Reduction of saliva-derived droplet diffusion by mouth-closed tooth brushing in the era of COVID-19

Purpose: To clarify the effect of mouth-closed tooth brushing on the suppression of droplet generation in comparison with ordinary (mouth-open) tooth brushing and to investigate the difference in plaque removal efficacy between mouth-open and mouth-closed tooth brushing.Methods: Fourteen adults participated in the study. The labial/buccal, lingual, and occlusal surfaces of each sextant were brushed with the mouth open and closed, and a high-sensitivity camera and a high-power light source were used to measure the number of generated droplets. The plaque removal efficacy of each type of tooth brushing was evaluated according to the O’Leary Plaque Control Record.Results: Significantly more droplets were generated by mouth-open brushing than by mouth-closed brushing. The number of droplets was highest when the lingual surfaces of the upper anterior sextants were brushed with the mouth open. In mouth-closed brushing, almost no droplets were observed from any region. The plaque removal rate with each type of brushing did not differ significantly among any regions except the lingual surfaces of the upper left sextant.Conclusion: Mouth-closed tooth brushing almost completely suppressed droplet generation and did not reduce the plaque removal efficacy. Therefore, mouth-closed tooth brushing is beneficial as an oral hygiene method during coronavirus disease 2019 outbreaks.