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Tuesday, July 5, 2022

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Preventing Black Fungus Infection: Understanding why oral care is crucial for people recovering from COVID

Black Fungus infection has sent shockwaves through people as well as the medical community. In the midst of a deadly pandemic, the increasing cases of fungal infection and the associated fatality fate has all worried. The biggest question now is – preventing black fungus infection. And while, many keep talking about immunity, most forget that good health begins from good oral hygiene.

Dental or oral care during COVID is perhaps one of the least talked about topics. People are often worried about their weight, and now their immunity.

With the spread of Black Fungus or Mucormycosis, people are finally checking their mouths. Even then, the concern for oral health remains low, when it should be the first priority. Unknown to many, proper oral hygiene is also crucial for preventing deadly fungal infections like black fungus as well as many other complications. In COVID times, proper oral hygiene is essential for life itself.

A tooth is all it takes – Case Study on importance of dental care during COVID

Last week, a 33-year-old female patient called me and complained of swelling and pain on the left side of her face extending to infraorbital (below the eye) region. She had pain in one tooth but could not visit the clinic because she was COVID positive. To make matters worse, since she had high grade fever, her physician had prescribed steroids along with other COVID medicines.

Otherwise in prime of her health, the patient suffered from hypothyroidism. And yet, there she was, in obvious pain and deteriorating health.

Quick look at the patient records showed a recommendation by me in January 2021 for extraction of decayed upper left premolar. She was consulting me for some prosthetic work and the advice was taken but no follow up was done. I should have perhaps insisted more of extraction but then…no one was anticipating the second wave that quickly gripped the country.

Result, extreme pain and swelling so severe that she was not able to open her left eye. And a possible risk of fungal growth that could become sever.

I immediately advised broad spectrum antibiotic to include both aerobic and anaerobic bacteria and Betadiene + Peroxide mouth wash thrice daily to stop any fungal growth as she was on steroids. She was advised not to rinse with hot water as it will spread the swelling.

Thankfully after, seven days, her condition is stable and the swelling has subsided. She has been put on oral hygiene regimen of mouth wash only now and is advised to visit clinic for extraction of the offending tooth when she is healthy enough.

Also Read | RECOVERING FROM COVID19: DO’S AND DON’TS WHEN RECOVERING FROM ASYMPTOMATIC, MILD OR SEVER COVID

What went wrong?

Our mouth is rich in micro-organisms. Our oral microflora is a combination of bacteria, viruses and fungi. When we are sign, indeed even during COVID, the antibiotics prescribed are mainly for the bacteria, which in turn causes major dental problems. But when your immunity is down, and antibiotics are taken for a long time, the microflora of your mouth changes.

With even good bacteria now dead, fungal infections take precedence. Candida, aspergillus and mucoromycetes (black fungus) are the commonly present, even in normal mouth. These, for a healthy person, seldom have potential to penetrate the mucosa. But when your immunity is compromised and count of normal bacteria is decreased, they can attach themselves onto your tongue, palate, gums and nasal cavity lining. This in turn causes thrush, white fungus and black fungus. What is noteworthy is that their attachment is a slow process, but when attached, they progresses very quickly and develop into life threatening condition.

This case was of a young patient who was in her prime health. I had recommended extraction but then for many, till its not hurting, its ok. What people do not realize is that when your immunity takes a hit, an innocent looking decayed root stump can and will develop into a potential life-threatening condition.  This is the reason why when old diabetic/hypertensive patients visit me with broken and decayed teeth, I strongly recommend them to get rid of the potential time bombs in their mouth.

Covid and the fungal infections should be an eye opener now. Many patients just insist on the medication. What is worse, many continue to repeat the same prescription without consultation.

Also Read | DIET PLAN FOR COVID19 AND POST COVID PATIENTS

What to do? How to prevent black fungus and other fungal infections through mouth

The primary objective is to maintain good oral hygiene. Brushing all parts of your mouth including palate, tongue and cheeks is as much important as brushing your teeth. Below are some important do’s and don’ts.

Do’s and Don’ts of Oral Care

  1. Change your tooth brush every month. Brushing with a right brush for 2 minutes is far more effective that brushing with an old worn-out brush for 10 minutes.
  2. Clean all parts of your oral cavity including palate, tongue and cheeks as well.
  3. You can use Alum water (Phitkary) to rinse your mouth after brushing.
  4. When infected by Covid, add Chlorhexidine based mouthwash in oral hygiene regimen. This reduces the viral load in your mouth and prevents transmission.
  5. GOLDEN RULE – Never take any medicine without the prescription.  
  6. If you have dental caries and develop swelling – cold rinse. This is because it means the bacteria has travelled to the inside of bone. Warm /hot rinses will aggravate the swelling and it will spread.
  7. If you have gum problem, the bacteria is around your bone between gums and teeth. In that case, warm rinses may offer some relief and may reduce swelling by washing away the pus.

While you maintain good health, it is very important to visit your dentist every 6 months to get full mouth checkup. Your practitioner is trained to detect and prevent future dental complication. Remember, your chemist can only give you medicines for the symptoms you have – which may provide symptomatic relief but never truly identity the root cause. So, avoid quick fix and do it the right way.

Disclaimer

Tips and suggestions mentioned in the article are for general information purpose only and should not be construed as professional medical advice. Always consult your doctor or a dietician before starting any fitness programme or making any changes to your diet.

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