The coronavirus infectious disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a pandemic in March 2020 by the World Health Organization.

In addition to affecting the respiratory, gastrointestinal, and neurological systems, COVID-19 has also been found to affect the oral, olfactory, and integumentary systems. Many oral mucosal lesions are reported in individuals who have been contracted with COVID-19. They include ulcers, erosions, blisters, plaque‐like lesions, reactivation of herpes simplex virus 1(HSV1), geographical tongue, loss of sense of smell, altered taste, dry mouth, angular cheilitis, and more.

Periodontitis is an inflammatory disease of supporting tissues of the teeth caused by specific microorganisms (periodontopathic bacteria) and it leads to alveolar bone destruction and subsequent tooth loss. It is one of the most prevalent diseases worldwide. Because aspiration of periodontopathic bacteria induces the expression of a receptor for SARS-CoV-2 (angiotensin-converting enzyme 2) and production of inflammatory cytokines in the lower respiratory tract, poor oral hygiene can lead to COVID-19 aggravation.

It can be hypothesized that periodontopathic bacteria are involved in aggravating COVID-19 and therefore proper management of good oral hygiene can potentially contribute to its prevention.

Similar to hand hygiene, oral hygiene is essential in reducing infection from the oral cavity, and thus, its transfer to the upper and lower respiratory tract.

How to keep a healthy mouth?

• Brush your teeth two times a day for two minutes and use a fluoridated toothpaste
• Floss two times every day
• Use an antiseptic mouth rinse daily with 1.5% hydrogen peroxide-based rinses such as Colgate Peroxyl or Ora-gel
• Many kinds of toothpaste contain sodium lauryl sulfate which can be irritating, however, it has been shown to reduce COVID-19.
• Prevent oral conditions by reducing or eliminating the use of alcohol, tobacco, and drugs
• Practice sensible healthy nutrition with less hard and sticky food
• Don’t overlook oral problems and seek care when and where possible
• Dental Hygiene Tips for COVID-19 Positive Patients
• Store oral health products separately
• Disinfect all oral health tools and products daily
• Discard and replace your toothbrush and toothpaste after recovery
• Clean your hands before oral care
• Disinfect your toothbrush with hydrogen peroxide
• Change toothbrush or electric toothbrush head every 3 to 4 months.

How to clean and disinfect your toothbrush

Rinse the toothbrush in 0.5 percent hydrogen peroxide for up to 15 minutes, and rinse off your toothbrush before brushing.

Toothbrushes can harbor bacteria, blood, and saliva. Not only does improper toothbrush care result in poor oral hygiene over time, but it can also spread contagious diseases. The coronavirus can stay on surfaces for up to three days, and this may include toothbrushes.