Dr. Keith Libou serves as Chief Clinical Officer at Delta Dental of New Jersey, the state’s leading dental benefits carrier.  He is licensed to practice dentistry in New Jersey, Pennsylvania, and Connecticut. In this Q&A, he addresses many common oral health and dentistry questions to help keep New Jersey residents informed during the COVID-19 pandemic.

Why is it important to take care of your oral health during the COVID-19 crisis?

First and foremost — with dental offices temporarily closed for routine visits, and most dentists only seeing patients for emergency dental care, the last thing you want right now is a dental problem. Unless you are experiencing a true dental emergency, such as severe pain, swelling, or persistent bleeding, it is very unlikely that you will be able to be seen for less-serious dental problems.

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Of course, oral health should be a priority all the time. There is a significant connection between oral health and overall wellness. In addition to the obvious things like brushing and flossing, with the limited access to dental care during the COVID-19 healthcare crisis, taking extra steps to minimize the chance of an emergency is more important than ever. Don’t chew on ice cubes or anything hard (think about cutting that apple into slices). Avoid sticky candy (they can rip out fillings and crowns). And keep in mind that the healthier you are, the more successfully you may fight off illnesses in general. It’s in everyone’s best interest to steer clear of any possible infections, which could lower your immunity, and bleeding gums happen because they are infected. If you have swollen gums due to gingivitis, then your body is launching an inflammatory response. While this doesn’t necessarily mean that your immune system is compromised, you would still be dealing with an infection in your body (your gums).

If someone does believe they have a dental emergency, what should they do?

If you think you have a true emergency, the first thing you should do is contact your personal dentist. Even if they are not available, they will likely be referring patients to other sources. On the Delta Dental of New Jersey and Connecticut website, we have posted resources that include a list of Delta Dental-participating dentists who are accepting new emergency patients if your own dentist is unavailable. You don’t have to be a Delta Dental subscriber to access the list, but make sure to ask any dentist you contact if they accept your dental insurance. One caveat – the list isn’t all-inclusive of every dentist who is accepting new emergency patients, but it provides a great starting point for someone in need of emergency assistance when their dentist is unavailable.

The dentist will ask questions to verify that it is a true emergency, such as an issue with pain, swelling, or persistent bleeding. They will also ask about your medical history and any other symptoms you might currently be experiencing. In this situation, it’s important that procedures be followed to ensure that the patient, the provider, and the dental team are all kept safe during treatment.

What oral health guidance and advice would you give to keep smiles healthy during the pandemic?

Especially now, with everyone sheltering in place and unable to participate in a lot of typical, everyday activities, it’s important to keep your normal routines. Have a regular wake-up time, get your exercise in, brush twice a day, and make sure you are flossing! 

It’s also important to pay attention to the cleanliness of the area where your toothbrush is located. Keep the toilet lid closed, especially when flushing. Flushing a toilet with the lid open creates a flume of airborne bacteria that settles within several feet. Breathable toothbrush covers or sleeves that cover the toothbrush head but also allow it to dry out are also a good idea. The important thing is to put some distance between your toothbrush and the toilet, and always make sure your toothbrush is in a place where it can dry out after use.

I’ve said it numerous times, but remember to floss. If you’re only brushing, then you are only cleaning 60 percent of the surfaces of your teeth. Flossing cleans the other 40 percent. When some people initially start flossing, they may see some bleeding and get discouraged. But bleeding means that some inflammation is present and is a sign that your oral health needs improvement. In fact, gingivitis is the most common cause of bleeding gums. When flossing becomes a habit, the bleeding and discomfort will typically lessen over time. If you have any questions about your experience with flossing or other dental issues, you can try contacting your dentist.

With so many people stuck at home with their children right now, there are heightened concerns about access to junk food. Any advice?

A lot of it comes down to common sense. The same guidance dentists give during normal times is especially important during a pandemic. Sugary snacks should be minimized or enjoyed in moderation. If you are going to have candy, chocolate is best, because it isn’t hard and sticky. The best drink you can give a child is water. While it may be tempting to quiet a child with a bottle of sticky fruit juice, these are high in sugar and can contribute to both child obesity and tooth decay. Remember to talk to your kids about their oral health. Children also watch what their parents do, and you can include them in watching your brushing and flossing routine.  It could be a good time to get them into a daily flossing program as well.  Remind them why dental care is important all the time, and especially right now.

Are there any oral health products you recommend?

Use a soft-bristled toothbrush. A toothbrush with firmer bristles may be helpful for detailing the tires on your car, but when it comes to your teeth, a soft brush is best to ensure you aren’t eroding your enamel. When it comes to toothpaste, I buy whatever is on sale, but I always make sure whatever I buy contains fluoride and has the American Dental Association Seal of Acceptance. I recommend avoiding some of the home remedies you see discussed on the Internet, such as charcoal whiteners, which can cause unnecessary abrasion, and oil pulling, which can dry out the mouth and contribute to tooth decay.

What can people with dental issues, or other medical issues that may impact their oral health, be doing to protect themselves right now?

I encourage everyone to follow best practices for at-home dental care and follow social-distancing guidelines; however, nothing I am recommending should replace the guidance of your personal physician. Make sure to stay in touch with your physician or medical provider throughout this crisis, ask questions, and follow their guidance.