Long COVID refers to persistent health issues that continue long after an initial COVID-19 infection. While commonly associated with fatigue and brain fog, an emerging area of concern involves a range of oral and dental health problems. Patients and healthcare providers are noticing various issues affecting the teeth and gums that appear following a COVID-19 diagnosis. This has prompted investigation into how the virus and the body’s response to it may impact oral tissues.
Reported Oral and Dental Symptoms
Individuals with Long COVID have reported a notable spectrum of oral health issues. Frequent complaints include unexplained toothaches that can feel like nerve pain and a heightened sensitivity to hot and cold. Another common problem is gum inflammation, or gingivitis, which causes the gums to become swollen, red, and prone to bleeding. These symptoms can occur even in individuals with a history of excellent oral hygiene.
Beyond pain and inflammation, some have reported more alarming changes, including a noticeable discoloration of teeth and a feeling that teeth have become loose. In some cases, this has progressed to teeth cracking or falling out. Another significant symptom is persistent dry mouth (xerostomia). This lack of saliva can further contribute to other oral health complications like mouth sores or changes to the tongue’s surface.
The duration of these oral symptoms can vary greatly; some may resolve within weeks, while others can persist for months. This variability underscores the complex and individualized nature of Long COVID’s effects on the body.
Potential Biological Explanations
Scientists are exploring several biological pathways to understand how Long COVID might lead to dental problems. One leading hypothesis centers on the widespread inflammation that a severe COVID-19 infection can trigger. The immune system’s overreaction, a “cytokine storm,” releases a flood of inflammatory compounds that can damage tissues throughout the body, including the delicate tissues of the gums. This systemic inflammation could be a primary driver behind the gingival inflammation seen in some patients.
Another area of investigation involves the vascular system. Evidence suggests that COVID-19 can damage blood vessels, leading to the formation of microclots. These tiny clots could potentially disrupt blood flow to the oral cavity, compromising the health of the teeth and gums. Reduced blood supply can weaken these tissues, contributing to problems like loosened teeth or even tooth loss, as these structures depend on a steady supply of oxygen and nutrients.
The virus itself may also play a direct role. The oral cavity has a high concentration of angiotensin-converting enzyme 2 (ACE2) receptors, which the SARS-CoV-2 virus uses as a gateway to enter human cells. This high density of receptors could make the mouth a site for direct viral attack or persistence, leading to localized tissue damage. Researchers also theorize that the infection could trigger an autoimmune response, where the body’s immune system mistakenly attacks its own oral tissues.
The Role of Secondary Factors
In addition to direct biological effects, secondary factors can contribute to a decline in oral health. The psychological stress associated with the illness can lead to physical manifestations. For instance, dentists have reported an increase in patients with cracked teeth, largely attributed to a rise in bruxism, or unconscious teeth grinding. This habit exerts immense pressure on the teeth, leading to fractures and jaw pain.
During the acute phase of a severe illness, personal care routines are often disrupted. Individuals who are very sick may neglect their regular oral hygiene practices, such as brushing and flossing. This lapse can allow harmful bacteria to build up, leading to gum inflammation and an increased risk of cavities that may persist long after the initial illness has passed.
Medications used to treat COVID-19 or its lingering symptoms can have side effects that impact the mouth. A common side effect is xerostomia, or dry mouth. Saliva is important for oral health because it helps neutralize acids and wash away food particles. When saliva flow is reduced, the risk of tooth decay and oral infections increases.
Managing Oral Health After COVID-19
If you are experiencing new or worsening dental issues after a COVID-19 infection, the first step is to schedule an appointment with a dentist. A thorough examination can help document your symptoms and rule out other common dental conditions that are not related to the virus. This professional assessment is necessary for an accurate diagnosis and an appropriate treatment plan.
It is also beneficial to maintain open communication with your primary care physician or a Long COVID specialist. Since the oral symptoms may be linked to systemic issues like inflammation, an integrated approach to your healthcare is advantageous. Your medical doctor needs to be aware of your dental symptoms, and your dentist should be informed about your overall health status.
For managing specific symptoms at home, certain steps can be helpful. If you are dealing with dry mouth, use over-the-counter saliva substitutes, stay well-hydrated, and chew sugar-free gum to stimulate saliva flow. To combat gum inflammation and prevent decay, maintain meticulous but gentle oral hygiene. This includes regular brushing with a soft-bristled brush, daily flossing, and considering an antiseptic mouthwash.