Mouth Sores and COVID-19: Causes, Symptoms, and Treatments
Mouth sores, also known as canker sores, have been reported as a potential symptom associated with COVID-19. While not as common as other symptoms like fever, fatigue, and cough, mouth ulcers can be painful and annoying complications of COVID-19 for some people.
COVID-related mouth sores can arise due to a variety of factors, from viral replication in oral tissues to malnutrition and immune dysregulation. Thankfully, there are a number of at-home remedies and over-the-counter treatments that can help soothe COVID mouth sores and speed healing.
Causes of Mouth Sores With COVID-19
Mouth ulcers are not a primary symptom of COVID-19, but researchers have identified several potential mechanisms that may explain their occurrence in some patients:
- Viral replication - Studies have detected SARS-CoV-2 virus in the oral cavity, indicating viral replication is possible in mouth tissues, leading to lesions.
- Inflammation - The immune response triggered by COVID can result in inflammation and ulcerations throughout the body, including oral mucosa.
- Nutritional deficiencies - Lack of vitamins and minerals which aid wound healing like vitamin C, zinc, and B-vitamins can prolong oral ulcer healing.
- Stress - High stress levels can manifest in the form of canker sores for some individuals.
- Dehydration - Inadequate fluid intake associated with COVID symptoms like fever, vomiting, and diarrhea may increase ulcer risk.
- Oral hygiene - Brushing too vigorously or oral health problems can result in mouth sores.
Common Locations for COVID Mouth Ulcers
Mouth sores caused by COVID-19 can develop on various soft tissues in and around the oral cavity. Some of the most common sites include:
- Lips
- Tongue
- Cheeks (buccal mucosa)
- Gums (gingiva)
- Roof of mouth (palate)
- Underneath the tongue (sublingual)
- Back of throat (oropharynx)
These areas contain mucous membranes which can become eroded and form painful ulcers. Proper oral hygiene and hydration are key to preventing inflammation and lesions when fighting viral infections like COVID-19.
Types of COVID Mouth Sores and Ulcers
Oral ulcers associated with COVID-19 can appear in various shapes and sizes. The main categories are:
- Canker sores - Round, shallow lesions with a white or yellow center and red border. These are the most common type.
- Cold sores - Fluid-filled lesions, often on the lips or around the mouth. Caused by herpes simplex virus.
- Traumatic ulcers - Caused by oral irritation or injury from rough teeth, dental work, or oral devices.
- Aphthous ulcers - Painful, round/oval sores with grayish bases typically occurring inside the mouth.
While canker sores are most associated with COVID-related mouth ulcers, any type of mouth sore can potentially occur with oral viral infections like COVID-19.
Symptoms of Mouth Sores Due to COVID-19
If you develop painful mouth sores during or after a COVID-19 infection, the ulcers may exhibit various signs and symptoms such as:
Pain and Discomfort
The number one symptom of mouth ulcers is pain and soreness. COVID mouth sores can cause discomfort or a burning sensation when eating, drinking, brushing teeth, or swallowing.
Redness and Inflammation
The mucous membrane around the mouth ulcer will appear red, inflamed and swollen. There may be generalized inflammation of oral tissues.
Open Sore
An open ulcer, lesion, or blister will be visible on the lips, gums, tongue, inner cheeks or elsewhere in the mouth.
Gray, Yellow, or White Center
COVID mouth ulcers often have a yellow or grayish patch in the center, surrounded by redness. This is a key identifying feature.
Bleeding
Some mouth sores may bleed when agitated by brushing, eating hard foods, or hot liquids. The blood is typically minor.
Lymph Node Swelling
Oral ulcers can sometimes lead to swollen lymph nodes under the jaw as the body fights the irritation. This lumpiness often subsides once the sore heals.
In addition to these local symptoms, mouth ulcers may arise concurrently with typical COVID-19 symptoms like fever, cough, headaches, loss of taste or smell, and fatigue.
How Long Do COVID Mouth Sores Last?
The duration of mouth ulcers related to COVID-19 can vary. Less severe sores may heal within 1-2 weeks, while larger or more numerous lesions can take 2-3 weeks to fully resolve.
How long mouth sores last depends on factors like:
- - Size of the ulcer
- - Number of sores
- - Location in mouth
- - Severity of COVID-19 infection
- - Overall health status
- - Treatment measures used
Practicing good oral hygiene, staying hydrated, and using over-the-counter treatments can all help speed healing of COVID-related mouth ulcers.
See your dentist promptly if mouth sores last longer than 2-3 weeks without improvement or have very painful symptoms interfering with eating, swallowing or speaking.
Treatments for Mouth Sores Caused by COVID
While there is no cure for COVID-19 mouth ulcers, several remedies can relieve pain and inflammation while accelerating healing. Treatment options include:
Saltwater Rinse
Gargling with warm salt water 2-3 times a day removes debris and soothes irritated tissues. Mix 1 teaspoon salt in 8 ounces warm water. Swish gently for 30 seconds before spitting.
Topical Anesthetics
Over-the-counter topical gels like Orajel or Anbesol contain benzocaine to numb pain. Apply sparingly to ulcer area up to 4 times daily as needed for temporary relief.
Medicated Mouthwashes
Antiseptic mouth rinses with chlorhexidine or hydrogen peroxide can help kill germs while reducing inflammation. Use as directed 1-2 times per day.
Coating Agents
Protectants like Orabase form a barrier over sores, shielding from irritation. Brush paste over ulcers before eating or drinking.
Antimicrobial Creams
Applying topical antibiotic, antiviral, or antifungal creams may prevent secondary infections and hasten healing. Ask your pharmacist for recommendations.
Oral Pain Relievers
Over-the-counter medications like acetaminophen or ibuprofen can temporarily reduce mouth sore pain and swelling if severe.
Hydrogel Patches
Soothing hydrogel patches like Zilactin provide moist wound healing over canker sores, shielding them from irritation.
Home Remedies
Natural remedies like turmeric, honey, aloe vera, and licorice root have antibacterial and healing properties. Apply thinly over ulcers several times daily.
Avoiding spicy, acidic, crunchy, or irritating foods until healed, staying hydrated, and getting proper rest also support the body’s natural healing process.
See a dentist promptly if mouth sore symptoms are severe or persist beyond 2-3 weeks. Prescription medication or debridement of ulcers may be options in stubborn cases.
When to See a Doctor
In most cases, minor COVID-19 mouth sores resolve on their own with simple at-home treatments. But contact your dentist or doctor right away if you experience:
- - Severe pain that prevents eating, drinking or talking
- - Sores lasting more than 2 weeks
- - Difficulty swallowing
- - Extreme redness or swelling
- - Sores accompanied by fever
- - Bleeding that won't stop
- - Suspected bacterial, fungal or herpes infection
Severe or persistent mouth sores may need further evaluation to rule out other conditions. Rare cases may require prescription antibiotic rinses, oral thrush medication, steroid treatments, or ulcer debridement.
Let your doctor know if you experience any mouth sores, bleeding, or oral pain while recovering from COVID-19. Prompt dental or medical attention can help minimize complications.
Preventing COVID Mouth Sores
Practicing exceptional oral hygiene and staying hydrated are key to preventing painful mouth sores during COVID-19 illness. Other prevention tips include:
- - Avoiding irritating foods during illness
- - Taking vitamins C, B12, zinc, and L-lysine supplements
- - Using coconut oil or vitamin E oil to moisturize lips
- - Quitting smoking and limiting alcohol
- - Applying SPF lip balm before going outside
- - Rinsing with salt water or baking soda solution
- - Brushing gently with a soft toothbrush
Avoiding mouth sores altogether is ideal. But if they do occur, treat them promptly for relief. With proper care most cases heal fully within a couple weeks.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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