The FDI World Dental Federation has stated ‘A good oral hygiene routine, regular dental check-ups and a healthy lifestyle are crucial for protecting oral health and maintaining general health’. Oral diseases, if left untreated, not only impact the mouth, but can also impact every aspect of life. The COVID-19 pandemic has severely impacted oral health around the globe. In addition to fuelling unhealthy eating and drinking habits1 the pandemic has severely disrupted dentistry services and access to care.’2
Keeping patients protected, not only from the virus but from dental disease where possible, is key to maintaining a high standard of quality care. Supporting patients in maintaining good oral health at home is therefore more important than ever. Dental teams can reach out to proactively advise, educate, and motivate patients to improve their daily oral hygiene routines.
The pandemic has been a catalyst for many people to become more aware of their own physical health along with the importance of self care. Oral health is also important to general health and wellbeing so this situation is an opportunity to proactively advise patients on how they can better maintain or improve their oral health at home. An effective oral hygiene routine should be evidence-based and ideally tailored to patients’ specific needs. This advice can be delivered to the patient whilst chair side or remotely through digital media. What is important is the patient is both aware and understands how they can help themselves to maintain or improve their own oral health at home.
Although largely preventable, dental caries and periodontal disease continue to be the two largest threats to oral health. Research has indicated possible associations between chronic oral infections and diabetes, heart and lung disease, stroke, and low birth weight or premature births.3 In other words, whilst oral health refers to the health of our mouth it ultimately supports and reflects the health of the entire body. So, what is the best advice we can pass on to patients at this time to support them?
We know that optimising daily toothbrushing can help to prevent dental caries and periodontal disease, but we should not assume that patients always know how best to achieve this. Another important factor to consider is the benefit of the entire dental team delivering consistent and evidence-based messages. This consistency in messaging can help support behaviour change in patients to help improve oral health outcomes.
Manual toothbrushes are accessible for most patients, easy to use and can be effective at plaque control. The way the toothbrush is used can be as important as the toothbrush itself. Patients should be made aware that the effectiveness of their toothbrush can be reduced, so it should be replaced every three months, or before, if the bristles become worn and splayed. Another reason to change their toothbrush is if they have had a cold or a virus. Once an infection has passed, together with the typical symptoms such as a cough, sneezing, or fever their toothbrush should be replaced.
In terms of toothbrushing technique, no particular technique has been shown to be better than another.4 The patient’s existing method of brushing may need to be modified to maximise plaque removal, emphasising the need to systematically clean all tooth surfaces.
To control caries, it is the fluoride in toothpaste which is the important element of toothbrushing in preventing, controlling, and arresting caries. Higher concentration of fluoride in toothpaste leads to better caries control.4 To help control gum disease the physical removal of plaque is an important element of toothbrushing as it reduces the inflammatory response of the gingivae and its sequelae. Unfortunately, many patients are unable to achieve optimum plaque control from brushing alone.5 This means an appropriate toothpaste technology which contains an antibacterial agent is also required.
In seeking a truly innovative approach to support everyday prevention, Colgate® has leveraged the recent change in focus of the dental profession from treatment of disease to proactive prevention, harnessed the trend to more health-conscious and educated patients
and built upon a new understanding of oral biology and oral health. As a result, Colgate® has developed the next generation of Colgate Total® toothpaste, embracing a contemporary approach to everyday prevention by delivering superior biofilm control6-7,* for Whole Mouth Health.**
As we consider biofilms, it is important to highlight their relative distribution in the oral cavity. Hard tissue surfaces make up for only 20% of oral surfaces, while the remaining 80% are soft tissue surfaces - mainly on tongue, cheeks and gums. Colgate Total® with 1450 ppm sodium fluoride and Dual-Zinc + Arginine enables superior biofilm6-7,* control delivering comprehensive benefits for the whole mouth.**
There is also evidence to support optimising toothbrushing by brushing for two minutes and discouraging patients from rinsing immediately after toothbrushing.8 The ‘spit don’t rinse’ message prevents the fluoride protection in the toothpaste being washed away. If a fluoride mouthwash is indicated this should be used at a different time to toothbrushing.9 Colgate® FluoriGard 0.05% daily rinse is medicinally licensed and clinically proven to prevent caries.
Finally, with all oral health advice it is also important to remember to reinforce diet messages to support oral health, reminding patients that the frequency and amount of sugary food and drinks should be reduced and, when consumed, limited to mealtimes.10
These oral care messages may seem rather simple; however, their impact will be far reaching in supporting patients whilst they are outside your direct care. Many patients are now especially open to these types of messages at a time when there has also been an increased use of digital media replacing face to face contact. A number of digital tools have been developed during this time to allow dental teams to engage remotely to raise the importance of oral health and educate and motivate their patients to keep oral health top of mind to improve their oral health. Visit patient educational resources today to see the range of educational resources available to share with your patients.
1. Abbas AM. Dietary habits in adults during quarantine in the context of COVID-19 pandemic.Obes Med. 2020;19
3. Benjamin RM, Public Health Rep 2010,125(2):158-159
4. Delivering better oral health – an evidence-based toolkit for prevention, Published by Public Health England, 2014
5. Adult Dental Health Survey, NHS digital, 2009
6. Manus L, et al. J Clin Dent 2018;29(Spec Iss A)A10-19
7. Daep C, et al. August 2019, data on file
8. Chestnutt IG et al,.(1998) Community Dent Oral Epidemiol 26 (6): 406-411.
9. Marinho VCC et al. Cochrane Database of Systematic Reviews 2003, Issue 3. Art. No.: CD002284
10. Moynihan PJ, Kelly S.A.M, (2013);Journal of Dental Research 93 (1) 8-18
* Colgate Total® provides superior in vitro delivery, penetration, and retention of Zinc through Arginine technology for biomass reductions vs Zinc control toothpaste
** Whole Mouth Health defined as teeth, tongue, cheeks and gums.