The relationship between wearing protective masks and poor oral health

Abstract

Since the beginning of the COVID-19 pandemic, the number of people wearing masks in everyday life has increased. At the same time, there has been a noticeable rise in the amount of patients with bad breath (foetor ex ore), gingivitis, caries, and xerostomia. The appearance of these symptoms and diseases caused by wearing a mask is designated by the term mask mouth. Тhe aim of this article is to establish the link between wearing protective masks and deteriorating oral health. From the conducted research, it has been established that wearing a surgical mask over a long period of time leads to reduced air exchange in the mask and “recycling” of exhaled air. This leads to inhalation of air with increased CO₂ content and increase in pCO₂ in the blood, which is subsequently compensated by rapid and deep breathing in most cases through the mouth. The goal is to exhale the accumulated CO₂. As the mask reduces air exchange, the level of CO₂ in the mask remains relatively high. Prolonged breathing through the mouth often leads to xerostomia. Saliva is known to have protective functions against the development of bacteria in the oral cavity through its antibacterial properties. Xerostomia can be a prerequisite for the development of various diseases of bacterial origin, such as gingivitis. Furthermore, oral respiration leads to an increase in temperature and CO₂ in the air in the mask and a decrease in pH in the oral cavity, which are optimal conditions for biofilm formation, plaque buildup, development of most bacteria, e.g., S. mutans, which is the main cause of caries.