We read with interest the series of cases reported by Martín Carreras-Presas, Amaro Sánchez, López-Sánchez, Jané-Salas, and Somacarrera Pérez (2020). We believe that the described oral vesiculobullous manifestations were suggestive of coronavirus disease 2019 (COVID-19) co-infections, which, at present, are overlooked AUTH O R CO NTR I B UTI O N

This paper details the characteristics of traumatic dental injuries (TDIs) during the Coronavirus 2019 (COVID-19) pandemic in 2020 at an Urgent Dental Care hub at King’s College Hospital Dental Institute, London, UK. For comparisons to be made, the characteristics of TDIs from a similar period in 2019 was also collected. Data was collected retrospectively from clinical records of patients suffering from dental trauma during both periods. An analysis was completed and conclusions drawn. The results suggest that the COVID-19 pandemic influenced the frequency, aetiology and type of TDIs. In order to suitably manage the provision of dental services, consideration must be given to the influence of pandemics on the characteristics of dental emergencies.

Objectives: Coconut oil is a cheap and accessible oil for many people around the world. There are numerous advocates for the practice of oil pulling to prevent common oral diseases. Therefore determining the effectiveness of oil pulling with coconut oil could potentially have monumental benefits. This review aimed to assess the effect of oil pulling with coconut oil in improving oral health and dental hygiene. Data: We included randomized controlled trials comparing the effect of oil pulling with coconut oil on improving oral health and dental hygiene. No meta-analysis was performed due to the clinical heterogeneity and differences in the reporting of data among the included studies. Sources: Six electronic databases were screened: PubMed, Medline, EMBASE, AMED, CENTRAL and CINAHL. Study selection: Electronic searches yielded 42 eligible studies, of which four RCTs including 182 participants were included. The studies lasted between 7 and 14 days. Significant differences were demonstrated for a reduction in salivary bacterial colony count (p ¼ 0.03) and plaque index score (p¼<0.001). One study also demonstrated a significant difference in staining compared to using Chlorhexidine (p ¼ 0.0002). However, data was insufficient for conclusive findings, the quality of studies was mixed and risk of bias was high. Conclusion: The limited evidence suggests that oil pulling with coconut oil may have a beneficial effect on improving oral health and dental hygiene. Future clinical trials are of merit considering the universal availability of the intervention. Prospective research should have a robust design with rigorous execution to provide a higher quality of evidence. Clinical significance: Oil pulling with coconut oil could be used as a adjunct to normal preventative regimes to improve oral health and dental hygiene although further studies are needed to determine the level of effectiveness.

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