Like “maskne” or zits around the mouth, “mask mouth” is an unpleasant condition of having stinky breath caused by prolonged wearing of masks.

“My breath smells like fart,” Chloe Cruz (not her real name) said. “I’ve always thought it was my ex-boyfriend who had bad breath because he also did not believe in deodorants, citing chemicals, but it took a pandemic—and lots of masks—to realize that maybe it was me.”

Cruz, a 38-year-old media practitioner, is part of her company’s skeleton staff that is required to wear a medical mask and face shield during work hours—nine hours, five days a week.

“It is worse than the metallic mouth I had when I was doing keto,” said Cruz, pertaining to the high fat-low carb ketogenic diet that advocates credit for dramatic weight loss. “My tongue feels thick and my inner cheeks are sticky. You know when you eat ice cream and it leaves a film around the mouth? That, but gross.”

Cruz admitted that while she practices daily dental hygiene, she is overdue for professional dental cleaning, and once, a dentist asked during a routine exam if she had “milk”—a polite way of telling her that she had sour breath.

“A tooth that had fillings also chipped during the lockdown exposing small cavities, and my trusted clinic is still closed because my dentist is a senior. My temporary solution is diligently gargling with antiseptic mouthwash.”

Unfortunately, Cruz’s mouthwash has alcohol (second on the ingredients list!) which causes xerostomia or dryness of the mouth, according to Dr. Jonas John S. Apostol of Apostol Dental Cosmetic Center.

To avoid mask mouth, Apostol recommended keeping a “top-notch oral home care routine,” which includes gargling with alcohol-free mouthwash, flossing, taking vitamin C and chewing gum with xylitol and sorbitol that has “sugar alcohol which stimulates saliva” and does not cause cavities.

And just as important as proper hand washing is proper brushing: Brush the teeth, tongue and inner cheeks with a soft-bristled toothbrush for two minutes, at least twice a day.

“People wearing masks for long periods breathe through their mouths, causing dryness that leads to bacteria buildup, then bad breath,” Apostol explained. The mask also prevents the habit of wetting the lips and playing with the tongue that kept the saliva going.

Apostol’s colleague and gum specialist Dr. Janin Villa Abrille-Lim added that bacteria can also bring gingivitis and periodontitis or the “inflammation of soft tissue and bone that support the teeth.”

Too thirsty

Masks are uncomfortable but necessary, and Cruz complained of being thirsty all the time while wearing them: “I manage to keep my breath OK at home, but it’s extra effort during extended shifts. My mouth and lips get so dry that it kinda felt the same when I had mumps and was painfully parched.”Dehydration is another cause of mask mouth.

For this, Dr. Abey Yongoyong Gordon prescribed plenty of water, around eight to 12 glasses per day. Eating high-fiber food can help, too. As for the mask mouth, she said the viscous saliva also sticks to the mask, developing bacteria. Health issues such as chronic sinusitis and gastric problems likewise lead to bad breath.

Food is a lockdown comfort, but it can cause offensive odor. Apostol lists those with onions, and are “spicy, garlicky, sugary, even starchy can contribute to dental plaque that doesn’t just cause unpleasant breath but also gum bleeding if left untreated.”

Apostol assured that people like Cruz should not be ashamed of consulting the dentist.

“Unpleasant breath was a common concern even before the pandemic,” Apostol said. “We do clinical and radiographic assessment and take note of all the issues present in their mouth, and give them a treatment plan.”

How about those who are still scared of going out?

Apostol said that “dentists, assistants and patients are required to wear full personal protective equipment,” on top of updating the clinic with “medical-grade equipment such as air purifiers with hepa filter, intraoral and extraoral evacuator machines, autoclave machines, UVC disinfection machines, fogging machines and chemical disinfectants.” His clinic also does triaging, and limits the numbers of patients per day.

Gordon, meanwhile, canceled waiting rooms, and had patients come alone and wait outside in their cars.

As for Cruz, she is super cautious with overall freshness even if she’s the only person smelling her breath under her face shield.

“I’m looking for another dentist covered by my health insurance,” she said. “Smelling awful is not a quarantine trend I’m jumping into.” INQApostol Dental Cosmetic Center: Medical Towers Makati, Legaspi Village, Makati City; tel. 0917-8724929, 87765976; Abey Gordon Dental: Cityland Pioneer, Mandaluyong City; tel. 0917-8019993.