While initial reports focused on respiratory illness, scientific observations have broadened the understanding of COVID-19’s effects throughout the body. Sore gums are not listed among the primary indicators like fever, cough, or loss of taste and smell. However, researchers have consistently noted a range of oral health changes in patients with the virus. These manifestations suggest the infection’s impact is not confined to the lungs but extends to the mouth and surrounding tissues, where the presence of sore gums, gingivitis, or mouth lesions may occur as a direct or indirect consequence of the SARS-CoV-2 infection process.
Oral Manifestations of COVID-19
Soreness, inflammation, or bleeding of the gums have been documented as part of the broader spectrum of oral symptoms associated with COVID-19. These issues are often categorized as gingivitis or periodontitis in infected individuals. Some patients experience desquamative gingivitis, which involves the peeling away of the outer layer of the gum tissue, leading to localized redness and pain.
Beyond gum complaints, other distinct oral issues are also linked to the viral infection. One notable finding is “COVID tongue,” which presents as enlargement, discoloration, or a loss of the small bumps on the tongue’s surface, a condition known as depapillation. Dry mouth, or xerostomia, is also frequently reported, affecting many patients and potentially contributing to gum problems.
The virus has also been associated with mucosal lesions, appearing as small ulcers or blisters on the gums, lips, and other parts of the mouth. These mouth sores may develop during the active infection phase or shortly after typical systemic symptoms subside. The appearance of these varied oral symptoms suggests the virus or the resulting systemic response is capable of affecting different cell types and structures within the oral cavity.
The Biological Mechanisms Behind Oral Symptoms
SARS-CoV-2 gains entry into human cells by binding to the angiotensin-converting enzyme 2 (ACE2) receptor. This receptor is highly abundant in various oral tissues, including the epithelial cells of the salivary glands, the tongue, and the oral mucosa. This high concentration of viral entry points makes the mouth a susceptible site for initial infection and replication, which can directly lead to localized tissue damage and inflammation.
Once the virus is established, the immune system mounts a defense that can lead to an exaggerated inflammatory response, often called a cytokine storm. This systemic inflammation releases high levels of pro-inflammatory molecules throughout the body. This widespread inflammation can damage blood vessels and tissues, including those in the gums and the periodontium, the tissue supporting the teeth.
The inflammatory process leads to vascular changes and damage that manifest as soreness, swelling, and bleeding. Another element is the dryness of the mouth caused by the virus’s effect on the salivary glands, which significantly reduces saliva production. Since saliva is a natural defense mechanism, its reduction allows bacteria to proliferate more easily, indirectly increasing the risk of gingivitis and periodontitis.
Distinguishing Viral Symptoms from Routine Dental Issues
Sore gums are a common ailment with numerous causes, making it challenging to attribute them solely to a viral infection. Typical dental issues, such as plaque buildup, poor oral hygiene, or aggressive brushing, are the most frequent causes of gingivitis. Gingivitis presents as red, swollen, and tender gums that may bleed easily. Stress, a common side effect of illness, can also lead to teeth clenching or grinding, indirectly contributing to gum discomfort.
Sore gums associated with a systemic viral infection often differ because they are typically accompanied by other distinct, non-dental symptoms. If gum soreness appears alongside fever, profound fatigue, sudden loss of taste or smell, or respiratory symptoms, the link to a systemic illness is stronger. The appearance of specific mucosal lesions or the distinctive “COVID tongue” are also more indicative of a viral cause than routine gingivitis.
If gum soreness persists for more than a few days, is severe, or is accompanied by signs of a dental infection, such as a localized pimple-like bump on the gum, a dentist should be consulted. However, if the gum issues are concurrent with the classic signs of a systemic illness, seeking advice from a medical doctor to evaluate for a viral infection is the appropriate first step. Addressing the underlying cause, whether it is viral inflammation or a bacterial dental issue, is the path to resolving the gum discomfort.