A LOT of emphasis is being put on hand hygiene, social distancing as preventive measures amid Covid-19 pandemic. However, there is another simple routine which is of equal importance, that is to maintain healthy oral condition.
This is an important preventive measure for healthy people, and even more crucial for the symptomatic patients. Bacteria from the mouth can be inhaled into the lung on tiny droplets of saliva. People with chronic gum inflammation problems like gingivitis and periodontitis have a lot of pathogenic bacteria and also increased inflammatory burden to the general health.
Routine dental services have been suspended due to most of its procedures are aerosol producing which may carry the virus and thus pose high risk of infection to the clinic personnel and also patients. However, we can still continue to play our part in looking after our oral health.
First is tooth-brushing. It is necessary for us to spend two minutes brushing all the teeth covering the outer, biting and inner surfaces and the gum line. Next, to clean in between the teeth, one can use dental tape or interdental brush. Mouthrinse containing antibacterial properties is not recommended for long term daily use because it may disrupt the bacteria balance. Japanese researchers from Tohoku University who study the function of oral bacteria discovered that some oral bacteria can reduce dietary nitrate to nitrite which is crucial in lowering blood pressure. In fact, a research on chlorhexidine mouthrinse which was just published last month by University of Plymouth, UK also showed that chlorhexidine disrupted the ability of oral bacteria to turn nitrate into nitrite.
Other recommendations from UK Oral health foundation website and Mouth Healthy website by American Dental Association are: don’t share toothbrush, to close toilet lid or cover the toothbrush when flushing the toilet to prevent splash/spray from contaminating the toothbrush, change the toothbrush every three months, and to stay hydrated by drinking plenty of water.
All smokers are urged to kick the habit following more concrete evidence showing that smokers have compromised lung health thus putting them at higher risk of getting infected with Covid-19 and to succumb to the disease. They have poorer recovery and higher mortality. This is reported by the China researchers on their Covid-19 cases. In the mouth environment, smoking reduces saliva production and blood supply. Lower saliva production means low buffering and antibacterial effect making it easier for teeth caries formation. Heavy smokers tend to have slower healing and most of the time infected wounds after teeth extraction.
Passive smokers are similarly found to have diminished lung health and equally prone to infection targeting the lung. People who have contracted and recovered from Covid-19 are vulnerable due to their reduced lung function. Researchers from San Diego University had shown tobacco residue settled on the furniture as long as six months after the smoker had vacant the house. As recommended by the American Non-Smokers’ Right Foundation, all users of cigarettes and e-cigarette should quit the habit in view of Covid-19 infection. They stress on ensuring the safety of the air because all of us are breathing shared air.
Increased consumption of health supplements is another trend to boost the immune system. But how sure are we that our body is absorbing all those nutrients? Little did we know that absorption of the nutrient largely depends on the gut microbe. Dr Shipra Vaishnava and her team from Brown University shows bacteria play a big part in vitamin A absorption and storage. We can re-programme our gut microbe into a healthy one by taking food with probiotic and prebiotic. Fermented foods like yoghurt, miso soup, tempeh are a good source of probiotics while high dietary fibre like grains, vegetables are good sources of prebiotic which is the food for the bacteria.
We should really cut down on refined carbohydrate and high sugary food because it has been shown to weaken our immune system. Nowadays, it is easy to find on social media platform posting of different varieties of cakes and pastry, using relatively easy-to-get ingredients. While this sweet indulgence may seem like the best comfort food to be served when we are forced to be homebound during movement control order (MCO), we need to realise that these sweet food tend to be very addictive and can easily pose as health threat, like teeth caries, increase body weight or even diabetes in the long run. Among those who succumb to Covid-19 infection, diabetes was one of the comorbidities presented in their medical records.
It is crucial for us to strengthen our immune system so the body is ready to fight the infection and recover fast if we get infected.
Dr Cheah Chia Wei is a consultant periodontist and lecturer with the Department of Restorative Dentistry, University of Malaya.