While face masks are critical to helping slow the spread of coronavirus, wearing them all day can also leave your breath in a stinky situation.

By Shannon Bauer
September 23, 2020
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While everyone experiences bad breath from time to time, the age of mask-wearing has brought the problem, well, right under your nose. The recent whiff, err, wave of bad breath, in addition to other oral health issues, is being referred to as mask mouth and is due to frequent wearing of protective face masks to prevent the spread of coronavirus. And since mask-wearing is the best line of defense against transmission, there has to be a way to have minty-fresh breath *and* stay safe...right? Right.

Here, dentists weigh in on the "mask mouth" conundrum, including why it happens and what you can do to stop the stink while still protecting yourself.

What is mask mouth, and why does it happen?

Whether you just scarfed down a bag of sour cream and onion chips or woke up after a night of too much wine, you've experienced bad breath at some point in your life. But if you've noticed an uptick in ~oral odor~ since the start of the coronavirus pandemic, all that mask-wearing is likely to blame. (Related: 'Maskne' Is a Very Real Thing—Here's How to Beat Face Mask Breakouts)

Simply put, mask mouth is the result of wearing a protective facial covering on the reg and for extended periods of time and can lead to, yes, bad breath but also increased risk of cavities, tooth decay, and inflamed gum tissue, says Jennifer Bell, D.D.S., a dentist in Holy Springs, North Carolina and spokesperson for the Academy of General Dentistry.

"Because your nose is covered while wearing a mask, you are inclined to breathe through your mouth, which can lead to a dry mouth, making it easier for bacteria that cause cavities and periodontal disease to thrive," explains Bridget Glazarov (aka Dr. Bridget), D.D.S., a general and cosmetic dentist in New York City. This build-up of bacteria is also responsible for producing a bad smell, aka halitosis or bad breath, according to the U.S. National Library of Medicine (NLM).

When you breathe through your mouth, you also dry out all of the saliva that usually acts as a buffer to neutralize acids, raises the pH of the environment in the mouth, and protects against bad bacteria, says Dr. Bridget. This leaves you at an increased risk for bacteria-caused cavities and tooth decay as well as viruses that contribute to gum disease. Think of it this way: the drier the mouth, the better the environment for bacteria to thrive, and, thus, the greater chance for mask mouth.

What's more, masks also could subconsciously hinder consumption of water, leading to overall dehydration and, as you probably guessed, dry mouth, says Bell. Add into the mix the fact that many are still spending ample time at home, where snacking and making poor nutrition choices is easier than ever. Most harmful oral bacteria thrive in an acidic, carbohydrate-rich environment, she explains. If the balance of bacteria is off (which is likely thanks to mask-wearing), then poor nutritional choices such as consuming foods high in sugar and sipping highly-acidic beverages could feed the bacteria, increasing the risk for dental damage, she explains.

On top of all of these mask-caused complications, there's also the issue of decreased dental care. While dentist visits and appointments were originally put on hold back in March, the American Dental Association has since urged patients to return to their regular appointments. Still, there has been a reduction in regular, preventative dental appointments, says Dr. Bridget, which is particularly a problem for those already dealing with mask mouth. Less frequent dental care might mean people are leaving cavities and gum disease untreated, which creates a recipe for bad breath and tooth decay, she explains. (Related: What to Expect at Your Next Ob-Gyn Appointment Amid—and After—the Coronavirus Pandemic)

Maybe you saw your dentist right before the world essentially shut down and got a clean bill of oral health (good for you). Or, hey, maybe you're still sticking to strict stay-at-home quarantine, in which you only need to cover up during your weekly grocery trip. Whatever your case may be, you're probably wondering: does mask mouth really affect me? So...

Who does mask mouth affect?

Technically, everyone wearing a face covering over their nose and mouth for any length of time. But it's most noticeable for folks returning to work who need to wear masks much of the day, says Dr. Bridget. It's believed that the longer a person wears a mask during the day, the more likely they are to develop this condition, adds Dr. Bell.

So teachers and students, hospital and essential workers, as well as restaurant and hospitality employees — rockstar people who need to wear a mask for hours — are most susceptible. Especially compared to someone who works from home and only leaves their house in a mask for an hour or two a day. (See also: What It's Really Like to Be an Essential Worker In the U.S. During the Coronavirus Pandemic)

How can you treat mask mouth?

Incorporating these steps may help treat mask mouth if it happens to you or, even better, prevent it from occurring in the first place. However, many of the below expert tips are just good for maintaining good oral hygiene at any time — pandemic or otherwise.

Clean your mask.

By now in the pandemic, you know that wearing a face mask can make breathing and talking feel a little, well, funny. And while you quickly get used to speaking louder during socially distanced convos and dealing with foggy glasses, your mouth doesn't handle the whole situation as well. "Rebreathing your own expelled air at higher quantities than normal can also cause a build-up of bad bacteria," says Bell.

One way to curb all this additional yuck? Wash your mask (or, if disposable, cut the ear hooks and toss in the trash before grabbing a new one) after each use according to the face-covering-cleaning guidelines from the Centers for Disease Control and Prevention (CDC). This is especially key because as you breathe inside a mask, your oral bacteria can become embedded in the fabric, which can also boost bacteria build up in your mouth when inhaled, she explains.

Practice good oral hygiene.

Brush and floss twice a day to stay on top of your oral hygiene habits, says Dr. Bridget, who recommends an electric toothbrush such as Burst Sonic Toothbrush (Buy It, $70, burstoralcare.com), which has extra-soft, fine bristles designed to get into those hard-to-reach areas and, thus, keep your whole mouth clean. When it comes to floss, Dr. Bridget is partial to Cocofloss (Buy It, $9, sephora.com) because the floss is made up of weaved fibers that are reinforced and help to really grab the plaque off your teeth. (And she's not alone — one Shape editor says Cocofloss made dental hygiene her favorite form of self care.)

"Fluoride in toothpaste can also help fight against bad bacteria, so I would most definitely recommend one to help protect and re-mineralize enamel," adds Dr. Glazrov. If bad bacteria in the mouth are allowed to thrive that can lead to demineralization, which weakens enamel, increases sensitivity, and makes it easier for acid, bacteria, and toxins to get even deeper into your teeth and lead to even more problems (i.e. cavities, decay). To soothe any already-present sensitivity and help remineralize and strengthen your pearly whites, Dr. Bridget recommends Sensodyne ProNamel Toothpaste (Buy It, $13 for 2, target.com). (Related: Why You Should Remineralize Your Teeth—and Exactly How to Do It, According to Dentists)

Keep hydrated.

I know, I know; drinking more water as the answer to seemingly every health concern ever, but it's legit — especially in the case of mask mouth. That's because proper hydration helps with preventing dry mouth as well as neutralizing acids and bacteria that contribute to tooth decay and gum problems, says Bell. (Related: The Best Ways to Stay Hydrated All Day Long)

Dr. Bridget recommends two liters or 8 cups of water throughout the day. But that's easier said than done when you're simply trying to survive while WFH with or without kids. So, try to pay attention to that dry mouth feeling — often accompanied by a bad taste, cracked lips, and/or burning sensation — and take a quick mask break to drink water to keep your mouth moist. Set an hourly alarm on your watch or buy a water bottle with markings for every hour to remind you to keep drinking, recommends Dr. Bridget. Oral rinses that target dry mouth can also help keep the mouth moist and more comfortable, adds Bell .

Avoid certain drinks.

While drinking ample fluids throughout the day is key for treating — and ultimately preventing — mask mouth, sipping on sugar-y beverages does not do you any favors. That's because they can dehydrate and, in turn, increase your chances of developing mask mouth. And the same goes for drinks, such as coffee, which is known to turn your mouth into a Sahara. But that doesn't mean you have to cut your a.m. cup of Joe altogether (*gasp*). Just be sure to rinse your mouth out with water before putting on your mask, since the sediment from coffee tends to linger on your tongue, further dehydrating and causing bad breath, explains Dr. Bridget. (Related: Is Your LaCroix Obsession Healthy?)

Take mask breaks.

This one's simple. Removing your mask in situations where social distancing is possible and/or when you're alone (i.e. in your car) will allow the good and bad bacteria in your mouth to reset, says Bell. It'll also allow you to throw back a few swigs of water.

Stock an emergency breath kit.

Lastly, if you're wearing a mask for multiple hours a day, Dr. Bridget recommends carrying an on-the-go kit for mid-day breath refreshing. Stash a travel-sized toothbrush, toothpaste, and floss to combat bad breath and havoc-causing bacteria. In a pinch, you could also pop a sugar-free mint, she adds. (Related: The Best Natural Toothpastes to Protect Your Teeth and Freshen Your Breath.)

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