The Covid-19 pandemic has had a severe impact on the UK’s oral health as brushing habits faltered and trips to the dentist became more difficult. Pharmacy teams have an important role to play in reinforcing good oral care routines and looking out for danger signs when things start to go wrong

An investigation by the Oral Health Foundation and Colgate shows that over half of British adults (55 per cent) feel they have neglected their teeth during lockdown. Around one in six (15 per cent) admit to not brushing their teeth as much as before the pandemic, while almost one in five (19 per cent) say they haven’t been brushing their teeth twice a day.

According to the research, lockdown has also fuelled unhealthy eating and drinking habits. One in five adults are now eating unhealthier foods and more than one in 10 drinking more alcohol.

“Since coronavirus, it has been easy to get into the mindset that your health is not completely within your control,” says Nigel Carter, chief executive of the Oral Health Foundation. “There are, however, elements of your health that you do have full authority over. One of these is the health of your mouth.

“Knowing that fewer people are brushing twice a day is disastrous for oral health as, along with consuming less sugar, it is one of the best ways to prevent tooth decay. Brushing last thing at night and at one other time during the day with a fluoride toothpaste takes just four minutes out of the day – an important and proactive step for self-care and something to prioritise.”

Knowing that fewer people are brushing their teeth twice a day is disastrous for the nation’s oral health

Containing Covid

While brushing should be encouraged, the sharing of brushes is a definite no-no – particularly now research has found that sharing a toothbrush, toothpaste, the same container for the brush and not changing a brush after infection are all possible cross-contamination routes for coronavirus.

In the study¹, hundreds of families were monitored over the course of 15 days and it was found that over half (55 per cent) of Covid-positive people who share a toothbrush passed the virus onto other family members in the household. (Around one in four people are openly willing to share their toothbrush with others.)

“There are many hundreds of different bacteria and viruses in our mouths and those sharing a toothbrush could be passing these onto others,” says Nigel Carter. “While this might be something relatively harmless, such as a common cold or cold sore, if the person you are sharing with is infected with viruses like hepatitis B and now coronavirus, these could also be passed on via the toothbrush, with severe health consequences.”

In addition to sharing a toothbrush, the research discovered an even greater risk for families leaving their toothbrushes in the same container. Two in three people (66 per cent) who tested positive for coronavirus and who share a toothbrush container with family members, passed the virus onto them.

Further findings showed that the same tube of toothpaste should not be used between members of the family, as this is another way of facilitating cross-contamination.

“Storing toothbrushes in the same container has always been a bad idea, but today this separation has become a real necessity,” says Nigel Carter.

“This is especially important if a person has the virus without the symptoms, as they could be unknowingly spreading the virus to loved ones. It is important to store a toothbrush away from others, in a dry place, and with the brush head pointing upwards. This allows the bristles to dry faster and hinders the spread of any virus or bacteria that may be lingering on the brush. If infected, soaking the brush in an antibacterial mouthwash after brushing could also help kill any microorganisms on the toothbrush.”

The same investigation found that more than half (54 per cent) of those who did not change their toothbrush after testing positive for Covid-19 passed the virus onto other people in their household. The Oral Health Foundation advises anybody who has had coronavirus, or symptoms of the virus, to change their toothbrush.

“As a population we are taking unprecedented measures, both personally and professionally, to reduce the spread of coronavirus. Advising people to change their toothbrush, along with other simple oral hygiene actions, are relatively easy steps they can take to reduce possible spread of Covid-19,” Carter adds.

The study also found that tongue cleaning was the most effective oral hygiene habit in reducing the spread of the virus as the tongue is a great reservoir of viral particles. Tooth brushing, interdental cleaning and tongue cleaning were all deemed essential in order to reduce the presence of the virus in the mouth.

DIY dentistry

The latest statistics from the NHS on dentistry in England make worrying reading. In the 24 months to December 2020 only 19.7 million adults were seen by a NHS dentist, which equates to 44.5 per cent of the adult population. The figures for children are even worse. Only 3.6 million children were seen by a NHS dentist in the 12 months to December 2020 – less than 30 per cent of the child population.

Meanwhile, the OHF/Colgate research shows that more than one in three people (36 per cent) reported toothache during the first lockdown, with nearly one in 10 (9 per cent) experiencing the pain for longer than two weeks. To remedy this, a concerning number (almost one in four or 24 per cent) went online to find solutions to fix their own dental problems.

One result was that, during the first phase of the pandemic, numerous news stories were reporting that people had been resorting to removing their own teeth because dentists were shut. “DIY home dentistry is a terrible idea and should be avoided at all costs,” says Nigel Carter.

“Home treatments in untrained hands often comprise shortcuts that come with added dangers and can lead to permanent damage to a person’s health.” 

Anyone experiencing any problems, like toothache, should book an appointment with their dentist, he says. “Having been closed at the beginning of the pandemic and dealing with a backlog of patients in the months that followed, most dental practices are now back to relative normality.”

With the support of Colgate, the Oral Health Foundation launched The Truth About Tooth Decay – an online hub that enables users to learn how to identify risk of tooth decay and spot the early warning signs, together with useful advice on preventing or managing the problem.

Most dental practices are now back to relative normality

Reference

1. Gonzalez-Olmo et al. Oral hygiene habits and possible transmission of Covid-19 among cohabitants’. BMC Oral Health (2020) 20:286