A PRACTICAL GUIDE FOR PATIENTS TO RESOLVE PPROBLEMS ORAL HYGIENE DURING THE STATE OF ALARM AND LOCKDOWN COVID-19
Due to the State of Emergency we are in because of the pandemic generated due to the SARS-CoV-2 Coronavirus (Covid-19), and in the face of the primary need to avoid the To spread the virus and thus reverse the curve of infections, at this time the following can be done only EMERGENCY DENTAL VISITS, but the rest must be postponed until that the lockdown ends.Dentists are very important agents of transmission of Coronavirus during our visits, both for check-ups and interventions, since the The tools we use generate aerosols (tiny water particles that spread) through the air) and we maintain very close contact with our patients.
To help you know what to do in the face of different unexpected oral situations that These may be common, we have prepared this practical guide for patients which we hope will be useful. When necessary, they should contact the dentist by phone or e-mail To avoid unnecessary travel. Your dentist will know how to help you.
What can I do if…
• My tooth hurts:
➢ Take one common pain reliever that you usually take for other ailments. ➢ Avoid the area
painful. Eat soft, lukewarm foods (neither too cold nor too hot).
and lightly seasoned. Eat from the other side. ➢ Don't stretch out completely on the sofa or in the
In bed, keep your head in a more upright position
elevated above the rest of the body. Use 2 or 3 pillows for
sleep.
• I have a toothache, and I can't control the pain with my mouth. measures from the previous section:
➢ THIS IS AN EMERGENCY. Contact the dentist.
• I've developed an abscess (bulk) on the gum:
➢ THIS IS AN EMERGENCY. Contact the dentist.
• My face has swollen up, or part of my face.
➢ IT IS AN EMERGENCY, especially if it is accompanied by a high fever (>38.5oC).
Contact the dentist.
• I have a wound in my mouth that is bleeding:
➢ Apply pressure to the wound area with gauze for 30 minutes. It is important that
Keep the gauze tightly in place without moving it for 30 minutes straight; do not undo it.
neither moving nor removing the wound to check if it has stopped bleeding. ➢ Finally
After 30 minutes, you can change the gauze for a new one and reapply pressure for 30 minutes.
a few more minutes. ➢ The bleeding should have stopped in about 2 hours.
- I have a wound in my mouth that is bleeding, and the bleeding won't stop with the measures I'm taking. from the previous section:
➢ THIS IS AN EMERGENCY. Contact the dentist.
• I have had a very strong trauma/blow to my mouth and a tooth has broken, or the tooth has come out of place:
➢ THIS IS AN EMERGENCY. Contact the dentist. ➢ Until you can contact a dentist, keep the tooth or broken piece in saliva or milk. Try to touch it as little as possible.
• My gums bleed when I brush my teeth or when I eat something hard:
➢ Brush your gums gently two or three times a day. The bristles of the brush should touch the gum, even if it bleeds. For the gums to stop bleeding, they need to be very clean, and brushing achieves this.
➢ Make sure it reaches all parts of the mouth: top, bottom, inside and outside. ➢ It can soak
brush or rinse with a Chlorhexidine 0.12-0.20% mouthwash, twice a day, for 30 seconds, no more than 15 consecutive days.
• I have gum disease and one of my teeth is loose:
➢ It's an important reason to visit once the lockdown ends, but not right now. IT'S NOT AN EMERGENCY.
➢ Avoid the irritating area and maintain good daily oral hygiene.
➢ If your gums bleed, follow the instructions in the previous section.
➢ Once the alarm situation has passed, go to the dentist.
• I have a piece of broken tooth/molar with a sharp edge that is bothering my tongue/mucosa:
➢ Try placing a little dental wax on the cut area (it's available in pharmacies and is used by orthodontic patients) to avoid contact with the tongue/mucosa, or file the cut area with a nail file.
➢ If you cannot solve it this way, contact your dentist.
• The prosthesis I wear moves or shifts, and I can't eat properly:
➢ It's an important reason to visit once the lockdown ends, but not right now. IT'S NOT AN EMERGENCY.
➢ If necessary, remove the prosthesis
some times.
➢ Once the alarm situation has passed, the dentist will resolve it.
• The prosthesis I wear has caused a sore in my mouth:
➢ It's a major reason to visit when the lockdown ends, but not right now.Wait a minute. It's not an emergency.
➢ Remove the prosthesis during these days until the sore has completely healed.
➢ Once the emergency situation has passed, contact your dentist.
• I have a sore in my mouth:
➢ Clean the sore area with an alcohol-free mouthwash, preferably one based on chlorhexidine.
➢ Avoid the area of the sore. Eat soft, lukewarm (neither too cold nor too hot) and lightly seasoned foods. Eat from the other side.
➢ Mouth sores can take 10-15 days to heal.
• I wear braces and one of my brackets has fallen off:
➢ IT'S NOT AN EMERGENCY.
➢ If a bracket or wire is rubbing against your teeth, place a little dental wax on the irritating area to prevent contact.
➢ Once the emergency situation has passed, the orthodontist will resolve it.
• My mouth hurts, especially when I open and close it, but not a specific tooth/molar:
➢ It's possible it's muscle pain. Muscle pain can increase in stressful situations like the one we're experiencing.
➢ Apply local heat to the painful area in 10-minute intervals several times a day. You can use microwaved seed-filled pillows, a hot water bottle, or a damp towel.
➢ Avoid eating hard foods, chewing gum, biting your nails, or other objects.
➢ Try not to clench your teeth. To avoid this, you can make opening and closing movements with the tip of your tongue touching your upper incisors (the front, top teeth).
• My child is getting a permanent tooth and the baby tooth hasn't fallen out yet:
➢ IT'S NOT AN EMERGENCY.
➢ With clean hands, or using gauze, you can gently wiggle the tooth for a little while each day to loosen it. If it's not bothering you, eating something hard like an apple can also help. But there's no rush: sooner or later, it will fall out.
➢ Once the alarming situation has passed, go to the dentist.
ORAL HYGIENE RECOMMENDATIONS
➢ Brush your teeth 2-3 times a day.
The brush filaments need to gently touch the gums. ➢ Make sure it reaches all parts of the mouth: top, bottom, inside and outside. ➢ Use a small amount (pea or chickpea size) of fluoridated toothpaste. ➢ There's no need to wet the brush, nor to rinse it with water when you're finished. ➢ Start brushing your child's teeth as soon as their first tooth appears. Use a small amount (a scraping measure) of fluoridated toothpaste (1000 ppm fluoride) from day one. From age 6, you can use toothpaste with slightly more fluoride (1450 ppm fluoride, a pea-sized amount). ➢ Young children need supervision when brushing their teeth until they are 7-8 years old.
➢ If you don't have the habit of brushing your teeth daily, you can take advantage of this lockdown situation to do so! He probably has more time than usual, and anything that improves his health will benefit him.
➢ Maintain a healthy diet! Try not to let the lockdown situation lead you to consume sugary products more frequently. ➢ Remember that soft drinks, cookies, pastries, chocolates, fruit juices, sweetened dairy products…contain a large amount of added sugars and should be consumed only occasionally.
➢ Healthy snack alternatives during confinement hours can be: whole fruit, carrots or cucumbers, or breadsticks. dip with hummus, tzatziki, olive tapenade…, cheese cubes, olives, toast, hazelnuts, almonds, walnuts and any dried fruit, dehydrated fruit
Authors: Maria Terrades*+; Isabel Maria Martinez Lizan+#; Cristina Nevot*+; Àngels García Pereiro*+;Valentina Muñoz*+; Silvana Requeijo*+; Germán Pareja+. *Primary Care Dentist. +Docent of Preventive Dentistry iCommunity of the UB.