COVID-19 and oral health

The arrival of the COVID-19 pandemic changed societies and individuals’ health across the globe. Shortly after the pandemic began, it also became clear that COVID-19 impacted oral health, too.

COVID-19 and your health

COVID-19 spreads when an infected person breathes out droplets or very small particles containing the virus. These droplets and particles can be breathed in by other people or land on their eyes, noses or mouth, causing them to become infected.

Symptoms of COVID-19 infection can vary in duration and in severity from person to person, but they generally appear two to 14 days after exposure. Symptoms can include:
 

• Fever
• Dry cough
• Difficulty breathing
• Fatigue
• Muscle aches
• Gastrointestinal upsets
   

Most people develop only mild to moderate COVID symptoms, but some develop severe illness, and a minority, usually the elderly or those with weakened immune symptoms, can develop critical illness. About a third of people infected with COVID-19 never develop symptoms at all.

The long-term impact of COVID-19 after infection is unclear. Some people who recover from COVID-19 continue to experience health problems in respiratory and other organ systems.

Oral symptoms of COVID-19

As with the symptoms related to overall health, the oral symptoms of COVID-19 can vary from person to person, but they can include:
 

• Loss of taste and smell
• Dry mouth
• Swelling of the tongue
• Burning mouth
• Mucositis (sore mouth and gut)
• Oral cysts, ulcers and lesions
• Spontaneous bleeding of oral tissues

The connection between gum disease and COVID-19

Recent studies show a connection between gum disease and the severity of COVID-19 symptoms. For those infected, gum disease is associated with higher risk of ICU admission, need for assisted ventilation and death.

Such findings highlight the importance of continuing to maintain your oral health, keeping up with regular dental cleanings and exams and sticking to a strong oral health care routine at home to prevent gum disease.

Stress, COVID-19 and oral health

The advent of COVID-19 hasn’t just affected the health of people worldwide, it also had a profound impact on societies and individuals through:
 

• Isolation
• Lockdowns
• Physical distancing
• Disruption of everyday life
• Political divisiveness
   

It’s no surprise then that COVID-19 also led to an increase in people experiencing stress, anxiety, depression and insomnia.

These mental health issues can themselves cause a worsening of overall health, including oral health. In addition, increased use of substances such as alcohol, tobacco and illicit drugs can likewise have a negative impact on oral health.

Pandemic-related mental health issues also caused an increased use of prescription medications such as anti-depressants and anti-anxiety medications, which can similarly have a harmful effect on oral health. Dry mouth is a common side effect of medications and of stress itself. Those who experience dry mouth have an increased risk for cavities and oral infections.

Other reports also noted an increase in bruxism, or stress-associated teeth grinding, since the pandemic began, as well as a higher incidence of temporomandibular joint disorder.

Remote work and your teeth

Working or going to school remotely can present another layer of challenges to your oral health.

Studies show that remote work or school can lead to an increase in tooth decay, likely because those who work from home tend to brush less often and they also tend to consume sugary or acidic treats and beverages throughout the day.

To help maintain your oral health during the workday, brush twice daily, floss at least once daily and choose healthy snacks and meals. Always keep in mind that it’s the overall time your teeth are exposed more than the content of a single food or drink that matters.

What are dentists doing about COVID-19?

Although many dentist offices closed for all services except emergency care in the early days of the pandemic, dental offices have since reopened. The American Dental Association (ADA) and the Centers for Disease Control and Prevention (CDC) now recommend that dental teams stick to stricter infection prevention protocols.

Dentists and their staff must wash their hands, sterilize tools and wear protective gear as a matter of course, but they take additional steps to help prevent COVID-19 infections. Offices:
 

• Disinfect surfaces and tools more often
• Wear more protective gear than usual
• Space out appointments
• Increase aerosol evacuation
• Use HEPA filters or air purifiers designed to help remove virus particles from the air
• Call you before an appointment to ask about your health, recent travel and contact with infected people
• Ask you to limit the number of people accompanying you to your appointment
• Check your temperature and other symptoms when you arrive
• Require you to wear a face mask when not being examined
• Arrange waiting room furniture to better allow for social distancing
   

Call your dental office to ask about their COVID-19 protocols and to discuss if your dentist’s protection measures make you feel safe enough to allow you to visit the dentist.

Can toothpaste and mouthwash prevent transmission of COVID-19?

In the early days of the virus, some speculated that using antibacterial mouthwash or brushing often might help reduce the risk of transmission. However, there is currently no evidence that the use of oral care products can prevent you from getting the virus. There is similarly no evidence that use of oral health care products can make your COVID-19 symptoms less severe or help you recover more quickly.

Some oral health care products can lower the amount of virus present in your saliva, but this does nothing to prevent infection (virus is present in saliva only if you’re already infected) or to reduce symptoms. Further studies are needed to determine if oral health care products might help reduce the risk of transmission to others.

Brush twice daily, floss daily and use fluoride rinse to maintain your oral health. Reduce the risk of COVID-19 transmission by getting vaccinated, social distancing and wearing a mask in enclosed public spaces.

Last updated April 4, 2023