Oral Hygiene: Office and home Care during the COVID-19 pandemic

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A peer-reviewed course written by Gregori M. Kurtzman, DDS, MAGD

Abstract

COVID-19 (SARS-CoV-2) emerged globally in the latter part of 2019 and has spread to every country leading to a pandemic with increasing infections and deaths related to the virus. COVID-19, having an aerosol transmission, causes infection primarily through the mouth, nose and eyes and is transmitted primarily by the mouth (breathing, coughing) and nose (sneezing). Use of masks when out in public has been recommended and in some geographic areas, mandated to limit potential contact with aerosols containing the virus in an attempt to stem infection spread. Recent studies have indicated that a large percentage of those infected with COVID-19 are asymptomatic carriers able to transmit the virus to others through normal activities that produce aerosol, such as talking, exhaling, sneezing and coughing. Viral load related to COVID-19 has been reported to be consistently high in the saliva and relatively higher than found in the oropharynx during the early stages of infection. Patients need to remove their masks during dental treatment and may, if the virus is present in the mouth, spread the virus into the room air via aerosol when talking or breathing prior to treatment initiation. High-volume evacuation aids in elimination of aerosols created during treatment but may not completely eliminate virus particle spread into the operatory air and hence throughout the office. Pretreatment rinsing with specific mouth rinses has been advocated to inactivate any SARS-CoV-2 virus present in the patients mouth and eliminate aerosolization of those active particles. This course will review the various mouth rinses available and their effectiveness on SARS-CoV-2 for use as pretreatment rinses and improved homecare to limit potential spread of the virus with asymptomatic carriers.

Educational objectives

At the conclusion of this educational activity, the dental professional should be able to:

1. Understand basic practices to limit or prevent COVID-19 spread in the dental practice.
2. Understand asymptomatic carriers and their potential to spread the virus in the dental practice.
3. Understand what mouth rinses are available and their effectiveness against COVID-19.
4. Understand how incorporation of antiviral oral rinses in homecare can limit potential spread of the virus to those one may encounter when not able to wear a mask such as fellow home residents and aid in improving periodontal health in general.

Gregori M. Kurtzman, DDS, MAGD, FACD, FPFA, DADIA, DICOI, DIDIA, is in private general dental practice in Silver Spring, Maryland, and is a former assistant clinical professor at University of Maryland in the department of restorative dentistry and endodontics. He is a former AAID Implant Maxi-Course assistant program director at Howard University College of Dentistry. Dr. Kurtzman has lectured internationally on the topics of restorative dentistry; endodontics, implant surgery, and prosthetics; removable and fixed prosthetics; and periodontics. He has published more than 720 articles, several ebooks, and textbook chapters. Dr. Kurtzman has earned fellowship in the Academy of General Dentistry (AGD), American College of Dentists (ACD), International Congress of Oral Implantology (ICOI), Pierre Fauchard Academy, and Association of Dental Implantology (ADI). He has attained mastership in the AGD and ICOI, and diplomate status in the ICOI, American Dental Implant Association (ADIA), and the International Dental Implant Association (IDIA). He is a consultant and evaluator for multiple dental companies. Dr. Kurtzman has been honored to be included in the “Top Leaders in Continuing Education”by Dentistry Today annually since 2006 and was featured on their June 2012 cover.  He can be reached at dr_kurtzman@maryland-implants.com.

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