Mask Mouth and the Effect on Kids Oral Health

We’ve been living through a pandemic for 18 months now, which means we have it all figured out, right? The kids have adjusted to learning from home, parents have developed a work from home routine, and masks are a staple accessory your toddler cannot wait to wear each day. Who am I kidding?? The past 18 months have been challenging in many ways for many people, including our little ones. We have all had to make sacrifices and be flexible and as much as I wish I could say it has become easier, things keep changing and we have to be ready for the unknown. 

One thing is for certain though. Our kids have become accustomed to seeing people in masks, and hopefully they are adjusting to wearing them themselves if they are 2+ years of age, based on CDC recommendations. While masks have been studied to help reduce the spread of COVID-19, there are other considerations to take into account for kids that are wearing them rather consistently. 

If your child is able to attend school again, there is a good chance that masks are required. This means they are wearing them for many hours a day, several days each week. While I highly encourage wearing masks to protect others and to help stop the spread of COVID-19, there are potential oral side effects that come with long-term wear.  You may have heard it before, but the term “mask mouth” has evolved in the past year. It has been studied that masks do play a role in how oral health is affected. 

Side effects to be aware of with long-term mask wear:

Mask wear has been shown to increase the number of breaths taken. For this reason, your child will likely breathe more through their mouth to compensate for the change in their breathing patterns. This may lead to a reduction in salivary flow and higher chance for dry mouth or dryness in the corners of the lips. Bad breath may begin to develop as a result of dry mouth, and more concerningly, your child may be at a greater risk for developing cavities or bleeding gums.  As you can see in the diagram, each step of the cycle affects the other, meaning it is important to recognize these side effects early on before it reaches the point of needing significant dental care.

Fortunately, there are things you can do as a parent to help your child’s oral health stay on the path to success even during a pandemic. 

Here are some tips to follow to help prevent mask mouth:

• The CDC recommends children wear masks that are designed for them. This will help ensure the fit is snug around the nose and mouth and hugs under the chin while not creating any open gaps on the sides.

• Encourage your child to stay hydrated when wearing a mask. It is important to encourage frequent water intake during long mask-wearing. Choosing water will provide dry mouth relief, stimulate salivary flow, help with bad breath, keep the gums hydrated and teeth clean from plaque buildup. Be sure water is the go-to-choice for hydration and sipping. Sipping on sugary beverages can lead to bigger oral health problems.

• Avoid certain ingredients found in toothpastes and mouthwashes that have been associated with causing dry mouth and gum irritation. Sodium lauryl sulfate (SLS) is one of the more common toothpaste ingredients and is mostly responsible for creating a foaming consistency in toothpaste. As a side effect, SLS may cause mouth sores or even dry mouth. Avoid products with SLS if your child is already experiencing a dry mouth or dryness in the corners of their mouth as a result from mask mouth. The alcohol in certain oral products also has a tendency to increase dry mouth. While a mouthwash can help relieve dry mouth as it relates to mask mouth, look for products that are “alcohol-free”.  

• Help with your child’s oral hygiene routine. One study found there to be a reported decrease in toothbrushing habits during the pandemic. By providing parental guidance and assistance with toothbrushing, flossing, and the use of a mouthwash (for children 6+ years of age), you are encouraging good oral health practices and helping prevent negative effects from mask mouth. It may even be advantageous to add an extra tooth brushing session to your child’s daily routine. If you are looking for exciting ways to motivate your little one to brush, check out Grin's pop-up brushing book or implement a family-fun brushing challenge. 

• Monitor your child’s gums. Swollen, puffy, red or bleeding gums are all signs of gingivitis. If you notice this when you are observing your child’s oral hygiene practices or when they are smiling, it is best to schedule a visit with your dental provider for a routine cleaning and check-up. In the meantime, parents are encouraged to help with brushing and flossing their child’s teeth until around age nine. Proper brushing techniques, such as angling the toothbrush towards the gumline, will also help with sweeping away bacteria that can lead to gingivitis. 

• If your child is experiencing bleeding or swollen gums, try using one of Grin's natural kids toothpastes to help them bounce back into health. Organic calendula oil, sea salt, and aloe leaf extract are three natural ingredients found in Grin Natural kids toothpastes “that are anti-inflammatory and soothe sensitive teeth and gums”.  Calendula oil contains both  antimicrobial and antioxidant compounds that aid in reducing the harmful bacteria known to cause cavities and poor gum health (gingivitis). The sea salt found in Grin’s toothpastes helps to create an alkaline oral environment, meaning the bad bacteria cannot stand a chance at surviving. The aloe leaf extract fights off plaque build-up. It’s also  a natural ingredient free of rough abrasives and as a result can be more gentle on your little one’s gums. 

• Encourage healthy snacking and eating. By teaching your child to understand which foods and drinks are healthy for their teeth, you are helping to reduce the likelihood of sugar and plaque building up behind the mask. Plaque is constantly accumulating on the enamel surface and when it interacts with sugar, an acid forms and the cavity process begins. This, in combination with the common mask mouth side effects, elevates your child’s risk for developing cavities. For more information on healthy eating, check out “Snacking during a pandemic”. 

• Lastly, maintain a good relationship with your dental provider. Frequent dental cleanings and checkups are even more essential during long term mask wear. Look for providers that are following COVID-19 disinfection protocols, safe social distancing practices, and proper use of personal protective equipment to help you and your child safe. 

While “mask mouth” is a reality of long-term mask wear during this pandemic, it does not have to have a negative influence on your child’s oral health. By recognizing the effects of mask mouth and implementing these simple steps and reliable dental products into your little one’s routine, your child’s smile can be healthier than ever. 

About the Author 

Kristen Cockrell is a Registered Dental Hygienist with a passion for preventive pediatric dentistry and oral health education. Kristen recently completed a master’s degree in dental hygiene education at the University of North Carolina at Chapel Hill. 

Photo credit: Harper @harper.dia ; Sarah Therese @sarahtheresev