03 Jun 20

As lockdown begins to ease and people start returning to work, school and normal life, two top dentists are urging people to brush their teeth to protect against COVID-19.

Martin Addy, Emeritus Professor of Dentistry at the University of Bristol, and his son Liam Addy, consultant in restorative dentistry at the Dental School and Hospital of Cardiff University, feel passionately that improved oral hygiene could play a massive part in containing the spread of COVID-19. Dentists and dental teams have a key role in informing the public about this, they say.

Direct and indirect spread by the hands has been identified as a major issue in COVID-19, which is the reason for the advice to wash hands regularly with soaps and handwashing products. In particular, detergent-based products exert rapid antimicrobial action against bacteria, fungi and viruses including the COVID-19 coronavirus.

Direct spread, however, mainly takes place by salivary droplets expelled by coughing, sneezing or just talking, which is what lies behind the recommendation to socially distance. Professor Addy explained: ‘These two issues, of detergents and the mode of salivary spread, fuel the request to the profession to reaffirm two-minute, twice-daily toothbrushing with toothpaste for everyone.’

He said: ‘The detergents in toothpaste are the same as those found in many hand washes and are effective against coronavirus, so we believe that advice to " wash your hands and brush your teeth" will be complementary in helping to prevent both the spread of and infection by coronavirus.’

The figures for toothbrushing frequency suggest that 75% of the UK population brush twice or more per day and 25% brush once or less, while 1-2% do not brush at all. ‘There is, therefore, room for the dental team to make a difference,’ he argued.

Protection needs to be sustained to be effective. ‘The duration of antimicrobial action of toothpaste lasts for three to five hours, so this will help slow the replacement of the virus in the mouth via the salivary glands where it replicates,’ explained Professor Addy. ‘Ideally of course, more frequent brushing would improve this toothpaste protection.’

‘In the context of helping to prevent the spread of the virus, timing of brushing is important,’ stressed Professor Addy. He advises that people brush just before leaving home, or taking public transport, and carrying toothpaste to apply via a finger.

Professor and Dr Addy’s key recommendations are:

  • Brush for two minutes with toothpaste before leaving home or taking public transport – and as often as you feel able
  • Spit out the toothpaste – don’t rinse – so that it stays in the mouth longer
  • Carry toothpaste to apply via a (clean!) finger while you are out and can’t easily clean your teeth
  • If you wear personal protective equipment (PPE) brush your teeth before putting it on.

They have developed an information sheet for dental teams to download and customise for their community, based on the slogan: ‘Wash Your Hands and Brush Your Teeth.’ 

Dr Addy stressed: ‘Dental teams need to exploit their considerable expertise and considerable skills to help in the preventive fight against COVID-19.’

Next time (Part 2): How better oral care can save the lives of elderly people