Changing routines: people skipping twice-daily toothbrushing, snacking between meals at home, and not visiting the dentist
Ahead of World Oral Health Day (WOHD) on Saturday 20 March and one year into the pandemic, FDI councillors and members say they are seeing first-hand the catastrophic aftermath of the virus on the health of people’s teeth and gums in dental practices around the globe.
“Let’s call it for what it is—a dental disaster,” said Dr Gerhard Konrad Seeberger, president of FDI World Dental Federation. “Restrictions have certainly played a part in oral health hesitancy, but they don’t tell the whole story.”
During the first wave of the COVID-19 outbreak, dental practices around the world were forced to close. For two to three months, all dental appointments had to be postponed or cancelled, except for urgent emergency treatments. The World Health Organization reported that oral health services were among the most affected essential health services because of the COVID-19 pandemic, with 77 per cent of countries reporting partial or complete disruption.
Between the first and second wave, dental practices in many countries were able to reopen. Dentists have always abided by the most stringent infection prevention and control protocols and have also revised hygiene measures mandated by governments during the COVID-19 pandemic. In addition, a recent survey indicates that oral health professionals have significantly lower SARS-CoV-2 infection rates than other healthcare workers in most parts of the world.
Despite this, many people have still avoided routine check-ups and only visit the dentist once they are in extreme pain. Many have developed advanced tooth decay and related complications, including infections, which makes treatment more complex.
Today, dentists are confronting the fallout from a year of disrupted dental care and treatment. Professor Paulo Melo, an FDI Councillor who teaches and practices dentistry in Porto, Portugal has seen a dozen of high-risk patients who were afraid of being infected with COVID-19 and postponed their appointments. High-risk patients are encouraged to have a dental check-up every three to six months. Instead, many patients have waited nine months to a year, or more, between appointments. Many have reported severe toothaches and complications, leading to extractions for some and endodontic treatments for others.
“During the pandemic, high-risk patients have tended to develop more than one problem, often exhibiting three or four at the same time because too much time has gone by without a check-up,” said Melo. “Problems typically include caries lesions and gum disease.”
“Dental caries that could have been treated with a simple restoration have now gone to the stage of apical periodontitis and abscesses, which call for more sophisticated treatment,” said Dr Vanishree MK, a Professor in Public Health Dentistry, based in Bangalore, India. “Patients should set aside their fear and not postpone essential, routine dental treatment.”
“One of the dramatic consequences of the pandemic is that oral health issues that were not considered urgent during the outbreak of the pandemic did in fact became urgent after having to wait two months to seek treatment,” said Dr Maria Fernanda Atuesta Mondragon, president of the Colombian Dental Federation and FDI councillor. “We’ve seen some patients undergoing orthodontic treatment who have lost the gaps that were created for their teeth to align, while others have developed significant periodontal issues.”
“Teenagers usually suffer from dental caries, and I’ve observed an increasing level of tooth decay in this age group,” said Dr Nahawand Abdulrahman Thabet, who practices in Cairo, Egypt, and is an FDI councillor. “A 15-year-old patient of mine admitted he had been snacking more while stuck at home since the closure of his school. I imagine thousands of kids his age are in a similar situation.”
The pandemic’s repeated lockdowns, restrictions on people’s movements and work-at-home edicts have all contributed to shifting daily habits and behaviours, ultimately impacting people’s oral health.
Modelling good oral care habits like day and night brushing is imperative, according to a global research study1 conducted by Unilever, which found that children mirror parents’ behaviours at a detriment to their own health. Children are seven times more likely to skip brushing if their parent does not brush day and night. Surveyed dentists agreed that the change in children’s oral care habits stemmed from the change in parents’ routines. Despite the ongoing challenges with the pandemic, it is crucial for parents to prioritise their oral care routines as well as those of their children.
Dr Seeberger emphasized that “people must not be afraid to visit the dentist. Safeguarding oral health is of paramount importance to ensure general health, well-being and a good quality of life.”
1. Unilever Global Research Summary Report 2021: Attitudes, Behaviours and Experiences of Oral Health During the COVID-19 Pandemic was conducted in November-December 2020 with 6,734 parents in 8 countries: Bangladesh, Egypt, France, India, Indonesia, Italy, Ghana, and Vietnam (available 19 March 2021).
