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Mask Mouth: Dental problems during the COVID pandemic

Increased dental problems during the pandemic

It’s 2020, and you’ve finally made some time to catch up on your self-care.  You’ve had your annual physical and bloodwork, all clear.  And you finally got your new glasses with your updated prescription.  Now you are relaxing at your dentist’s office while your hygienist cleans your teeth.  It feels great to have your teeth cleaned again.  You missed your appointment in the spring due to the nation wide shut down, so it’s been almost a year since your last cleaning. 

Frustrated person wearing mask with hands on their head

But you aren’t too worried, because you’ve been doing everything you should be doing at home, brushing twice a day, and flossing every day. Well, almost every day.  Plus, you haven’t had a cavity in years and your hygienist always praises you for your healthy gums.  You did tell your hygienist though that your spouse thinks your breath stinks.  That’s new, but you can’t really tell.  You diligently wear your mask all day at work and cannot really tell what your breath smells like anymore.  Your dentist finishes her examination and shows you your x-rays and photos from today’s visit.  You are surprised to find out that you have a couple cavities, and your gums are inflamed, and you cracked an old filling on a back tooth!  How is this possible? 

mask mouth

This year, dentists across the globe have been noticing a significant increase in dental problems in their patients, especially those who wear a mask all day.  The term “Mask Mouth” has come about to describe the symptoms and conditions we are seeing.  Jacksonville dentist Dr. Rachel Monteiro answers our questions about dental related problems during the pandemic and gives us some pointers on how to keep a healthy smile in 2020.

what dental problems are people having due to wearing a mask?

Patients who have otherwise had healthy teeth and gums for years are now experiencing cavities, gum inflammation, periodontal disease, and bad breath.  Many people are also having broken fillings and crowns, cracked teeth, TMJ pain, and other muscular pain in their head and neck. 

why does wearing a mask cause dental problems?

People have a tendency to breathe through their mouths when wearing a mask.  If you haven’t noticed yourself doing it already, pay attention today and see if you catch yourself doing it.  Mouth breathing leads to dry mouth, decreasing your saliva flow.  You need saliva to neutralize acids in your mouth, and to cleanse your teeth throughout the day.  With less saliva, your mouth becomes more acidic, which makes your teeth more prone to bacterial decay.  With less saliva to cleanse the teeth, plaque builds up on the teeth and under the gums, causing irritation in the gums and worsening existing periodontal disease and gingivitis. 

Some people also tend to posture their lower jaw down and forward when wearing a mask, especially N95 respirators or high-level surgical masks.  This may be at attempt to create space between your mouth and the mask, or it could be your body’s attempt to open the airway as a response to decreased air flow when wearing a respirator or mask.   However, this position puts strain on the muscles around the TMJ, and on the joint itself.  This can lead to acute TMJ pain, or generalized headaches, neck pain, and facial pain.  

why are people experiencing more cracked teeth and broken fillings during the pandemic?

There are a few possibilities.  The main one is stress related clenching and grinding.  Let’s be honest, who hasn’t felt stressed this year?  It is common for people to clench and grind their teeth at night, or even during the day, when life becomes more stressful.  This can lead to increased forces on the teeth, causing them to crack or fracture. 

Clenching and grinding can also be exacerbated by TMJ dysfunction, and vice-versa.  Like we discussed above, TMJ problems can be brought about by mask wearing due to our tendency to posture our lower jaw down and forward while wearing masks.  Also, working from home, often in unergonomic environments (hunched over the kitchen table, curled up with your laptop on the sofa) can lead to strain on the muscles in the head, neck, and shoulders.  This muscle strain can loop into a clenching/grinding cycle, and ultimately lead to cracked and fractured teeth.  

what can i do to cure or prevent mask mouth?