New Study Investigates Possibility of COVID-19 Transmission Through Dental Care Implements

Is it ever a good idea to share things like toothbrushes or even toothpaste, especially during a pandemic? After all, it’s been established that oral diseases, such as caries, are communicable. In fact, caries can even be transmitted through a kiss. But what about the highly contagious novel coronavirus?

Spanish researchers from Madrid’s Rey Juan Carlos University and Granada’s Granada University teamed up to discover how oral hygiene habits may affect transmission of COVID-19 among cohabitants. Their observational cross-sectional study, recently published in BMC Oral Health, examined the oral hygiene habits of 302 subjects who were infected with COVID-19, and who also cohabited with another person.¹

Their observations led researchers to conclude that while daily oral hygiene plays an important role in minimizing risk of viral transmission, inappropriate dental care habits could contribute to the indirect transmission of COVID-19 between cohabitants. The researchers, however, note that there were some limitations with the study, and that further research is needed.

HOW TO SAFELY MAINTAIN ORAL HEALTH

SARS-CoV-2 infects humans via our ACE2 receptors, which can be found in the upper respiratory system and salivary gland duct lining as well as in the mouth—especially the tongue. Because viral transmission occurs through direct or indirect contact with mucous membranes, such as those in the oral cavity, good oral hygiene is paramount to help curtail viral load.

But while toothbrushing, interproximal cleaning, and tongue brushing have never been so important, it is also critical to prevent viral spread through cross-contamination from oral hygiene devices. Use of these everyday implements produces friction between brush bristles and the oral mucosa. This can reportedly exacerbate coronavirus transmission.

To avoid cross-contamination, researchers recommend that toothbrushes be decontaminated with agents such as povidone-iodine at 0.2% or hydrogen peroxide diluted at 1% after use. Viral transmission can also be curbed by storing toothbrushes in separate holders, with brush heads up to facilitate proper drying, which can help eliminate microbial buildup. It is even suggested that toothpaste tubes not be shared. And sharing toothbrushes is definitely frowned upon from an antiviral standpoint.

Since oral hygiene activities typically take place in the bathroom, another recommendation is to keep toothbrushes at least 3.5 feet away from the toilet. This is because studies have shown that toilet flushing can generate significant droplets to spread pathogens, some of which can be inhaled. Closing the lid before flushing can help.

OUT WITH THE OLD

An additional measure that can be taken in the interest of viral containment is to swap out old toothbrushes for new ones after an illness. In fact, this may not be a bad time to add in some disposable aids—such as dental picks or interproximal brushes—to help ensure a better clean between teeth. Used in conjunction with mouthrinse, this is a beneficial combination.

Reference

1. Gonzalez-Olmo MJ, Delgado-Ramos B, Ruiz-Guillén A, Romero-Maroto M, Carrillo-Díaz M. Oral hygiene habits and possible transmission of COVID-19 among cohabitants. BMC Oral Health. 2020;20:286.