How To Treat And Prevent ‘Mask Mouth’

In case ‘maskne’ (you know, the breakouts and skin irritation caused by masks and face coverings) wasn’t enough, ‘mask mouth’ is here as another side effect of wearing personal protective equipment (PPE) to slow the spread of COVID-19. Dentists are seeing a rise in patients complaining of bad breath, tooth and gum sensitivity, and even cavities, which can be exacerbated by prolonged periods of mask wearing.

Good oral health isn’t just about maintaining a bright smile. It actually impacts the body from head to toe. “In recent years there have been hundreds of studies done showing the correlation between systemic diseases and oral health,” says Brian Harris, DDS, a cosmetic dentist and founder of Klēn. “The mouth is the entry point to the body and it contains 500 to 600 different types of bacteria, and those with poor oral health are going to carry a higher concentration of harmful bacteria.”

With face coverings here to stay (at least for the foreseeable future), it’s time to get serious about your oral health. Here, top dentists break down the ins and outs of treating and preventing mask mouth.

What Is Mask Mouth?

As the name suggests, the new oral hygiene disorder is a result of wearing a face mask for extended periods of time. Symptoms of ‘mask mouth’ include:

• Halitosis (a.k.a. bad breath)
• Tooth decay and cavities
• Gum inflammation (puffy gums, gingivitis, etc.)

Wearing a mask can affect dental health by creating a dry and acidic mouth environment. “This is because we tend to breathe through our mouths while wearing masks and tend to hydrate less,” says Jennifer Jablow, DDS, a New York City-based celebrity dentist and co-founder of MASKnSIP. You might associate wearing a face covering with increased moisture on the skin, but the mouth itself is dry. “We get a dry mouth environment from this and less salivary flow, which is a natural protection to wash away bacteria and keep the mouth pH at an optimal level,” she explains. “When the mouth is dry, it becomes more acidic, which is a perfect environment for plaque and bacteria.” The result? “Gum problems, stinky breath, and even cavities,” she notes.

What Causes Mask Mouth?

Let’s get one thing straight: The mask itself is not harmful. Face coverings are made of safe materials and allow us to breathe without expelling respiratory droplets. When masks are worn for an extended period of time, however, they can change some conscious and subconscious behaviors that lead to stinky side effects.

• Mouth Breathing: Wearing a mask causes many people to change their breathing habits. We are meant to breathe in and out through the nose. But, once the mask goes on, we often switch to breathing through the mouth, which causes mouth dryness. Dry mouth then leads to a decrease in saliva production. While primarily composed of water, saliva also contains a number of important enzymes, proteins, and minerals that are necessary for fighting disease-causing bacteria, preventing plaque build up, and keeping the mouth clean. If saliva isn’t present to neutralize the mouth, cells decompose and cause bad or sour breath.
• Dehydration: Like mouth breathing, dehydration also causes dry mouth and, in turn, bad breath. Most people who are wearing PPE all day are in professions where they are surrounded by a higher volume of people, like healthcare workers. Because of the fear of contracting the virus, a lot of people don’t want to remove their mask to eat or drink.
• Acidic Drinks: Whether you’re on the frontlines or adjusting to a new normal at home, the coronavirus pandemic is stressful. Unsurprisingly, a lot of people have turned to coffee for an energy boost and alcohol for comfort. Both are fine in moderation, but, when consumed regularly, these acidic beverages can have a negative impact on oral health — staining the teeth, causing sensitivity, and eroding enamel.

How to Treat & Prevent Mask Mouth

“The main cause of mask mouth is more related to the bacteria and chemistry of the mouth than anything else,” Dr. Harris says. “The best thing you can do is to use the right products to keep things in balance.” With that in mind, below are the products and good habits that will help treat and prevent mask mouth:

1. Stay Hydrated

Steer clear of acidic sodas, iced teas, and sports drinks in favor of a higher pH water, like Essentia or Smartwater Alkaline, Dr. Jablow says. Because hydration is key to good oral health, Dr. Jablow and fashion expert Christina Wilson created the MASKnSIP, the first antibacterial mask designed for drinking. It features a resealable flap and straw hole that allows you to keep hydrated all day long — without removing your mask.

2. Brush Regularly

Brush two times a day, preferably with a sonic toothbrush. For toothpaste, Dr. Jablow recommends using a toothpaste with zinc ions to kill bad breath at its source and xylitol to balance pH. Her pick? The IntelliWhite Carbon Power Clean Toothpaste and Power Boost Whitening Gel duo.

3. Don’t Forget About Your Tongue

“The absolute best fix for mask mouth is the use of a tongue cleanser morning and night, along with a mouth rinse designed to treat halitosis and not just cover it up,” Dr. Harris says. The Klēn Tongue Cleanser is specially designed to remove bacteria from the entire tongue at once, while the Natural Mint Rinse is formulated to “neutralize breath odors and hydrate the mouth,” he shares.

4. Try Water Flossing

We’ve all heard about the importance of flossing, but Dr. Jablow recommends upping the ante with a water flossing device because it is “much more efficient than string floss.” Her tip? Add a capful of peroxide in the water tank for a deeper clean. “The oxygen from the peroxide will kill the bacteria under the gumline that causes inflammation,” she notes.

5. Remove Tartar

To complement your brushing, flossing, and tongue scraping routine, Dr. Harris created the In Between Klen kit to help remove plaque and tartar build up and stubborn stains in between professional cleanings. “Tarter is the hardened biofilm of plaque on the teeth and it is loaded with bacteria, which is what causes bad breath,” Dr. Harris explains. “Removing that tarter can improve the smell of the breath, and, at the same time, it improves the look of the teeth.”

The Takeaway

Bad breath may not necessarily be a primary concern because your mask and social distancing prevents it from wafting over to your friends or peers, but gum inflammation, tooth decay, and bad breath can be your mouth’s way of notifying you of a larger problem.

Previous studies have found a link between heart disease and periodontal disease (gum infection). Gum disease is believed to increase the risk of heart disease because the inflammation and bacteria in the gums may eventually lead to narrowing of the arteries. “The plaque that builds up and the bacteria that resides inside that plaque can cause chronic low-grade inflammation, which is a cause of many systemic diseases,” Dr. Jablow says. “There is an increased risk for heart problems.” Serious periodontitis is also linked to respiratory disease, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome, and possibly cancer.

The bottom line: If you think you have mask mouth, don’t ignore it.