Let’s say, hypothetically, that “someone you know” has been occasionally forgetting to brush their teeth in the morning. Hypothetically, would that person’s teeth begin to rot out of their head and if so, how soon? What happens when you don’t brush your teeth regularly?

“In less than 24 hours, a plaque biofilm forms on your teeth and gums, which is a layer of bacteria that can cause bad breath, unpleasant tooth discoloration, or worse—gum disease, which causes our gums to bleed and can lead to loss of bone that supports your teeth,” says Lawrence Fung, DDS, founder of Silicon Beach Dental.

Okay, so that’s in 24 hours, but technically this hypothetical person is still brushing within that period of time, just once a day instead of twice. A-OK?

“It would be best to brush twice daily,” says Dr. Fung. One reason is that aforementioned biofilm buildup—more is more when it comes to removing it. “Another reason is brushing with fluoride toothpaste will introduce a healthy safe dose of fluoride to help protect your teeth from getting cavities.”

The gum disease process can begin in as little as 12 hours. “Some signs of the gum disease process, or gingivitis, is swelling, bleeding gums, and bad breath,” says Dr. Fung. “If you do not address things at the early stages, where it’s gingivitis, the inflammation of the gums can start to cause irreversible damage to the supporting bone and fibers that hold your teeth in place.”

This damage is known as periodontal disease. “That process can occur either very slowly in the form of chronic periodontitis or some specific cases it can be quick onset in the form of aggressive periodontitis,” says Dr. Fung. “Some risk factors that can cause it to come on quicker to cause bone loss can be tobacco use, drug use, conditions that cause decreased immunity, and certain diseases like diabetes.” Often bone loss presents as gum recession.

When periodontitis becomes advanced, it can result in everyone’s worst nightmare—lost teeth. It’s also been linked to heart disease, which Dr. Fung points out is a risk factor for COVID-19 complications. “During these uncertain times of COVID-19, it is more important than ever to do everything to keep our overall health as high as possible,” he says.

Notably, even gingivitis can make us more susceptible to illness because it causes inflammation. “Gingivitis can provoke an immune response—it’s that constant irritation or inflammation from gingivitis that causes periodontitis,” says Dr. Fung. “While there is not enough evidence out there yet [to link it with COVID-19 risk], it only makes sense that if we don’t take care of our body as a whole, including our oral health, then it places us at a higher risk for COVID19.”

So, even though “someone you know” might feel less inclined to brush right now than usual, it’s potentially more important than ever to maintain healthy oral hygiene. If this hypothetical person has slipped up a time or two since quarantine began, the important thing is just for “that friend of yours” to get back on track as soon as possible. “After diligent home care—brushing twice a day, getting cleanings twice a year—the beginning stages of gum disease will go away,” says Dr. Fung.

Plus, “your friend” will save themself from being hot-boxed by halitosis in the new, mask-mandated world whenever we do return to the regularly-scheduled (good-oral-hygiene-conducive) programming of daily life.