In 2020, the General Council of Dentists and the Spanish Dental Foundation developed and published the guide “The Mouth in the Time of COVID-19”, an approach to the question of which aspects marked the relationship between oral hygiene and COVID-19. After that approach, there were no few studies that focused on this relationship.
In this regard, we remind you that we addressed on our blog the issue of how one of the most serious oral diseases, periodontitis, poses a greater risk of exacerbating problems derived from COVID-19 infection.
This time, we will focus on the relationship of oral hygiene as a preventive method to avoid the contagion and spread of the virus that has originated one of the most important global pandemics in history.
How can proper oral hygiene become a weapon against COVID-19? Here are some key points.
The oral cavity, entry point, and channel for the propagation of COVID-19
Since COVID-19 primarily affects the respiratory system, it is not surprising that the mouth, along with other areas, is among the most susceptible to the virus. The oral, nasal, and eye mucosa are the main entry points for the coronavirus into the body, and just as poor oral health increases the risk of systemic diseases, it also increases the risk of COVID-19 infection.
Infection
The infectivity of SARS-CoV-2 depends on its ability to penetrate cells, something that occurs through the angiotensin-converting enzyme-2 (called ACE-2) as the main receptor. Because the epithelial cells that line the inside of the mouth show a high expression of ACE-2 and the fact that the oral cavity is one of the main connections between the body and the outside, it has been concluded that the mouth is one of the areas at greatest risk of colonization and viral infection by COVID-19.
Poor oral hygiene could cause an overexpression of ACE-2 receptors in the mucosa, through which the virus enters the body’s cells more easily.
That is why paying special attention to oral hygiene by maintaining good habits makes it possible to prevent the most serious consequences of COVID-19. A proper cleaning routine reduces the viral load in the mouth, and therefore, the chances of transmission also decrease.
Propagation
It is now known that in the initial phase of COVID-19 infection, the virus concentrates mainly in the nose, mouth, throat, and larynx, so the risk of contagion is very high simply by talking, coughing, or sneezing in the presence of others, if there is no physical barrier to prevent the expulsion of the virus through microdroplets, also known as Flügge droplets.
These small secretions that are involuntarily and inadvertently expelled through the mouth and nose are the ideal means of transportation for the coronavirus and what has facilitated its extremely high rate of contagion before the imposition of a barrier such as masks.
Can wearing a mask negatively affect oral hygiene habits?
The truth is that yes, and this has been shown by various studies conducted over the past year. A mask is one of the most effective preventive measures to avoid COVID-19 contagion, there is no doubt about that, but at the same time, it can lead to neglect of our oral hygiene and also to the intake of less liquids, which favors the development of oral pathologies.
Spending a lot of time with the mouth covered can cause us to forget about this part of our body more easily and, therefore, to overlook the need for its care and cleaning.
The use of the mask itself is not responsible for the appearance of problems and diseases of the mouth, but a lack of hygiene associated with it is.
The best advice to counteract the negative effects of prolonged mask use is to optimize oral and interdental hygiene habits, increase the frequency and duration of brushing, and include mouthwash or mouthwash in the cleaning routine.
Mouthwash or mouth rinse to prevent COVID-19
There are several medical organizations and dental professionals that have pointed to the use of cetylpyridinium chloride (CPC) as an important measure to prevent and reduce the viral load of COVID-19 in the oral cavity.
This conclusion has been reached after various research studies, which have shown its antiviral effect against the coronavirus, as it is capable of reducing the infection capacity of SARS-CoV-2 by up to 1,000 times.
CPC is a powerful antiseptic compound that effectively eliminates bacteria and other microorganisms and can be present in toothpaste and also in mouthwashes or mouth rinses. Among other benefits of this compound, it is non-corrosive or oxidizing and has a neutral pH, so its use in the mouth is completely harmless.
Cetylpyridinium chloride vs. Chlorhexidine
Both compounds can be present in the formulation of mouthwashes that can be found on the market, but there are differences between them in terms of preventive action against COVID-19. While chlorhexidine is an effective agent in biofilm control and the treatment of gum diseases of bacterial origin, cetylpyridinium chloride is considered a broad-spectrum antiseptic against bacteria, viruses, and fungi.
It is possible to find mouthwashes or mouth rinses that include both compounds, and their use is highly recommended, so if you still do not use mouthwash in your daily oral hygiene, this is undoubtedly a very good time to incorporate it into your cleaning routine.
Improving oral hygiene, more vital than ever
In the absence of a 100% effective cure or treatment and aside from the development of nascent vaccines, it is obvious to conclude that prevention is the main means to stop contagion and oral hygiene is the best weapon to achieve this.
How to do it? Both at home, by improving cleaning routines, and in the dental office, through more frequent and thorough check-ups.
Do you have doubts about how to address the care of your mouth? Do you think you need to review your oral health with special attention to your gums or need advice to improve your oral hygiene? Do not hesitate to contact our team of experts, who together with Dr. Liñares, will be responsible for addressing any questions and offering you the best diagnosis and treatment.