Their teeth fell out. Was it another consequence of COVID-19?

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Earlier this month, Farah Khemili put a winter green breath in her mouth and noticed a strange sensation: a lower tooth waving against her tongue. Khemili, 43, of Voorheesville, New York, had never lost an adult tooth. He touched the tooth to confirm it was loose, initially thinking the problem may be the tick. The next day, the tooth flew out of her mouth and into her hand. There was neither blood nor pain. Khemili survived an encounter with COVID-19 this spring and joined an online support group as she endured a range of symptoms experienced by many other “long haulers”: brain fog, muscle aches, and nerve pains. There is still no rigorous evidence that the infection can lead to tooth loss or related problems. But among the members of his support group, he found others who also described tooth loss, as well as sensitive gums and teeth turning gray or chipped. She and other survivors unnerved by COVID’s well-documented effects on the circulatory system, as well as symptoms such as swollen fingers and hair loss, also suspect a connection with tooth loss. But some dentists, citing the lack of data, are skeptical that COVID-19 alone can cause dental symptoms. “It is extremely rare for teeth to literally fall out of their sockets,” said Dr. David Okano, a periodontist at the University of Utah in Salt Lake City. But existing dental problems can worsen from COVID-19, he added, especially when patients recover from acute infections and struggle with its long-term effects. And some experts say doctors and dentists need to be open to such possibilities, especially since more than 47% of adults aged 30 and over have some form of periodontal disease, including infections and inflammation of the gums and bones surrounding the teeth, according to a 2012 report from the Centers for Disease Control and Prevention. “We are now beginning to examine some of the bewildering and sometimes disabling symptoms that patients suffer months after recovering from COVID,” including these reports of dental problems and tooth loss, said Dr. William W. Li, president and chief physician of the company. Angiogenesis Foundation, a non-profit organization that studies blood vessel health and disease. While Khemili had become more diligent about her dental care, she had a history of dental problems before contracting the coronavirus. When she went to the dentist the day after her tooth came out, she found that her gums weren’t infected but she had significant bone loss from smoking. He referred Khemili to a specialist to take care of a reconstruction. The dental procedure is likely to cost you just under $ 50,000. The same day Khemili’s tooth fell out, her partner went to Survivor Corp, a Facebook page for people who have experienced COVID-19. There, he found out that Diana Berrent, the page’s founder, was reporting that her 12-year-old son had lost one of his adult teeth, months after he had a mild case of COVID-19. (Unlike Khemili, Berrent’s son had normal, healthy teeth with no underlying disease, according to his orthodontist.) Others in the Facebook group wrote about teeth falling out without bleeding. A woman lost a tooth while eating ice cream. Eileen Luciano of Edison, New Jersey had an upper molar in early November when she was flossing. “That was the last thing I thought would happen, that my teeth would fall out,” said Luciano. Teeth falling out without blood is unusual, Li said, and provides a clue that there may be something going on with the blood vessels in the gums. The new coronavirus wreaks havoc by binding to the ACE2 protein, which is ubiquitous in the human body. It is not only found in the lungs, but also in nerve and endothelial cells. Therefore, Li said, it is possible that the virus has damaged the blood vessels that keep teeth alive in COVID-19 survivors; this may also explain why those who have lost their teeth feel no pain. It is also possible that the widespread immune response, known as a cytokine storm, may manifest in the mouth. “If the reaction of a long COVID transporter is in the mouth, it is a defense mechanism against the virus,” said Dr. Michael Scherer, a dental technician in Sonora, California. Other inflammatory health conditions, such as cardiovascular disease and diabetes, he said, are also related to gum disease in the same patients. “Gum disease is very sensitive to hyperinflammatory reactions, and long-range COVID transporters certainly fall into that category,” Scherer said. Dentists haven’t seen many of these cases, and some dismiss these individual claims. But doctors like Li say the surprises of COVID-19 require the profession to be on the lookout for unexpected consequences of the disease. “Patients could bring new discoveries,” he said, and doctors and dentists need to work together to understand the long-term effects of COVID-19 on teeth. For now, Khemili hopes her story can serve as a warning. If people aren’t taking the proper precautions to protect themselves from the coronavirus, “they might be looking at something like this.”

© 2019 New York Times News Service