Preventive Dental Health During COVID-19


Preventive Dental Health During COVID-19

Updated 4/14/2020

Do the best you can, be mindful! Now your best might need to be a wee-bit better.

Prevention at home: Because of COVID-19, dental practices across our country are limiting care to emergency management of infections and pain. We are afraid our restrictions could last many months, so now is the time to make sure you are doing all you can at home to lessen future dental problems and to slow down current ones. Although we would love to see everyone right away when we are allowed to return, we will need to prioritize the patients that are having dental problems and we appreciate your understanding ahead of time for this.

Consider these things to lessen dental emergencies and future dental problems. Many of you have heard these recommendations, but please take them seriously as all preventive activities are now having to happen at home. Those who are conscientious and active with your daily dental preventive care should be fine during this time of social distancing, stepping up your game never hurts. Keep in touch with your dental team. Contact us if problems arise so actions can be offered to lessen their impact. Teledentistry is now available at Smiles at France and many other offices.

Slow Brushing: Most of us brush way too quickly. Fast brushing is not cleaning and doesn’t allow the bristles to get between the teeth and under the gums. Slow down and be mindful at least once a day brush the full 2 minutes, like you would if cleaning between the tines of a fork, not a smooth spoon. The best times to brush your teeth are after breakfast and right before bed. Remember to wash your hands when finished brushing.

If you haven’t switched to a Sonicare, now is the perfect opportunity! It may tickle your gums for a short period of time, but they clean more effectively without damaging your teeth or gums. One of our favorite Sonicare features is the 2 minute timer, which takes the guess work out of brushing. Check out our Facebook page to see the video on how to use a Sonicare properly.

Toothpastes: Chose your toothpaste wisely! We always recommend using a paste that is not too abrasive and contains fluoride for tooth decay prevention. If you aren’t sure which one to choose, check for the ADA Seal of Acceptance or consult with us if you have specific questions. If you currently use special prescription fluoride toothpaste from our office (Clinpro or Prevident), and are running low, please contact us and we would be happy to mail out your order. If you are dealing with sensitive teeth, use a sensitive toothpaste (such as Sensodyne) with 5% potassium nitrate as your toothpaste exclusively.

Slow Flossing: If you floss infrequently, future dental care is going to get expensive for you. Slow flossing, at least once a day, at any point in the day is recommended. Nighttime before bed is best and remember to wash your hands when finished flossing.

Not all floss cleans equally. Unwaxed floss is your best option if the spaces of your teeth allow. If you have tight contacts, continue to work at this because the more you floss, the easier it gets as the teeth are allowed to move more. If you try unwaxed floss and it gets stuck, use waxed floss to help remove the shreds. Some people have such tight contacts that they need a lightly waxed floss, this is ok, but try to avoid Glide floss as this does not clean nearly as well from our experience. If you need to use floss forks or floss picks, they are still effective. Just be sure to slow down and angle them at both directions of the teeth. We are hoping you find something that is effective, not difficult, and fits into your new routines.

Other cleaning aids:

Water flossers (Water Piks) are an excellent aid. They remove larger chunks of debris between your teeth, but do not remove the tenacious plaque. However, the fresh water changes the plaque to make the plaque less harmful, this is good. Remember to wash your hands when finished water flossing. (For the majority of patients, we recommended flossing first then using Waterpik and then brushing your teeth with fluoride toothpaste last.)

Tooth picks and interproximal brushes (Proxabrushes) are effective at cleaning the spaces between the gums and teeth, especially when these spaces are larger around dental implants or you have more root exposure. Many love these products! Remember to wash your hands when finished.

Dental Implants: Implants require similar careful cleaning as your natural teeth. They are your second chance to a stable, comfortable, healthy and beautiful smile. Take care of this investment with your active and conscientious home care. Water Piks and Proxabrushes are favored aids in cleaning around dental implants.

Slow, thoughtful chewing and biting: As we age, our teeth become increasingly brittle. Forceful, rapid or aggressive biting and chewing of our food makes teeth prone to breakage. Slowing down avoids these preventable accidents. Don’t attack your food as you eat! Remember to wash your before and after you eat.

Any teeth with fillings, crowns, bonding, veneers or root canals may be prone to fracturing as we age beyond 60. Biting and pulling into a cold bagel, pizza, your favorite crusty bread, beef jerky, bacon, apples… could increase the risk of a sudden tooth fracture. Biting carrots on your side teeth is something I avoid, cut them up first. Rapid chomping on your molars is asking for trouble and chewing on ice is very risky.

Eating crunchy, hard candies and chewy toffees or caramels is inviting problems of breaking teeth, pulling out fillings or dislodging crowns. Be mindful of what and how you are eating, plus the consequences of your chewing habits.

Gum chewing: If you chew gum, please do it slowly and thoughtfully. Many attack their gum as they chew. This is not much different than aggressive clenching or grinding your teeth together. Sugar-free gum, especially when sweetened with xylitol helps lessen tooth decay by increasing saliva and reducing acid levels. Icebreakers cube gum would be the recommended gum of choice for gum chewers out there.

Drinking: Water is still the best for any sipping, especially between meals. If you drink something different, try searching the PH of your drink of choice online. PH is a measure of how acidic something is. A pH of 7 is neutral, anything lower is acidic. You want to avoid anything under 5.5, as these drinks will dissolve enamel and dentin and could make your teeth more sensitive. Even if your drink is “diet”, it will still dissolve your teeth because it has acid in it. Diet just lacks the fuel (sugar) that will feed the bacteria. If your favorite beverage is “fizzy,” it is likely acidic. Having acidic beverages with a meal reduces their damage by diluting and often neutralizing their acidic effect. Having these beverages between meals is asking for trouble.

Black coffee is usually acidic, it may slowly dissolve the cement that holds our crowns on too, especially if you sip on it! Beer is acidic too, who knew! Sipping wine at nighttime is very destructive to teeth. You can enjoy coffee, beer or wine with a meal, drinking quickly or rotate with water. Just avoid dragging it out after your meal.

**It is recommended to delay brushing your teeth about 45 minutes after consuming an acidic beverage. The acidic softened enamel can actually be brushed away if you brush too soon.

Online resources for acidic drinks:

This reference is a great overview on tooth erosion.

Sip or snack all day, you will get decay: Every time you sip or eat something that has any digestible nutrients, you can get 20-45 minute of acid production from the plaque and bacteria that are stuck on your teeth. This causes decay. Nibbling, munching, grazing, sipping or nursing any food or drink is inviting decay. We recommend to limit your food intake to meals. Just do the best you can. If you have a dry mouth, the acid production and attack may last for hours after a single sip or snack.

Sore Throat: Make sure any mints, cough drops or lozenges are sugar free. Honey is sugar. The best sweetener for any drop or mint contains xylitol. Xylitol will not promote decay. Avoid crunching these or breaking a tooth may result.

Clenching our teeth: Wear your appliance if you have one as a reminder to stop daytime clenching and for protection at nighttime. Tongue resting lightly on the roof of your mouth, lips lightly together, teeth apart, and jaw muscles relaxed; is how you should hold your face at rest. Having your teeth together, tongue pushing forward and down, lips apart is not a resting posture.

Disinfecting orthodontic appliances, mouth guards, whitening trays, partial dentures, full dentures and their storage cases: Foaming soap or any soap can do an effective job or removing bacteria, fungus and viruses that may become attached to these devices. Hold your appliance carefully and use your toothbrush (the soap disinfects your toothbrush too) to brush all surfaces for at least 20 seconds with a nice sudsy mix, then rinse carefully. Not too hot or they will warp! Air-drying when not in use to lessen the regrowth of microbes, unless directed otherwise. Also clean your case with soap and water, they can get disgusting. Remember to wash your hands when finished.

Toothbrush care: We generally recommend replacing toothbrushes or Sonicare toothbrush heads after 3 months if using twice a day or sooner if the bristles become frayed from being too aggressive. Consult your dental team if your brushes are fraying.

If you are sick and are concerned about your toothbrush harboring pathogens, place it in the dishwasher to sanitize it. If you have a power toothbrush, only the replaceable head goes into the dishwasher, not the handle. You can also disinfect your toothbrush with hand soap and water.

Teeth that are sensitive to cold or touch near the gumline: Usually sensitivity is due to root exposure from aggressive scrubbing with your toothbrush, exposure to acidic drinks or clenching and grinding your teeth. Brushing with a toothpaste (Sensodyne) that contains 5% potassium nitrate usually lessens this sensitivity for over 90% of people. For challenging situations, you will need more contact time with the paste. “222 Technique:” Place a dap of Sensodyne on your finger, rub it on the sensitive tooth areas for 2 minutes, 2 times a day for 2 weeks. Most will do the “111 Technique,” which may be enough: 1 minute, 1 time daily, for 1 week. Do the best you can. Remember to wash your hands when finished.

Temporary or provisional restorations: If you have a tooth with a temporary filling or crown (provisional), please clean it carefully and thoroughly. Avoid all chewing and biting on these short-term fixes as they will need to last longer than we originally hoped for. Please floss them by pulling the floss through rather than your normal up and down technique when finished.

Denture wearers: Whether full or partial dentures, please be careful and chew slower. Thoroughly clean your teeth and denture every time after you eat to avoid sore areas that could turn into ulcers. Use a small amount of adhesive as needed and thoroughly remove any adhesive at nighttime. Remember to wash your hands when finished cleaning them.

Brighten your smile with home whitening. This is a perfect time to whiten your smile while spending more time at home. Using approved materials and techniques it is safe and effective. Call us if you need refill on your whitening supplies, we can send them to you.

We are actively planning for when we are allowed to see non-emergent care including all preventive maintenance visits. Please let us know in advance if there are any other dental problems that may require more time at your visit than normal so we can plan accordingly.

This is general information to improve your overall dental health. Consulting your dental team is always recommended for your unique circumstances, but we hope these general guidelines help.

David A. Cook, DDS
Smiles at France
4999 France Ave So, Ste 230
Minneapolis/Edina, MN 55410
(612) 824-7033