums,” Eugenia Roberts, DDS, a clinical assistant professor at Midwestern University Clinics in Arizona, told Healthline. “During a pandemic, the goal is to optimize your immune system. A healthy mouth frees the body’s immune system to fight off other intruders.”
Dental care emergencies only

As COVID-19 spreads across the United States, the American Dental Association advised dental offices on March 16 to restrict their operations to emergency procedures only.

In states such as New York, dentists have been prohibited from providing nonemergency services, including aesthetic work, exams, cleanings, and fillings.

“This accomplishes three very important things,” says Luong. “It preserves the nationwide supply of personal protective equipment for our front-line heroes, prevents the spread of this virus through congregating in dental offices, and eliminates the need for dental emergency patients from flooding into emergency rooms that are better used fighting the virus.”

Many dentists have turned to telemedicine to counsel patients by phone or video conferencing.

“Unless you are in extreme pain or swollen, you first try to telecommunicate with your dentist, as he or she may be able to give you a prescription or refer you to the appropriate provider,” Todd A. Ross, DDS, an adjunct clinical assistant professor at NYU College of Dentistry, told Healthline.

“Most dentists are keeping themselves and their phones open to give advice whether you should be seen for a dental issue,” said Strandburg. “If you have sharp or throbbing pain in your teeth, gums, or mouth, you should contact your dentist immediately. If you have any swollen areas in your mouth, on your cheeks, or under your chin, you should also contact your dentist.

“Any pain or trouble swallowing or breathing may be better served by your medical doctor, but if you believe this is coming directly from your mouth or teeth, contacting your dentist may also be a good idea,” he added. “If you chip a tooth, it’s up to your dentist to decide whether it’s a ‘minor’ chip that can be addressed later or a ‘major’ chip or crack that requires immediate care.”

Normal toothaches should be managed with over-the-counter pain relievers, which are shown to be more effective than medications containing opioids, advised Frederic Barnett, DDS, chair of dentistry at Einstein Healthcare Network in Philadelphia.

Dentists face one of the highest risks of contracting coronavirus, even greater than nurses or paramedics.

“We literally work 6 inches away from our patients’ faces during dental procedures,” Luong said.

As a result, expect your dentist to take additional safety measures if you do have to make a visit for an emergency procedure — for your protection as well as the safety of the dentist and their staff.

“When you look at HIV in the ’80s, dentists were on the front lines of healthcare prevention and really altered their standard of infection prevention protocols to address patient and provider concerns,” Ronnie Myers, DDS, dean of Touro College of Dental Medicine at New York Medical College, told Healthline. “I am confident they will rise to the occasion again.”