Dental and jaw discomfort is a recognized complaint among people experiencing COVID-19. This pain is usually a side effect of the systemic illness, not a sign of a new cavity or gum disease. The underlying mechanisms—including sinus pressure, nerve irritation, and physical stress—explain why a respiratory virus can cause pain seemingly located in the teeth. This article details how the body’s response to the infection translates into a toothache sensation.
Referred Pain Originating in the Sinuses
One of the most common physical explanations for tooth pain during a COVID-19 infection involves the sinuses. The maxillary sinuses are two large air-filled cavities located directly above the upper jawbone. The roots of the upper back teeth, particularly the molars and premolars, often extend very close to the floor of these sinuses.
A typical respiratory viral infection, including COVID-19, causes inflammation and congestion within the nasal and sinus passages. This swelling leads to a buildup of mucus and pressure inside the maxillary sinuses. This pressure presses down onto the sensitive nerve endings that are intertwined with the nerves of the adjacent upper teeth.
This phenomenon is known as referred pain, where the brain interprets a pain signal originating in the sinus as coming from the teeth. A key indicator that the pain is sinus-related is that it tends to affect multiple upper teeth on one or both sides of the face. The discomfort may also be accompanied by facial tenderness, nasal congestion, or a feeling of pressure that worsens when bending over.
Systemic Inflammation and Nerve Response
Beyond physical pressure, the body’s generalized immune reaction to the SARS-CoV-2 virus can directly contribute to dental pain. The viral infection triggers a widespread inflammatory state, characterized by the release of immune signaling molecules called cytokines. This surge of systemic inflammation increases the sensitivity of nerves throughout the body, including the trigeminal nerve, which controls sensation in the face and teeth.
When the trigeminal nerve is irritated, the dental pulp—the soft tissue inside the tooth containing nerves and blood vessels—can become hyper-responsive, leading to a condition similar to pulpitis. This heightened nerve sensitivity can cause pain that feels sharp, pulsating, or electrical-shock-like, even in teeth that are otherwise healthy. This inflammatory state can also exacerbate minor, pre-existing dental problems, such as decay or hairline cracks, turning previously asymptomatic issues into sources of noticeable discomfort.
The virus may also indirectly affect the teeth by causing inflammation and clotting issues in the small blood vessels that supply the gums and dental structures. Reduced blood flow to these areas contributes to discomfort and sensitivity. This biological mechanism provides a distinct explanation for pain that is not localized to the upper jaw and may affect lower teeth as well.
Physical Stressors: Clenching and Grinding
The physical and psychological toll of being ill can manifest as involuntary muscle activity that causes significant dental and jaw pain. Illness-related stress, anxiety, and general discomfort often trigger bruxism, the subconscious habit of clenching or grinding the teeth. Dentists have reported a substantial increase in this behavior, sometimes referred to as “COVID clenching,” during and after the pandemic.
Sustained clenching places immense force on the teeth, jaw joints, and surrounding muscles. This constant pressure can lead to muscle fatigue and pain that radiates into the ears, head, and neck, mimicking the symptoms of a temporomandibular joint (TMJ) disorder. The excessive force can also cause teeth to become sensitive, chipped, or fractured.
This mechanical strain is often amplified at night, leading to morning jaw soreness and headache upon waking. The physical stress from grinding can also wear down the protective enamel layer of the teeth, leading to increased sensitivity to temperature changes and further discomfort.
When to Seek Professional Dental Care
While many COVID-related toothaches resolve as the infection subsides, certain symptoms suggest the need for immediate professional evaluation. You should contact a dentist if the pain is severe, intolerable, or prevents you from sleeping or functioning normally. Persistent pain that continues for more than a week after the other COVID symptoms have cleared also warrants an examination.
Warning Signs
Warning signs of a potential dental emergency include swelling in the jaw or face, a metallic taste suggesting a loose filling, or pain triggered by biting down hard on a single tooth.
Temporary Relief
For temporary relief while recovering, over-the-counter pain relievers and warm salt water rinses can help reduce inflammation. Applying a cold compress to the outside of the cheek may also soothe a sore jaw joint.