Countermeasures Against COVID-19 from the Viewpoints of Dental Diseases: Strengthening Innate Immunity with the Toothpick Method of Brushing
Office HAT Inc.
ORIC 321, 5303 Haga, Kita-ku, Okayama, Okayama 701-1221, Japan
Coronavirus disease (COVID-19) patients with periodontal disease have an 8.8-fold higher mortality rate than those in the patients without periodontal diseases. This was higher than the odds ratio for patients with diabetes. Periodontal disease is associated with ulcers in the periodontal pocket, and gram-negative bacteria called periodontal pathogens invade the tissue through ulcers. Bacteria in the ulcer site are phagocytosed and sterilized by leukocytes. Following the autolysis of leukocytes, lipopolysaccharides (LPS) on the bacterial cell wall spread throughout the body, which is a major cause of multiple organ failure. Thus, periodontal disease is considered to contribute to the mortality rate of COVID-19. Ulcers in the periodontal pocket can be repaired using by a new developed brushing method called the toothpick method. The toothpick method can significantly improve gingival bleeding in one week, which is quicker than conventional periodontal treatment methods. Mechanical stimulation by the toothbrush causes gingival basal cells, fibroblasts, vascular endothelial cells and osteoblasts to proliferate and repair the tissue. However, these cell proliferations cease to occur 0.5 mm away from where the toothbrush bristles make contact with the gingiva. The toothpick method of brushing is characterized by its ability to stimulate the interdental gingiva, which is the initial site of periodontitis. As the toothpick method can repair periodontal ulcers, it will strengthen biological defense mechanisms against chronic degenerative and infectious diseases.
-  M. A. Shereen, S. Khan, A. Kazmi, N. Bashir, and R. Siddique, “COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses,” J. Adv. Res., Vol.24, pp. 91-98, doi: 10.1016/j.jare.2020.03.005, 2020.
-  N. Shimasaki and H. Morikawa, “Prevention of COVID-19 Infection with personal protective equipment,” J. Disaster Res., Vol.16, No.1, pp. 61-69, doi: 10.20965/jdr.2021.p0061, 2021.
-  S. Shinoda, “Epidemiology of the Novel Coronavirus Disease 2019 (COVID-19) and several Remarkable Pandemics,” J. Disaster Res., Vol.16, No.1, pp. 97-109, doi: 10.20965/jdr.2021.p0097, 2021.
-  Y. Taniguchi, N. Yoshioka, K. Nakata, T. Nishizawa, H. Inagawa, C. Kohchi, and G. Soma, “Mechanism for Maintaining Homeostasis in the Immune System of the Intestine,” Anticancer Res., Vol.29, No.11, pp. 4855-4860, 2009.
-  N. Marouf, W. Cai, K. N. Said, H. Daas, H. Diab, V. R. Chinta, A. A. Hssain, B. Nicolau, M. Sanz, and F. Tamim, “Association between periodontitis and severity of COVID-19 infection: A case-control study,” J. Clin. Periodontol., Vol.48, pp. 483-491, 2021.
-  A. Kumar, A. Arora, P. Sharma, S. A. Anikhindi, N. Bansal, V. Singl, S. Khare, and A. Srivastavab, “Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis,” Diabetes Metab. Syndr., Vol.14, No.4, pp. 535-545, doi: 10.1016/j.dsx.2020.04.044, 2020.
-  S. S. Socransky and A. D. Haffajee, “Dental biofilms: difficult therapeutic targets,” Periodontol. 2000, Vol.28, pp. 12-55, 2002.
-  T. Tomofuji, D. Ekuni, K. Irie, T. Azuma, N. Tamaki, T. Maruyama, T. Yamamoto, T. Watanabe, and M. Morita, “Relationships between periodontal inflammation, lipid peroxide and oxidative damage of multiple organs in rats,” Biomed. Res, Vol.32, No.5, pp. 343-349, 2011.
-  D. Ekuni, T. Yamamoto, R. Yamanaka, K. Tachibana, and T. Watanabe, “Proteases augment the effects of lipopolysaccharide in rat gingiva,” J. Periodont. Res., Vol.38, No.6, pp. 591-596, 2003.
-  T. Tomofuji, D. Ekuni, T, Sanbe, T. Azuma, N. Tamaki, K. Irie, T. Maruyama, T. Yamamoto, T. Watanabe, M. Miyauchi, and T. Takata, “Effects of improvement in periodontal inflammation by toothbrushing on serum lipopolysaccharide concentration and liver injury in rats,” Acta Odontol. Scand., Vol.67, No.4, pp. 200-205, 2009.
-  Y. Iwamoto, R. Nakamura, T. Watanabe, and A. Tsunemitsu, “Purification and amino acid analysis of human parotid saliva lysozyme,” J. Dent. Res., Vol.49, No.5, pp. 1104-1110, 1970.
-  Y. Iwamoto, R. Nakamura, T. Watanabe, and A. Tsunemitsu, “Heterogeneity of peroxidase related to antibacterial activity in human parotid saliva,” J. Dent. Res., Vol.51, No.2, pp. 503-508, 1972.
-  M. Shimoda, K. Ooki, and O. Kobashi, “The bactericidal substance defensin and its mechanism of action,” Jap. J. Bacteriol., Vol.50, No.2, pp. 471-480, 1996 (in Japanese with English abstract).
-  Jap. Soc. Periodont., “JSP Evidence Report on Periodontal disease and Systemic, Health, 2015,” Ishiyaku Pub., Tokyo, 2016 (in Japanese).
-  W. Nesse, F. Abbas, I. Ploeg, F. Spijkervet, P. Dijkstra, and A. Vissink, “Periodontal inflamed surface area: quantifying inflammatory burden,” J. Clin. Periodontol., Vol.35, pp. 668-673, 2008.
-  T. Yoneyama, M. Yoshida, T. Matsui, and H. Sasaki, “Oral care and pneumonia,” Lancet, Vol.354, doi: 10.1016/S0140-6736(05)75550-1, 1999.
-  S. Abe, K. Ishihara, M. Adachi, H. Sasaki, K. Tanaka, and K. Okuda, “Professional oral care reduces influenza infection in elderly,” Arch. Gerontol. Geriatr., Vol.43, No.2, pp. 157-64, 2006.
-  Y. Munenaga, T. Yamashita, J. Tanaka, and F. Nishimura, “Improvement of glycated hemoglobin in Japanese subjects with type 2 diabetes by resolution of periodontal inflammation using adjunct topical antibiotics: results from the Hiroshima study,” Diabetes Res. Clin. Pract, Vol.100, pp. 53-60, 2013.
-  N. Takeuchi, D. Ekuni, K. Irie, M. Furuta, T. Tomofuji, M. Morita, and T. Watanabe, “Relationship between periodontal inflammation and fetal growth in pregnant women: a cross-sectional study,” Arch. Gynecol. Obstet., Vol.287, pp. 951-957, 2013.
-  K. Suzuki, R. Shinohara, M. Sato, S. Otawa, and Z. Yamagata, “Association between maternal smoking during pregnancy and birth weight: An appropriately adjusted model from the Japan environmental and children’s study,” J. Epidemiol., Vol.26, pp. 371-377, 2016.
-  T. Tomofuji, T. Azuma, H. Kusano, T. Sanbe, D. Ekuni, N. Tamaki, T. Yamamoto, and T. Watanabe, “Oxidative damage of periodontal tissue in the rat periodontitis model: Effects of a high-cholesterol diet,” FEBS Lett., Vol.580, pp. 3601-3604, 2006.
-  E. Thailade, W. H. Wright, S. B. Jensen, and H. Loe, “Experimental gingivitis in man, II A longitudinal clinical and bacteriological investigations,” J. Periodont. Res., Vol.1, pp. 1-13, 1966.
-  N. Sugi, K. Naruishi, C. Kudo, A. Hisaeda-Kako, T. Kono, H. Maeda, and S. Takashiba, “Prognosis of periodontitis recurrence after intensive periodontal treatment using examination of serum IgG antibody titer against periodontal bacteria,” J. Clin. Lab. Anal, Vol.25, pp. 25-32, 2011.
-  M. Horiuchi, T. Yamamoto, T. Tomofuji, A. Ishikawa, M. Morita, and T. Watanabe, “Toothbrushing promotes gingival fibroblast proliferation more effectively than removal of dental plaque,” J. Clin. Periodontol., Vol.29, pp. 791-795, 2002.
-  M. Morita, K. Nishi, and T. Watanabe, “Comparison of 2 toothbrushing methods for efficacy in supragingival plaque removal, The Toothpick method and the Bass method,” J. Clin. Periodontol., Vol.25, pp. 829-831, 1998.
-  M. Morita, M. Tsurumi, H. Hiraiwa, M. Sakata, E. Kishimoto, M. Kondo, and T. Watanabe, “Quantitative evaluation of oral prophylaxis using Tooth Mobility Checker,” Jpn. J. Periodont. Assoc., Vol.29, pp. 205-210, 1987 (in Japanese with English abstract).
-  B. Cakilci, N. Tamaki, T. Yamamoto, T. Tomofuji, J. Shimono, M. Tsuneishi, S. Kokeguchi, K. Fukui, and T. Watanabe, “Reduction of gingival bleeding by professional toothbrushing compared to one-stage full-mouth disinfection,” Intern. J. Oral Health, Vol.5, pp. 17-24. 2009.
-  M. Quirynen, C. Mongardini, M. de Soete, M. Pauwels, W. Coucke, J. van Eldere, and D. van Steenberghe, “The role of chlorhexidine in the one-stage full-mouth disinfection treatment of patients with advanced adult periodontitis, Long-term clinical and microbiological observations,” J. Clin. Periodontol., Vol.27, No.8, pp. 578-589, 2000.
-  T. Sakamoto, M. Horiuchi, T. Tomofuji, D. Ekuni, T. Yamamoto, and T. Watanabe, “Spatial extent of gingival cell activation due to mechanical stimulation by toothbrushing,” J. Periodontol., Vol.74, pp. 585-589, 2003.
-  T. Tomofuji, D. Ekuni, T. Yamamoto, M. Horiuchi, T. Sakamoto, and T. Watanabe, “Optimum force and duration of toothbrushing to enhance gingival fibroblast proliferation and procollagen type I synthesis in dogs,” J. Periodontol., Vol.74, pp. 630-634, 2003.
-  T. Tomofuji, D. Ekuni, T. Sanbe, T. Azuma, N. Tamaki, K. Irie, T. Maruyama, T. Yamamoto, T. Watanabe, M. Miyauchi, and T. Takata, “Effects of improvement in periodontal inflammation by toothbrushing on serum lipopolysaccharide concentration and liver injury in rats,” Acta Odontol. Scand., Vol.67, No.4, pp. 200-205, 2009.
-  T. Watanabe, “Practice and Utility, Toothpick Method Brushing – Host Activation Treatment for Periodontal Diseases,” Oral Health Association of Japan, 2017 (in Japanese).
This article is published under a Creative Commons Attribution-NoDerivatives 4.0 Internationa License.