As I write this, we are in week three or four or five or? These days it’s hard to keep track of time as one day seems to meld into another. Caring for your teeth during quarantine is probably not something you’re spending a lot of time thinking about.

The streets of NYC outside my window and when I ride my bicycle straight down the middle of 5^th Avenue ride on the way to my office are sparse of people and cars. The lines outside supermarkets are akin to the lines that typically form outside a sports arena or a rock concert.

It’s surreal and otherworldly.

At 7 pm every evening, hoots and hollers emanate from nearly every window in our neighborhood as a salute of appreciation to our frontline healthcare workers. It boosts their energy and reminds all of us that we’re not alone in this. We are, in fact, facing the calamity together. 

Truth-be-told, it feels good to let out a good primal scream.

Yes, life as we knew it is on hold for the moment. Many of our heretofore normal routines have been disrupted, including our regular visits to the dentist.

In accordance with Covid-19 federal, state, and professional guidelines, dental practices across the country are discouraged/”prohibited” from performing such standard procedures as cleanings, routine fillings, cosmetic care, etc. We can deliver emergency and urgent care only. My office is open on Mondays and Tuesdays from 10-2 for patients in such need only.

Because routine dental visits, examinations, and cleanings are impossible right now, it is critical to focus on your personal oral hygiene for the sake of your teeth and gums. So, to help you, I put together a list of my best tips for caring for your teeth during quarantine and keep you out of the dentist’s office for emergency care.

Caring For Your Teeth During Quarantine

Brush Your Teeth At Least Twice Daily! and do it this way:

• Use a soft-bristled brush
  
• Brush for two full minutes. If you’ve become accustomed to singing Happy Birthday To You while washing your hands, sing it four times while you brush. That’s about two minutes.
  
  
• Brush every tooth surface – no shortcuts! Look in the mirror while you brush. I can’t tell you how many people under-brush and miss certain areas of their dentition, especially their lower front teeth. 
  
  
• Change your toothbrush every 2-3 months, and after you’ve been ill, even a common cold or stomach virus.
  
  
• Don’t allow your toothbrush to touch someone else’s brush and try not to share toothpaste and floss. Coronavirus is contagious through saliva.
  
  
• Consider buying an automatic toothbrush from the pharmacy. Even an inexpensive battery-operated brush will do a better job than a manual brush. Some even come with a handy timer just in case Happy Birthday To You is not part of your repertoire.
  
  
• Always use fluoridated toothpaste.
  
  
• Be gentle. You’re are attempting to remove plaque from the surfaces of your teeth – not soap scum from your bathroom grout. 

Floss Daily! – and do it this way:

Look in the mirror while you floss. Allow the floss to follow the contours of your teeth instead of snapping it between them. You don’t want it to crash, gnash, and slash your delicate gums. Be sure to wash your hands after you care for your teeth.

Brush Your Tongue!

Before you put your toothbrush away, brush your tongue with one or two swipes. This reduces the number of bacteria in your mouth and helps mitigate bad breath, which is caused by sulfur-producing germs that reside in the nooks and crannies of your tongue. Be sure to rinse your brush afterward to eliminate the bacteria clinging to the brush bristles.

A tongue rake, available at most pharmacies, is also effective.  

Remove The Grunge!

If you were due for a cleaning before the shutdown, your teeth might be feeling a bit grungy. A slurry paste of hydrogen peroxide & baking soda can help remove some of that filmy feeling and will remove some staining.  

About Snacking

Along with reading, binge-watching Netflix, and the series you previously missed, you may be snacking more than usual. Even healthy snacks, like fruits, contain sugars that can promote tooth decay.

Are you an essential worker? Chances are you’re not eating as healthy as you would under normal circumstances. Be mindful of proper nutrition – your health is of the utmost importance.

With regards to sugar, it’s not so much the amount of sugar that you consume in a day that is the problem, but rather the frequency of sugar consumption. For example, your teeth would be less challenged if you consumed an entire chocolate bar in one sitting versus nibbling on it throughout the day.

Frequent snacking leads to more bacteria residing in your dental plaque – they literally go into overdrive as if on a food orgy. Each time you consume sugar-laden or carbohydrate-rich foods, these bacteria release acids onto the tooth surface, which can dissolve the enamel and initiate the decay process.

Snacks with low fiber content such as candy and pudding are more of a dental threat than are crunchy snacks such as granola and carrots because textured foods provide a certain amount of cleansing as they rub against tooth surfaces while you chew. 

But be mindful of potential tooth cracking snacks such as popcorn which can wreak havoc on a tooth if you bite down hard on an unpopped kernel or if the skin of a kernel wedges into your gum. Read: Toothcrackers – 5 Common Foods That Can Crack Your Teeth

A strategy to offset the damaging effects of bacterial attacks is to frequently and vigorously swish your mouth with plain water to dislodge any particulate matter between your teeth, as well as to dilute the acid after you eat. 

You can also do a quick brush of your teeth after snacking. But, this is important – do not brush your teeth immediately after eating or drinking something acidic. Acid can soften the enamel of your teeth. So, wait about 15-20 minutes for your teeth to remineralize before you brush.

Avoid Tooth-Staining Food & Beverages

As if you don’t have enough restrictions placed upon us, be mindful that certain foods and drinks are notorious for staining and discoloring teeth. With barbershops as well as hair and nail salons off-limits, you might not be looking as well-groomed and manicured as you normally do. Don’t add insult to injury by unnecessarily discoloring your teeth.

Try to minimize the following:

• Energy drinks
  
  
• Coffee & tea
  
  
• Red wine and dark-colored spirits – The liquor store in my neighborhood is boasting sales rivaling the holidays.
  
  
• Carbonated beverages – These can make your teeth more prone to staining.  This is especially true if you are sipping on it throughout the day. Such beverages, including seltzer, are more acidic than plain water.
  
  
• Candy – It’s okay to indulge, but remember what I said about frequency.  Candy that is chewed and swallowed is less threatening than the gooey chewy type. Sucking candy and caramel linger the most and present the most significant challenge to your teeth.
  
  
• Berries
  
  
• Tomato-based sauces
  
  
• Citrus fruit – Citric fruit can be very acidic and cause pitting on tooth enamel, which makes your teeth more prone to staining.
  
  

Consider Purchasing A Water-Irrigating Device

AirFloss by Phillips SonicCare and the water-irrigating device by WaterPik® are two popular brands. Many of my patients swear by them. Water irrigation is an excellent proactive and preventive measure that enhances your oral hygiene. Irrigating devices, when used properly, quickly and simultaneously flush food from between your teeth and stimulate your gums. And, they are especially helpful if you have a bridge, crowns, or implants.

If you purchase an irrigation device, use a low-pressure setting (you aren’t power-washing your deck, you know). Never shoot the jet of water down into your gums but rather direct the stream perpendicular to the gums and through to the gums and through your teeth in a cheek to tongue direction.      

Note: Irrigation devices are not to be used instead of flossing and brushing. They’re meant to be used in addition to flossing and brushing.

If You’re Prone To Periodontal Or Gum Problems:

• Use An Antiseptic Rinse
  
  If you are prone to periodontal or gum problems, including sensitive or bleeding gums, I recommend using an antiseptic rinse like Cool Mint Listerine or original Listerine (for all of you old-schoolers) along with the already discussed tips above.
  
  If you suffer from dry mouth, take note. Listerine and like antiseptic rinses contain quite a bit of alcohol, which can be both irritating and desiccating.  You can still use them but dilute the solution with water and don’t use it every day. There are also non-alcohol rinses sold in most pharmacies that contain triclosan or fluoride.
  
  
• Try This Homemade Paste of Hydrogen Peroxide & Baking Soda
  
  The use of a creamy paste made with 3% hydrogen peroxide and baking soda had long been advocated as an effective and conservative approach to treating gum disease.
  
  Known as the Keyes Technique (named after dental researcher Dr. Paul Keyes), it involves applying the paste to your teeth and gently brushing it into the crevices between teeth and gums.
  
  Popular in the 1980s, there has been a lot of controversy regarding the efficacy of this approach to treating periodontal disease, and science does not support much of Dr. Keyes’s claims of success.
  
  But with the current situation when routine dental care is not accessible, I believe that the use of hydrogen peroxide and baking soda paste could be effective in addressing tender, swollen, and bleeding gums.
  
  There is no exact proportion in making this paste – just take a tablespoon of baking soda and add just enough peroxide to create a paste about the consistency of cake batter-not too dry and not too wet.
  
  The technique also calls for a follow-up rinse with warm saltwater. Saltwater rinsing, an age-old home remedy for a multitude of oral irritations, not only has anti-bacterial properties but is soothing as well.
  
  Baking soda & peroxide paste is also helpful in removing stains from your teeth – but remember, brush gently with a soft0 bristled brush.

Caring For Your Teeth During Quarantine – In Conclusion

I hope the tips above help you keep your mouth, teeth, and gums healthy during this crisis. They are helpful tips anytime, and especially now.

I miss my wonderful patients. I miss my beloved staff. And, I so look forward to being with you all (but not all at once) in hopefully the not-too-distant future.

Dr. Sinkin