Abstract
Patients: We present the case of a 36-year-old woman at 29 weeks of gestation. She had contracted coronavirus disease 2019 （COVID-19） twice: once before the pregnancy, where the only symptom was a severe headache, and then at 25 weeks of gestation. After the second infection, she experienced a new onset of facial pain and clenching that exacerbated her pre-existing headache and gingival pain. Before the second infection, the gingival pain area was localized to the anterior teeth in the maxilla. Afterward, it expanded to the anterior teeth in the mandible. Moreover, the headache and gingival pain were worse than those she experienced before she fell pregnant. After delivery, she used a night guard to prevent clenching. She was followed up for 7 months postpartum, during which her headache and gingival pain ceased from months 1 to 3. Her chief complaint of clenching and gingival pain disappeared at 7 months postpartum, but her headache and fatigue persisted.
Discussion: The pre-existing headache was believed to be a combination of migraine and tension-type headache, and the gingival pain was possibly related to tension-type headache and myofascial toothache. Exacerbation of pre-existing symptoms after COVID-19 was considered due to a weakened antiviral immune system during pregnancy and differences between the COVID-19 delta and omicron variants.
Conclusions: COVID-19 infection during pregnancy exacerbated pre-existing symptoms in our patient. Thus, pregnant women should take care and avoid viral infections. Furthermore, if a patient experiences various orofacial pains, multiple symptoms may be involved. Therefore, dentists should suspect odontogenic and nonodontogenic toothache and carefully monitor the patient’s progress.
