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Here are five words you never want to have to utter to yourself: do I have mask mouth?
The phenomenon is supposedly what happens when you wear face masks or face covers for long periods of time and end up with bad breath and various other dental issues.
Some dentists in the US have reported a spike in patients seeking relief from bad breath caused by so-called mask mouth. Experts fear the condition could increase the chance of getting tooth decay or gum disease, HuffPost reported.
But Professor Damien Walmsley, the British Dental Association’s scientific advisor, says “attempts to link mask use and tooth decay appear motivated more by political prejudice than protecting public health”.
There has been no research or evidence to confirm mask mouth is an issue. However, it’s been suggested it could occur – not because of the mask itself, but more because wearing a mask for long periods of time, especially quite tight face masks, could end up drying out your mouth.
Most people tend to breathe through their mouth more, rather than their nose, when wearing a mask, which has a drying affect. This is more of a hypothesis, though.
As dental surgeon Dr Zainab Al-Mukhtar, from Harrow On The Hill Dental Practice, explains: “The oral issues associated with mask-wearing come from the tendency to breath through the mouth that some people feel the need to do while wearing a mask, along with the possibility of drinking less water and less mouth hydration. This is more likely to be the case with masks that are tightly fitted around the nose over a length of time.”
This dryness could increase the risk of tooth decay and bad breath.
Saliva is needed to keep the mouth healthy – and when wearing a mask, saliva can be reduced and your mouth might become more dry. Reduced salivary flow can lead to bacterial stagnation and a reduced pH in the mouth, says Dr Al-Mukhtar. “A low pH environment allows for bacteria responsible for tooth decay to thrive,” she adds.
There’s currently no evidence of tooth decay caused by wearing a mask, says Dr Robert Chaffe, a dentist at White & Co Dental. That said, if wearing a mask makes your mouth feel dry, this can increase the risk of tooth decay, he admits. Wearing a mask could cause bad breath if your mouth became dry, but it could also just be making you notice the smell of your own breath a bit more.
“I think anecdotally, wearing a face covering may highlight breath changes such as coffee breath, as the air is trapped between your mouth and nose,” says Dr Chaffe.
Anna Middleton, a dental hygienist and founder of London Hygienist, also points out that wearing a face mask has not been proven to exacerbate oral health conditions.
Someone who has any of these conditions – such as decaying teeth, receding gum lines or sour breath – “will have experienced these problems without wearing a mask,” she adds. “A mask cannot cause these issues directly.”
Face covers and masks are considered crucial in the fight against Covid-19.
Professor Damien Walmsley says claims on ‘mask mouth’ are “risible”. “East Asian societies – where face coverings have been ubiquitous for decades – are not confronting an epidemic of decay,” he points out.
“Dentists wear masks as a matter of course, and we’re not exactly at the front of the queue for extractions. If patients have seen a deterioration in their oral health, it makes more sense to look at lockdown diets and lack of access to dental services than to indulge in myth-making.”
The good news is that you’re not destined to have a mouth that feels like a desert and smells like a swamp. Experts agree you’d need to have a dry mouth for a significant length of time in order for your dental state to take a turn for the worse.
There are some simple ways to keep your mouth healthy. Here’s what dentists suggest:
Floss daily.
Drink plenty of water.
Brush your teeth twice a day for two minutes. Use an electric toothbrush if possible and a fluoride toothpaste.
See a dentist and hygienist every six to 12 months.
Chew gum to help stimulate saliva flow.
Consider use of a fluoride mouthwash once per day.
Keep your mask clean (which goes without saying during a pandemic). Change your mask daily and wash reusable face covers on a hot wash (60 degrees and over) with detergent.
Avoid a high frequency of sugary snacks and drinks.
Brush your teeth after eating meals if you are prone to food trapping or stagnation.
Ultimately mask mouth is not something to worry about, says Dr Reena Wadia, a periodontist at RW Perio. “There are no dental health hazards of wearing a mask as long as you stay hydrated and keep up your dental home care regime.”
- Update: This article has been updated with new comments from a hygienist and the British Dental Association.