Eager for strategies to reduce your COVID-19 risk? It’s time to consider oral health. 

SARS-CoV-2 101: How the Virus Spreads

The primary mechanism of SARS-CoV-2 (i.e., COVID-19) transmission appears to be contact spreading due to viral droplets. Put simply, the most likely way to contract coronavirus is by touching a contaminated surface, and then introducing viral particles into the body via a portal of entry (eyes, nose, or mouth). 

Although it is possible to become infected by inhaling aerosolized particles, most studies show that the majority of transmission occurs through contact transmission from contaminated surfaces. (Keep in mind that the average individual touches their face 20 times in an hour, and that the main reason to wear masks in public is to stop us from doing so–i.e., to avoid transmission of virus through our nose, mouth, and eyes.)

Once inside the portal of entry, a droplet that contains SARS-CoV-2 particles may or may not cause infection. That’s where additional risk factors come into play.

Mitigating Infection Risk

Your risk of being infected with SARS-CoV-2 is directly linked to:

1. The viral load of the particle (how much of the virus is inside the droplet you’ve been exposed to), and
2. Your immune system (how well your body can fight off the infection). 

To mitigate risk, then, you can take two approaches: 

• Use antiseptics to break down the viral load of SARS-CoV-2 particles in portals of entry (e.g., by rinsing with biocidal rinses)
• Make positive lifestyle changes to build up your immune system. 

We recommend you do both. 

In this post, we focus on oral hygiene strategies both to reduce the number of infection particles inside your mouth and to improve your immune health. Even if you are exposed to SARS-CoV-2, following these tips will minimize your risk of contracting the virus.

Reducing Viral Load 

The Virus: A Deeper Look

In order to understand how oral health rituals can protect you against infection, it’s important to understand what an actual coronavirus particle looks like. 

SARS-CoV-2 is caused by an RNA strand, which hijacks a cell’s normal machinery and tricks it into treating the virus’ genetic material as its own. When coronavirus takes control of your cells, it forces them to produce copies, increasing the severity of infection in your body.

But RNA can’t travel through your bloodstream on its own. It needs a special protective vehicle, which comes in the form of a “lipid envelope.” The lipid envelope encapsulates the RNA strand and provides support for proteins needed to bind to host cells:

Animation representing membrane disruption by hydrogen peroxide on SARS-CoV-2 virus

An important mechanism to mitigate transmission of coronavirus is to interfere with the lipid envelope. 

This is what we do every time we wash or sanitize our hands: the soap and alcohol-based sanitizers cut into the membranes which encapsulate viruses, rendering them inactive and thus stopping the process of transmission. Once the phospholipid cell membrane is disrupted, the virus can no longer replicate.

Viral Load in the Mouth

Studies show that in infected individuals, the throat and salivary glands are a major site of viral replication and shedding. In fact, emerging studies show that live coronavirus particles are detectable in saliva samples of both symptomatic and asymptomatic individuals. 

By reducing the number of infective particles inside your mouth, you have a powerful way to reduce the risk of transmission–both getting it and giving it.

In a June 2020 study at Cardiff University, researchers found that oral rinses, much like the  soap we use on our hands, have the ability to break down the lipid envelope of coronavirus particles. 

One of the safest oral rinses is hydrogen peroxide, which can be found in products like ECO Balance Oral Healthcare Booster and Colgate Peroxyl Mouth Sore Rinse.

Hydrogen peroxide inactivates coronavirus by releasing free radical oxygens that disrupt the lipid membrane and dismantle the viral particles, presenting a promising strategy for reducing transmission of SARS-CoV-2 infection. 

In fact, the American Dental Association has already recommended that all patients rinse with 1.5% hydrogen peroxide prior to beginning treatment, as a means of protecting our dental professionals. 

Whether you are trying to protect yourself from infection or trying to protect others from being infected, integrating hydrogen peroxide into your oral routine is a good idea.

Viral Load in the Nose

Second to the mouth is the nose: another imperative portal of entry where viral loads are incredibly high in individuals with active SARS-CoV-2. Past studies have shown that in patients infected with general coronaviruses, the use of a simple over the counter nasal saline rinse is sufficient to decrease viral shedding of particles. Today, researchers are beginning to find that the same is true with the novel SARS-CoV-2; using NaCl nasal rinses has antiviral properties within the nasopharyngeal areas.

Building Immunity

Using oral antiseptics to keep your portals of entry clean is only one part of the equation. The other part lies in your body’s natural immune response to disease, in which the mouth plays a huge role.

Apart from the few viral particles inside the normal mouth, the majority of microorganisms in the oral cavity are bacteria–700 different species, in fact, which collectively make up the oral microbiome.

When we brush and floss regularly, these bacteria live in a happily balanced ecosystem and we keep infections at bay. 

However, when we let our oral rituals break down, whether it be forgetting to brush or eating an unhealthy diet, we allow the bad bacteria to out-colonize the good, setting off an inflammatory cascade which puts the rest of our body’s systems at risk. 

TL;DR: Action Steps to Minimize Infection

Today, more than ever, it’s important to maintain healthy rituals and lifestyles in order to maximize your immunity. 

The odds that you develop coronavirus hinges on two factors: the viral load (the “invader”) inside your body, and your immune system (the “defender”).

You have a choice: to break down the invader or to build up the defender. 

Through committed oral health rituals, you have the capacity to do both. 

References:

Ramalingam S, Graham C, Dove J, Morrice L, Sheikh A. A pilot, open labelled, randomised controlled trial of hypertonic saline nasal irrigation and gargling for the common cold. Sci Rep. 2019;9(1):1015. Published 2019 Jan 31. doi:10.1038/s41598-018-37703-3

Valerie B O’Donnell, David Thomas, Richard Stanton, Jean-Yves Maillard, Robert C Murphy, Simon A Jones, Ian Humphreys, Michael J O Wakelam, Christopher Fegan, Matt P Wise, Albert Bosch, Syed A Sattar, Potential Role of Oral Rinses Targeting the Viral Lipid Envelope in SARS-CoV-2 Infection, Function, Volume 1, Issue 1, 2020, zqaa002, https://doi.org/10.1093/function/zqaa002

Wrapp D , Wang N , Corbett KS , et al. . Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science 2020;367(6483):1260–1263.

Wölfel, R., Corman, V.M., Guggemos, W. et al. Virological assessment of hospitalized patients with COVID-2019. Nature 581, 465–469 (2020). https://doi.org/10.1038/s41586-020-2196-x