Is dry mouth a symptom of COVID-19?

Is dry mouth a symptom of COVID-19

What is COVID-19?

COVID-19 is a respiratory illness caused by the novel coronavirus SARS-CoV-2. It spreads through close contact by coughing and sneezing of a person infected with COVID-19. It has an incubation period of 1-14 days, and you may experience the symptoms between 5-14 days after the exposure. COVID-19 virus is rapidly evolving with numerous new symptoms seen in several cases. So, the question that is often asked, Is dry mouth a symptom of COVID-19.

Let’s get started;

Common symptoms of COVID-19

The symptoms of COVID-19 may vary. However, fever (88% cases), cough (68%), and fatigue (38%) are among the most common symptoms. Other symptoms include shortness of breath, muscle and joint pain, chills, nausea and vomiting, loss of taste or smell, dry mouth, nasal congestion, blood in spit, diarrhea, and eye irritation. 

Most COVID-19 infections are mild and require isolation, rest, hydration and pain medication. However, it can be fatal in elderly patients with other co-morbidities.

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What is dry mouth and its common causes?

Dry mouth or xerostomia is a salivary gland disorder where salivary glands can’t make enough saliva to keep the mouth wet. Saliva is essential for the optimal oral health. It lubricates and forms a protective layer over teeth, gums, and other tissues. It contains bicarbonates, phosphates, and proteins that maintain a healthy pH (6.8-7.2) in the mouth. Also, the saliva swallowed once or twice every minute prevents the build-up of bacteria in the mouth.

Symptoms of dry mouth

It is not unusual to experience dry mouth under stress or during hot summer days when you are dehydrated. However, if you experience dry mouth throughout the day with thick, stingy saliva, lips sticking to the teeth, trouble swallowing and speech, burning in the mouth, bad breath, altered taste and frequent mouth sores, consult your GP. These are the symptoms of xerostomia. 

Causes of dry mouth

The most common cause of dry mouth is chronic stress. People under chronic stress frequently suffer from dry mouth, mouth ulcers, infections, and periodontal disease. The fight-and-flight mode (stress) stimulates the sympathetic nervous system and suppresses the parasympathetic system responsible for saliva production and other resting body functions. 

Medications are the second most common cause of dry mouth. Talk to your GP if you have lately started experiencing symptoms of dry mouth and you are on medications and have changed medication in the past few weeks.

Other causes of dry mouth are Sjögren’s syndrome (an autoimmune disease of salivary glands), diabetes (an endocrine disorder, Parkinson’s disease (a neurological disorder), etc.

Read more: Can you brush your teeth with olive oil? 

Is dry mouth a symptom of COVID-19?

Is dry mouth a symptom of COVID-19

Yes, dry mouth can be one of the earlier signs of COVID-19. A study on a large group of people documented that only a tiny percentage (0.18%) of COVID-19 patients suffer from dry mouth. Later studies reported that 30-60% of COVID-19 patients suffered from dry mouth. Different stats might suggests the rapidly evolving virus with new symptoms.

The symptoms of dry mouth may occur 3-4 days before the onset of other symptoms or 1-2 days after the symptoms and could range from moderate to severe in intensity. 

Most people feel improvement in symptoms of dry mouth after the initiation of COVID-19 treatment, with complete resolution of symptoms within 7-15 days in most cases. 

Occasionally, dry mouth occurs secondary to nasal congestion, a symptom of COVID-19. An obstruction in the nasal passage disrupts nasal breathing and allows you to breathe from the mouth, resulting in dry mouth. Moreover, stress is a well-documented cause of dry mouth, and increased stress levels in hospitalized COVID-19 patients can also provoke dry mouth.

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How does COVID-related dry mouth happen?

The spike protein on SARS-COV-2 virus has a high affinity for ACE-2 receptors and infects cells that express ACE-2 receptors on their surface. ACE-2 receptors are distributed widely throughout the body. They are present in blood vessels, heart, kidneys and gut, salivary glands, and taste buds. Due to abundant ACE-2 receptors throughout the body and the spike’s protein affinity for ACE-2 receptor cells, we see wide variation of COVID-19 symptoms.  

Salivary glands and taste buds on the tongue have a ton of ACE-2 receptors and, therefore, become the primary target of the SARS-CoV-2 virus, resulting in dry mouth and loss of taste. However, not all COVID patients develop a dry mouth and loss of taste, but these symptoms are likely to occur if you are infected with the SARS-CoV-2 virus. 

Another theory postulates that SARS-CoV-2 enters the spinal cord and brain through the nerves and attacks the autonomic nervous system that controls the secretion of salivary glands. 

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How do you know if dry mouth is due to COVID-19?

It’s challenging to determine COVID-related dry mouth as dry mouth can have various causes. First, you must check your lifestyle; if you have started taking a new medicine in the past few weeks, you’re under stress or lately dehydrated. However, if you experience dry mouth and other symptoms commonly associated with COVID-19, it may warrant further evaluation for COVID-19.

If you experience symptoms of dry mouth and other COVID-19 symptoms, isolate yourself and get tested for COVID-19. You can get one of the following tests:

COVID-19 rapid antigen test (RAT)

You can get RAT from a nearby pharmacy. Follow the instructions given on the kit and check the results. If the test is positive, consult your GP and follow the COVID-19 guidelines. If the result is negative, repeat the test after 24-48 hours if you feel under the weather or develop other COVID-19 symptoms. False negatives can also occur in asymptomatic cases or later phases of infection.

PCR test

If you have symptoms of COVID-19, you can ask your GP or nurse to request one for you, but they are now reserved for severe COVID-19 patients, pregnant and geriatric patients.  

Consult your GP

Isolate yourself at home and take an online appointment with your GP. Speak with your GP about all your symptoms and get a prescription. Discuss about dry mouth if you have any concerns about it. 

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How to treat COVID-related dry mouth?

COVID-19-related dry mouth is self-limiting and resolves within 15 days after COVID-19 treatment without any long-term consequences. You can get symptomatic treatment if it’s bothering you. In many cases, no treatment is required, and normal salivation returns within 2-3 days after initiation of the treatment. 

The following tips can help you with dry mouth: 

Drink plenty of water 

Drink 2-3 liters of water daily to keep yourself hydrated. Keep a glass of water at your bedside and take 1-2 sips every 15-20 minutes or whenever you feel like. Frequent sipping can help combat dryness and prevent oral ulcers, tooth decay, and gum disease. 

Foods you need to eat

Omega 3 fatty acids are beneficial for dry mouth. Eat flax seeds, chia seeds and fatty fish such as samon, makerel, kippers, sardines and caviar.

Vitamin D intake

Low vitamin D is associated with risk of COVID-19, increased inflammation, clotting in blood vessels and dry mouth. Vitamin D deficiency is more common in obese and diabetic patient. Vitamin D supplementation decreases the severity of infection and hospitalization. 15-20 minutes sun exposure during mid-day or mid-afternoon also help in vitamin D formation. It’s recommended to take 5000IU of vitamin D daily for two weeks to reduce the severity of COVID-19 and symptoms of dry mouth.

Vitamin E application

Vitamin E scavenges free radicals and reduces inflammation. You can also apply vitamin E on the painful, dry and inflamed areas in the mouth. Use them 2-3 times a day. The thick oil lubricates the inflamed mucosa from abrassion and stays in place for a relatively longer time.

Zinc supplementation

Zinc is an essential mineral that activates various enzymes and proteins that catalyze different reactions in the body. It also helps absorb vitamins A, E, and folic acid. Zinc deficiency increases the risk of infection and degenerative diseases. The recommended daily allowance (RDA) of zinc is 11mg for men and 8 mg for women.

It is distributed in varying concentrations in different body organs, i.e., 60% in muscles, 30% in bones, and 10% in skin, hair, kidneys, and plasma. If zinc deficient, you are more likely to get viral infections. Several studies show that zinc supplementation reduces viral replication, boosts immunity, and helps in faster recovery when given during the COVID-19 infection. 

It is recommended to take 50mg Zinc supplementation for ten days to improve salivary gland function and early recovery from COVID-19 symptoms.

Foods you need to avoid 

Saliva creates a protective coating on the teeth, gums, and other tissues in the mouth. A dry mouth makes you more prone to oral ulceration and gum disease. Steer away from foods that can irritate and injure your gums, such as spicy, acidic foods and hard, crunchy foods. Also, avoid smoking, alcohol, and caffeine as they cause dehydration and can worsen the symptoms of dry mouth. 

Maintain good Oral Hygiene

Reduced salivary flow decreases bacterial clearance from the mouth, leading to bad breath, tooth decay, and gum disease, and strict oral hygiene maintenance can save your teeth and gums from these problems.

Brush your teeth twice daily with an extra-soft bristles toothbrush and fluoride toothpaste. Floss daily to remove plaque and debris from between the teeth. Rinse your mouth after every meal. Avoid snacking. You can rinse your mouth with antibacterial mouthwash between meals. 

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Use air Humidifier 

Dry indoor air can also aggravate symptoms of dry mouth, especially during cold weather or inside air-conditioned rooms. Use an air humidifier in your room, especially during sleep. If you don’t have a humidifier, place some water in a wide-open container. Water evaporated from the container will keep the room humid. 

Open the window for at least 1-2 hours in the early morning and evening to ensure proper ventilation in the rooms. Practice deep breathing or meditate in the open air during the early hours of the day. These exercises relieve stress and oxygenate your lungs with fresh, unpolluted air. 

Chew Sugar-Free Gum

Sugar-free chewing gum containing phosphopeptide-amorphous calcium phosphate (CCP-ACP) and xylitol stimulates saliva production and temporarily relieves dry mouth. Xylitol is a non-fermentable carbohydrate not metabolized by gum and tooth decay-causing bacteria. Chewing CCP-ACP gums increases the growth of good bacteria that promote an optimal alkaline environment in the mouth.  

Use artificial Saliva

Don’t use saliva substitutes until necessary. First, try home remedies. Over-the-counter biotene saliva substitutes are available in oral rinse spray, and lozenge forms and help forms a protective layer akin to saliva. You can use them several times a day.

Oil pulling

Oil pulling is an ayurveda technique and has been used for centuries. It improves gum health, removes toxins, reduces inflammation, relieves the symptoms of dry mouth, removes malodor, and has many other benefits.

Take one tablespoon of any plant oil (avoid hydrogenated oils), such as sesame oil, extra-virgin olive oil, or coconut oil. The best results are obtained with coconut and olive oil. Swish it around the mouth for 15-20 min and spit it out. It pulls all the toxins from the mouth, lubricates, and freshens your breath. 

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