Sir, I read with interest the recent correspondence in the BDJ entitled 'A COVID complication' by Buxton et al.1I noticed the quandary for clinicians encountering such situations and the fact that the child was still maintaining oral hygiene with a fluoride-free toothpaste (I assume with a toothbrush).

There is evidence to support the utilisation of toothbrushes as a methodology to perform sampling for SARS-CoV-2 with a reported sensitivity of 60%.2 Another alternative to nasopharyngeal swab (NPS) sampling are buccal swabs (sensitivity of 58.9%). These methodologies may be utilised in patients, paediatric included, who seem unamenable to NPS sampling. Toothbrush sampling appears to be painless, economical, requires no specialised training for collection, can be self-collected and involves a device (toothbrush) with which the paediatric patient is familiar inside the oral cavity. Further research into these methods would seem to be relevant.