COVID Tongue & Mouth Sores

COVID Tongue & Mouth Sores
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COVID Tongue & Mouth SoresClinical Content Reviewed by Dr. Jay Khorsandi, DDS
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Table of Contents

  1. What Is COVID Tongue?
  2. Symptoms
  3. Causes of COVID Tongue
  4. Causes of Mouth Sores
  5. How Common Is It?
  6. Treatment
  7. How Long Does It Last?
  8. Outlook
  9. Frequently Asked Questions
  10. References

COVID tongue is a condition that causes the tongue to swell, turn white or grow small bumps on the surface. About 11 percent of people who get COVID-19 experience tongue-related symptoms, but only 1 in 500 of them are diagnosed with COVID tongue.

Not all of the symptoms can be traced directly back to the coronavirus.

Much more research and study of COVID tongue is needed, experts say.

What Is COVID Tongue?

COVID tongue is a painful condition that causes the tongue to swell, turn white or grow small bumps on the surface. It may be accompanied by other oral issues like ulcers and a burning sensation in the mouth. In a study of 666 COVID-19 patients, 78 (11 percent) experienced these symptoms.

COVID tongue and mouth sores can be treated using antibacterial and antifungal medications and mouth rinses.
In rare cases, the condition can adversely impact your oral health and overall health.

Symptoms

Some common symptoms of COVID tongue include:

  • Macroglossia (a condition that causes your tongue to swell and stiffen)
  • Mouth ulcers
  • Indentations on the side of the tongue
  • A sore tongue
  • White tongue
  • Geographic tongue (red patches with white or colored borders on the tongue)

These mouth and tongue issues are also symptoms of many other oral health conditions. If you suspect that your case may be related to COVID-19, see your doctor for confirmation.

What Causes COVID Tongue?

The exact cause of COVID tongue is unknown, though it is likely related to the COVID-19 coronavirus. Scientists believe that the heavy concentration of ACE receptors (proteins that can easily host the virus) in the tongue makes symptoms like tongue swelling and lesions more likely. Further study is needed to confirm the association.

What Causes Mouth Sores?

Oral symptoms like ulcers and lesions are not a direct consequence of a COVID-19 infection. Instead, opportunistic diseases, or secondary diseases, may trigger these effects, taking advantage of your lower immunity.

COVID-19 can compromise your body’s defense against bacterial and fungal infections as it progresses. Some COVID treatment plans can have this effect, too.

For example, immune system deterioration can reactivate the common herpes simplex virus in the body. This viral infection may then trigger many oral problems, including ulcers in the mouth and on the lips.

Lifestyle factors also may play a role.

Lifestyle Factors

Lifestyle factors that are associated with an increased risk of developing COVID tongue include:

  • Excessive work stress
  • Chronic anxiety
  • Few or no recent dental office visits
  • Poor oral hygiene

How Common Is COVID Tongue?

Your risk of developing COVID tongue or mouth sores is low. According to one expert’s estimate, less than 1 in every 500 COVID patients experiences these symptoms.

In another study of hospitalized individuals with the virus:

  • 11 percent had tiny, inflamed bumps on their tongue
  • 6 percent had a swollen tongue with grooves on the side
  • 6 percent had mouth ulcers
  • 4 percent had swelling elsewhere in their mouth
  • 4 percent had patches on their tongue

Treatment

If you experience any mouth or tongue complications with the coronavirus, see a dentist. Among the treatment options are:

  • Antibacterial mouth rinses or antifungal medications for tongue lesions
  • Oral valaciclovir (an antiviral drug used to control herpes infection) for lip and mouth sores
  • Anti-inflammatory steroids, bite blocks or surgery (in severe cases) for macroglossia

If your condition does not improve with treatment, you may be referred to a specialist.

How Long Does COVID Tongue Last?

While each patient responds differently to treatment, COVID tongue and mouth sores should disappear in three to 21 days. You can accelerate your recovery by practicing good oral hygiene and following your doctor’s treatment instructions carefully.

Outlook

COVID-19 symptoms like COVID tongue and mouth ulcers are generally manageable, even in patients who develop more severe complications in other parts of the body. Geographic tongue usually goes away without treatment.

The lack of a clear link between COVID-19 and some of these rare oral issues can make these cases difficult to treat. If your COVID tongue and oral symptoms do not resolve, your doctor will monitor your condition and attempt different types of treatment as more information becomes available.

Frequently Asked Questions

What are symptoms of COVID in the mouth?

A small fraction of people who have COVID-19 develop oral symptoms like: 

  • Tongue pain
  • Swelling
  • Tongue discoloration
  • Lesions in the mouth, on the tongue and on the lips
  • Small bumps on the surface of the tongue
Does COVID-19 trigger a rash in the mouth?
In rare cases, painful lesions develop in the mouth and on the tongue of people with COVID-19. However, it’s not clear whether these issues are caused by COVID-19 or by other factors.
Is a white coating on the tongue a symptom of COVID?
White tongue (also called candidiasis or oral thrush) is a fungal infection. The condition can be caused by many different factors, including COVID-19. Having a white coated tongue does not necessarily mean that you also have COVID-19.

References

Symptoms of COVID-19. (February 2022). Centers for Disease Control and Prevention (CDC).

Are Oral Mucosal Changes a Sign of COVID-19? A Cross-Sectional Study at a Field Hospital. (August 2021). British Journal of Dermatology.

Trio of Organizations Agree More Research Needed on Covid-19’s Effect on Oral Health. (February 2021). American Dental Association.

The Oral Complications of COVID-19. (January 2022). Frontiers in Molecular Biology.

'Covid Tongue' May be Another Coronavirus Symptom, British Researcher Suggests. (January 2021). NBCNews.

Oral Manifestations of COVID-19 in Hospitalized Patients: a Systematic Review. (2021 December). International Journal of Environmental Research and Public Health.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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