What Is Lyme Disease?

Lyme disease is spread by blacklegged ticks that carry the Borrelia burgdorferi bacteria. When bitten, the insects transfer what are called spirochetes. This can result in a bull’s eye rash, a raised or flat bump, a liquid-filled sac, or necrosis at the site of the bite.

Although the spirochetes themselves generally don’t cause direct harm, the host may have an aggressive response to their presence, which often comes with widespread inflammation.

Why Lyme Disease Is Significant

Lyme disease has been a nationwide notifiable disease since 1991. Consequently, the Centers for Disease Control and Prevention (CDC) has collected substantial nationwide data related to borreliosis cases.

As a result, recent statistics show that about 476,000 people are diagnosed and treated annually for this infection in the U.S. This figure also includes those who are treated based on suspected Lyme infections.

It’s important to note that Lyme infections tend to increase in the warmer months (fall and spring), which places more people at risk of contracting B. Burgdorferi infections. Experts further claim that Lyme disease cases are rising across the country, with suspected cases being much higher than those reported.

General Clinical Manifestation Phases

Borreliosis symptoms generally appear within three to 30 days after the initial tick bite and go through three phases:

• Early localized phase
• Early disseminated phase
• Late persistent phase

If diagnosed early, the patient can receive successful treatment to resolve the symptoms. However, symptoms may persist or be stubborn to treat no matter what the stage of the disease. Many patients experience reoccurring symptoms or are subject to new infections following recovery and some never recover. Still, early diagnosis and treatment frequently leads to full recovery.

Early Localized Phase

Most but not all people will have the well-known bull’s eye rash after being bitten by a tick infected with Lyme disease. This typical bulls-eye rash is due to a target lesion with a central papule (small, raised area of about 3/8 inch) at the center of a growing circle of inflammation.

However, victims may notice a papule with little or no surrounding inflammation or a macule (flat) bite mark that is warm around the edges. Other evidence of bites include a vesicle (a fluid filled sac) or a bite area with a necrotic center because the surface tissue in the area is dying.

Without treatment, localized inflammation can spread up to 12 inches and remain for days or weeks.

Early symptoms during this stage include:

• High temperature
• Stiff neck
• Swollen glands
• Conjunctivitis
• Joint pain
• Fatigue
• Problems focusing
• Light sensitivity

Early Disseminated Phase

The burgdorferi spirochete can spread into the bloodstream and settle in various areas of the body within weeks or months after the initial infection. When this happens, the victim may notice several small rashes in circular formations on the body. These lesions are generally smaller in diameter than the first bulls’ eye rash if this was present at all.

Symptoms in this stage are more severe and can include:

• Lyme carditis (light-headed arduous breathing chest pains palpitations fainting)
• Facial nerve palsy
• Acute lymphocytic meningitis
• Neck stiffness
• Myalgia
• Radiating, burning, and shooting pain on the skin
• Moving pain in the bone, joint, and muscle
• Fatigue
• Iris and optic nerve inflammation or damage

Late Persistent Phase

Post Treatment Lyme Disease Syndrome (PTLDS) is the third phase, which occurs within months or years after the initial infection. This phase can include the following symptoms:

• Nerve damage
• Muscle weakness
• Arthritis and similar joint and bone problems
• Inflammation of the tendons
• TMJ pain
• Widespread nervous system damage
• Brain inflammation

An overlap of physical symptoms occurs across the last two phases, often leading to misdiagnosis. Because LD mimics other physical diseases, it is essential to find a dentist who is knowledgeable about Lyme disease and its presence in the mouth and facial area.

Orofacial Symptoms

Orofacial symptoms occur in the face, mouth and general head area and are of specific concern to dentists. Some of these symptoms involve temporomandibular disorders (TMDs). These disorders frequently involve pain in jaw bones and problems with the muscles that affect opening and closing the mouth.

With Lyme disease, many people can experience pain in the face and teeth and even facial nerve palsy. Unexplained burning or tingling sensations, and an altered sense of taste or dry mouth (xerostomia) are other common issues that patients exhibit.

Further orofacial symptoms include headaches, peripheral neuropathy involving tingling or pain in the lips, tongue, and face, and acute parotitis. Inflammation, obstructions in ducts, and infectious organisms are often behind the development of acute parotitis. Additionally, patients report having headaches, elevated temperatures, and facial swelling with acute parotitis.

Patients may present with halitosis (bad breath), despite excellent oral hygiene. Sensitive teeth, pulpitis (dental pulp inflammation) and acidic oral pH are further typical dental symptoms linked with Lyme disease.

Dental Link to Lyme Disease

Lyme disease can be exacerbated by root canals and dental extractions, often living in the teeth rather than the enamel. Similarly, this disease appears to flourish in the dentin and tiny tubules of the teeth which can extend to three miles, giving these organisms plenty of space to multiply and spread. As such, the Borrelia burgdorferi bacteria and related organisms pose a unique threat to dentistry patients before and after root canals or tooth extractions.

Because of this threat, it is vital that anyone with Lyme disease or who suspects they have contracted this disease consult an experienced dentist. Likewise, it is important that they consult with dentists who are familiar with non-traditional or green dentistry methods. These methods are often preferred over mainstream medical or dental treatments as they place less stress on patients’ immune systems.

READ: The Oral Complications of Lyme Disease

How Green Dentistry Approaches Lyme Disease

If you or we suspect that you have Lyme disease, we may recommend a serological test. The first test seeks to identify B. burgdorferi antibodies with a sensitive enzyme immunoassay (EIA) or an immunofluorescent assay (IFA). If these results are negative, no further tests are required.

If the test is positive, a western immunoblot essay test follows. This test is administered to determine the presence of Immunoglobulin G (IgG) and Immunoglobin M (IgM) antibodies indicating the presence of B. burgdorferi.

Alternatively, a second EIA can be done. It is often necessary to do a second test as these organisms can go undetected for two to six weeks after exposure and stay in the bloodstream after treatment, producing false-positive test results, which affects diagnosis and treatment.

Depending on the results, we will tailor our treatment to meet your needs. This might mean undergoing a microbiome test, ozone therapy, laser dentistry or something else as part of an overall solution for your condition.

LISTEN: Dr. Patel talks about using ozone therapy to treat Lyme disease

Book Your Appointment Today

Do you have a Lyme disease diagnosis or suspect you may be struggling with symptoms related to Lyme disease? Dr. Patel and her team at Green Dentistry can help you get concrete answers and start effective therapies, so you can feel better faster. Call today at (415) 918-6783 to schedule.

What Our Green Dentistry Patients Say About Us

“Dr. Patel has been my dentist for over 15 years and there is no one I trust more with my teeth. What I like most is that she leans towards preventative care. I had so many dental issues before coming to her, and she has systematically and thoroughly addressed them all with professionalism and care. If you are looking for a long term dentist, I highly recommend Dr. Patel.” – Caroline B., March 2025

“Dr. Patel is AMAZING! I have never been to such a kind, warm dentist or medical practice. Dr. Patel and her staff genuinely care so deeply about their patients’ longevity and overall health. Who knew the dentist could feel like a spa and improve your entire wellbeing! I have gained so many insights from my first couple of visits about my sleep quality, TMJ, and oral microbiome health.” – Stella, March 2025

“First time seeing a dentist in 10 years and I couldn’t be happier! I come from a holistic health background and it was imperative to find a dentist who understood the whole body impact of dental health. Laser treatments, DNA testing, bacteria testing, and so many others. Whole experience from start to finish left me feeling well informed and well cared for. 10/10 would recommend it!” – Maya M., February 2025

“This office is a godsend. Beyond amazing staff, beyond kind! Dr. Patel is the BEST dentist in the country. It is definitely more expensive than other practices, but this is NOT a regular office. She is at the forefront of dental technology, she is caring, her staff is caring. Seriously, I cannot say enough good things.” – Jenn C., January 2025

References

1. Gwenn L. Skar; Kari A. Simonsen. Lyme Disease. National Library of Medicine. 2024, September 1.
2. G M Heir, L A Fein. Lyme Disease: Considerations for Dentistry. National Library of Medicine. 1996 Winter;10(1):74-86.
3. Isabel Mello, DDS, MSc, PhD, FRCD(C). Dentistry and Lyme Disease: What We Currently Know Based on the Available Evidence. European Society of Medicine. 2024, May 21.
4. Sharmila Baliga, Sangeeta Muglia, and Rahul Kale. Salivary pH: A Diagnostic Biomarker. National Library of Medicine. 2013 Jul-Aug; 17(4): 461–465.
5. Saudi J Anapest. Exacerbation of Chronic Pain After Dental Extractions in a Patient With Post-Treatment Lyme Disease Syndrome. National Library of Medicine. 2018 Jan-Mar; 12(1): 112–114.
6. Paul Mead, MD1; Jeannine Petersen, PhD1; Alison Hinckley, PhD. Updated CDC Recommendation for Serologic Diagnosis of Lyme Disease. CDC. 2019, August 16, / 68(32);703.