Perception of the changes in the marginal periodontium aspect in a group of young adults during the onset of the COVID-19 pandemic

Background and Aim: To determine the influence of the SARS-CoV 2 virus pandemic on periodontal status and to establish which factors are involved in these changes. Methods: Analysis of 50 questionnaires randomly distributed through the google forms program, with easy-to-follow graphics and processing of personal data while respecting confidentiality. The questionnaire included 30 questions with one or multiple answers and text boxes for individual completion. The questions were about oral hygiene and the gingival changes observed by participants in the first months after the pandemic broke out, including the lockdown period. Results: The average age of participants was between 20 and 30 years, most with higher education, from urban areas, 8.2% of them with pre-existing periodontal diseases but only 6.3% followed a periodontal treatment. 32.7% of participants tested positive for Sarcov2. The impairments of the marginal periodontium were observed by the increase with 9.6% (from 19.4% to 29%) of the gingival color changes, with 16.2% (from 16.1% to 32.3%) of the gingival volume, with 23% (from 51.6% to 74.2%) of gingival bleeding at tooth brushing and with 6.5% (from 0% to 6.5%) of dental mobility. Interest in oral health was modified by changing the frequency and the time of tooth brushing (less than 3 min increased with 8.2%), by reducing dental checks and halving specialized prophylaxis. 75% of the participants noticed an increase in stress during the pandemic, and 38.8% noticed a direct influence of the pandemic situation on their oral hygiene. Conclusions: The negative action of the SARS-CoV 2 virus is not limited to the direct one, the effects of the pandemic being felt in the field of oral health, having repercussions on the condition of periodontal tissues by influencing the measures of prophylaxis of these diseases.

Reduction of saliva-derived droplet diffusion by mouth-closed tooth brushing in the era of COVID-19.

PURPOSE: To clarify the effect of mouth-closed tooth brushing on the suppression of droplet generation in comparison with ordinary (mouth-open) tooth brushing and to investigate the difference in plaque removal efficacy between mouth-open and mouth-closed tooth brushing. METHODS: Fourteen adults participated in the study. The labial/buccal, lingual, and occlusal surfaces of each sextant were brushed with the mouth open and closed, and a high-sensitivity camera and a high-power light source were used to measure the number of generated droplets. The plaque removal efficacy of each type of tooth brushing was evaluated according to the O'Leary Plaque Control Record. RESULTS: Significantly more droplets were generated by mouth-open brushing than by mouth-closed brushing. The number of droplets was highest when the lingual surfaces of the upper anterior sextants were brushed with the mouth open. In mouth-closed brushing, almost no droplets were observed from any region. The plaque removal rate with each type of brushing did not differ significantly among any regions except the lingual surfaces of the upper left sextant. CONCLUSION: Mouth-closed tooth brushing almost completely suppressed droplet generation and did not reduce the plaque removal efficacy. Therefore, mouth-closed tooth brushing is beneficial as an oral hygiene method during coronavirus disease 2019 outbreaks.

Relationship between Toothpaste Dilution Ratio and Droplets Generated during Tooth-Brushing.

Guidelines for using toothpaste during tooth-brushing in public places during the coronavirus epidemic are lacking. In addition, the advantages and disadvantages of using toothpaste in terms of droplet generation during brushing, the number of droplets generated, and their scatter range are unknown; therefore, we investigated the relationships between diluted toothpaste viscosity, the number of droplets generated, and the droplets' flight distance. We developed a system to quantitate droplet generation during tooth-brushing. Brushing with water generated 5965 ± 266 droplets; 10.0× diluted toothpaste generated 538 ± 56, 4.00× diluted toothpaste generated 349 ± 15, and 2.00× diluted toothpaste generated 69 ± 27 droplets. Undiluted toothpaste generated no droplets. Droplet number tended to increase with increased toothpaste dilution ratio and decreased viscosity (r = -0.993). The maximum flight distances were 429 ± 11, 445 ± 65, 316 ± 38, and 231 ± 21 mm for water, 10.0×, 4.00×, and 2.00× diluted toothpaste, respectively. The maximum flight distance and toothpaste viscosity correlated negatively (r = -0.999). Thus, the less diluted the toothpaste, the fewer the droplets generated during brushing, and the shorter their flight distance. The use of an appropriate amount of toothpaste is recommended to prevent droplet infection during tooth-brushing.

Brief motivational interviewing counseling to improve oral hygiene behavior among adolescent

Aim: To analyze the effect of the brief motivational interviewing counselling approach on the knowledge, attitudes and tooth brushing practice of adolescents. Method: This research is a quasi-experiment with a pre-test and post-test design with a control group design. The research sample was 80 adolescents aged 12 and 13 years. Respondents were divided into two groups, namely 40 intervention and control groups based on inclusion criteria. The intervention group was given the MI approach, and the control group was assigned conventional dental health education. The MI group also received follow-up over the phone. Both groups filled out knowledge and attitude questionnaires before being given treatment. Plaque index and tooth brushing practice examinations were performed at baseline and four weeks after intervention. Results: The results showed an increase in the average score of oral health knowledge, attitude, tooth brushing practice in all groups. The plaque index showed a decrease in the average score in all groups. The test of both groups showed that brief MI counseling was more effective than conventional dental health education, oral health knowledge(p=<0.001), attitude((p=<0.001), tooth brushing practice(p = 0.001), plaque index (p = 0.011). Followup MI by telephone in adolescents is beneficial in the research during the covid-19 pandemic as a promotive and preventive effort to improve dental health behaviour. The MI method by telephone is very interesting for adolescents, easily accessible and time-efficient. Conclusion : The MI counselling brief intervention can change dental and oral health behaviour through increasing knowledge, attitudes, tooth brushing practices and reducing the dental and oral hygiene index scores of adolescents. MI interventions need to be combined with other interventions to get more effective results for research sustainability.

Effects of oral care on prolonged viral shedding in coronavirus disease 2019 (COVID-19).

AIM: To assess the effects of oral care on prolonged viral shedding in coronavirus disease 2019 (COVID-19) patients. METHODS AND RESULTS: We evaluated the clinical course of eight COVID-19 patients, including their duration of viral shedding, by PCR testing of nasopharyngeal swabs. The average time from the onset of symptoms until the virus was no longer detectable was 31.6 ± 11.8 days (mean ± SD; range 17-53). Thus, it took 15.1 ± 14.7 (1-40) days from the time of clinical recovery for the virus to become undetectable. In two patients who had mental retardation and psychiatric disorders, the viral shedding period continued for 44 days or 53 days. These two patients did not voluntarily brush their teeth. When they were instructed on the importance of oral care, including tooth brushing and gargling, their tests for the coronavirus became negative. CONCLUSION: Most of the patients with COVID-19 had a viral shedding period of 30 days or less. In cases of prolonged viral shedding (≥44 days), noninfectious viral nucleic acid may have accumulated in uncleaned oral cavities and continued to be detected. We propose that tooth brushing and gargling remove such viral nucleic acid and improve the accuracy of PCR testing.