The Covid-19 pandemic has changed the way we live and interact socially. This year has been difficult for everyone, especially when in social lockdown. During challenging times comfort eating and loss of routine can affect oral health.

The most common dental disease is dental decay and gum disease. The presence of high bacteria (plaque) levels around teeth contribute to these oral health conditions. So times in our lives when dental hygiene habits alter in response to a change in daily routine, plaque levels can increase. And in conjunction with an increase in snacking due to boredom brought on by social isolation, we have a perfect storm in our mouths.

Dental decay

Breakdown of tooth structure happens when the surface of the tooth is bathed in an acidic environment for long periods. The frequency, volume of acid attack and duration of the acid exposure will dictate the speed at which the breakdown takes place.

The mouth becomes acidic whenever we eat. Bacteria in our mouths process food particles in our mouth and produce acid. The bacteria live on our teeth in colonies and visually appear as plaque. The types of food consumed will determine how quickly acid is produced.

High sugar content in foods consumed are the leading culprits in high volumes of acid build up on teeth. Also the high frequency of exposure to sugars and simple carbohydrates means the mouth is constantly acidic. The result is net loss of minerals from the tooth structure eventually leading to dental cavities.

During times when we find ourselves shuttered at home like the covid-19 lockdowns, eating is a comfort. And comfort foods aren’t always the best for our general health, including our teeth. High sugar foods and acidic soft drinks are the staple of most comfort foods.

How to reduce the risk of dental decay?

  • Reducing plaque levels: The less plaque on your teeth means less bacteria to produce acid. Also the proportion of healthy bacteria is higher. These tend to produce less acid. So regular, thorough tooth brushing and flossing is important.
  • Fluoridated toothpaste: The use of tooth paste with fluoride is very important. The fluoride will make the outer layer of the tooth more resistant to acid attack. Tooth paste also helps with keeping bacteria levels low.
  • Avoid rinsing after tooth paste application: Leaving the toothpaste in the mouth overnight will help increase fluoride uptake by the teeth. So don’t rinse your mouth with water after brushing your teeth before bedtime.
  • Hydration: Drinking fluoridated water helps supply a regular amount of fluoride to the teeth. It will also keep you hydrated to maintain good quantity and quality of saliva. Saliva is important in helping neutralise acid but is also antibacterial. It helps keep bacterial growth low. Saliva also helps clear food particles from your teeth.
  • Avoid snacking frequently: Snacking keeps your mouth in a constant state of acidity. If your saliva is inadequate at keeping up with clearing the acid or neutralising the acid, the teeth will rot. Especially night time snacking before bed. It is recommended you don’t eat, especially high sugary foods, up to an hour before bedtime.
  • Food types: Replace snacks which are high in added sugar like sweet biscuits, cakes, lollies, sticky chocolates, with savoury foods. Fresh fruits and vegetables, like celery, carrots eaten with dips are preferable. Nuts and dairy based foods, like cheeses are also good to snack on.
  • Visiting the dentist: It may be difficult getting to your usual dentist during lockdown. But once the lockdown is over a visit will be beneficial in treating any early signs of dental decay. Dental decay which has not become a cavity is reversible with the right change in lifestyle choices. The dentist will be able to advise and coach you to achieving this.

Gum disease

Gum disease is a condition which can vary from mild gingivitis (inflamed gums) to severe periodontitis (inflamed gums with bone loss around the teeth).

The main cause of gum disease is invariably the presence of high plaque volumes. In the case of periodontitis, individuals susceptible to this form of gum disease, have higher numbers of a certain bacteria type which causes the damage to the underlying bone. Furthermore, these individuals also have a genetic predisposition to bone breakdown from an exaggerated immune response to the presence of bacteria located against the gums.

This diagram shows the effects of plaque build up and gum disease.

How to reduce the incidence of gum disease?

  • Regular tooth brushing: A good routine of thorough tooth brushing and flossing regularly reduces the plaque levels and keeps the plaque mix healthy.
  • Regular professional cleaning: Having regular visits to the dentist will ensure any pockets of plaque and calculus (tartar) build up is removed. Build up of bacteria against the gum line and below the gum line leads to inflammation of the gums. Early detection of gum disease is crucial to avoid a future of complex dentistry.
  • Medicated mouth rinses: Mouth rinses are a good adjunct to proper tooth brushing. It should never be used in isolation and for prolonged periods. Mouth rinses should be considered like antibiotic use. When the gums bleed and there is discomfort, use the mouth rinse for up to 2 weeks until the symptoms reduce and disappear. A good oral hygiene maintenance regime thereafter is all that is necessary to keep the symptoms returning.
  • Proper tooth brushing: Whether you use an electric tooth brush or manual tooth brush, improper technique will not help cleaning of teeth. Plaque builds up mainly at the gum line. The bristles need to reach these areas in particular. Taking the time to brush each tooth is also necessary. Speak to your dentist for proper instruction.
Swollen gums from build up of tartar or calculus.

Covid-19 pandemic has changed our lives. In some ways for the better but in others for the worst. But despite being in lockdown, we should still be able to look after our oral health. Maintaining some oral hygiene routine and making better choices with what we eat and how we eat can make a big difference to the state of our oral health.

Roland Chong

Roland has over 20 years experience as a general dentist. Roland does all aspects of general dentistry with a special interest in prosthodontics (crown and bridge work) and cosmetic dentistry. A member of the International Team of Implantology, Roland is constantly developing his skills by collaborating with international experts.