Earlier in November, Farah Khemili noticed a bottom tooth wiggling against her tongue.
Khemili, 43, of Voorheesville, N.Y., had never lost an adult tooth. The next day, the tooth flew out of her mouth and into her hand.
Khemili survived a bout with COVID-19 this spring, and has joined an online support group as she has endured a slew of symptoms experienced by many other “long haulers”: brain fog, muscle aches and nerve pain.
There’s no rigorous evidence yet that the infection can lead to tooth loss or related problems. But among members of her support group, she found others who also described teeth falling out, as well as sensitive gums and teeth turning gray or chipping.
She and other survivors unnerved by COVID’s well-documented effects on the circulatory system, as well as symptoms such as swollen toes and hair loss, suspect a connection to tooth loss as well. But some dentists, citing a lack of data, are skeptical that COVID-19 alone could cause dental symptoms. “It’s extremely rare that teeth will literally fall out of their sockets,” said Dr. David Okano, a periodontist at the University of Utah in Salt Lake City.
But COVID-19 may worsen existing dental problems, he said.
Some experts say that doctors and dentists need to be open to such possibilities, especially because more than 47% of adults 30 or older have some form of periodontal disease, including infections and inflammation of the gums and bone that surround teeth, the Centers for Disease Control and Prevention said.
“We are now beginning to examine some of the bewildering and sometimes disabling symptoms that patients are suffering months after they’ve recovered from COVID,” including these accounts of dental issues and teeth loss, said Dr. William W. Li, president and medical director of the Angiogenesis Foundation, a nonprofit that studies the health and disease of blood vessels.
The coronavirus wreaks havoc by binding to the ACE2 protein, which is found in the lungs and on nerve and endothelial cells. Therefore, Li said, it’s possible that the virus has damaged the blood vessels that keep the teeth alive. It’s also possible that a widespread immune response may be manifesting in the mouth.
“If a COVID long hauler’s reaction is in the mouth, it’s a defense mechanism against the virus,” said Dr. Michael Scherer, a prosthodontist in Sonora, Calif. “Gum disease is very sensitive to hyper-inflammatory reactions, and COVID long haulers certainly fall into that category.”