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Dentists see pandemic stress in patients with more grinding, cracked, broken teeth

Pressures of the pandemic causing more people to involuntarily clench their jaws and grind teeth
A dentist works on a patient on Monday, July 26, 2021, in San Juan, Texas. THE CANADIAN PRESS/AP-Joel Martinez/The Monitor via AP

Stress and anxiety connected to the ongoing COVID-19 pandemic is revealing itself in people’s mouths, say dentists who report increasing cases of patients with cracked, broken and damaged teeth over the past 20 months.

Bruce Ward, a Vancouver-area, dentist, said he’s noticing the pressures of the pandemic are causing more people to involuntarily clench their jaws and grind their teeth with extreme amounts of force while sleeping.

“It’s like two pieces of ivory rubbing together,” said Ward, describing the grinding sound often first noticed by others.

Signs of teeth grinding are an aching jaw in the morning, headache and sore teeth, but sometimes it’s much worse, he said.

“I pulled two teeth (recently) that were split right up the middle and right across the bottom of the tooth and right out the other side,” said Ward, about the patient’s teeth that were weakened by grinding.

Ward, a past president of the British Columbia Dental Association, said he has been participating in Zoom meetings with colleagues who say they are seeing more damaged teeth lately as a result of grinding, a condition known as bruxism.

“Particularly, during the last year-and-a-half it’s been a huge uptick all across our business,” he said.

Teeth grinding and jaw clenching are usually related to stress and stress levels for people have increased during the pandemic, Ward said.

Teeth are designed to withstand chewing pressure, but involuntary grinding increases the function dramatically, to the point where teeth can crack, chip or loosen, he said.

“It’s very harmful to your joints and also it really stresses your muscles,” Ward said. “It also stresses your teeth. It’s huge, the force on your teeth.”

Dentists usually recommend patients start to use a special mouthpiece at night to protect their teeth and take measures to reduce stress in their lives.

“A lot of people say to me, ‘How can I stop it?,’” Ward said. “And I go, ‘Move to Fiji, sell everything you’ve got and lay on the beach all day.’“

Nirmala Raniga, a Vancouver addictions and mental health counsellor, said the pandemic has placed extra stress on people and it can show itself in many different forms and places, including peoples’ mouths.

“Stress causes problems in your mouth where at night you can be clenching, grinding and that causes headaches, migraines,” she said. “It causes fractures in your teeth and fillings.”

Raniga said teeth grinding and clenching at night and sleep talking are signs of the body’s attempts to address emotional issues.

“It is a way of releasing stress,” she said. “Your body is releasing stress by grinding, so the idea is how do you release your stress by working through these painful memories.”

The Canadian Dental Association said evidence of increases in teeth grinding issues during the pandemic is anecdotal but delaying oral health care can lead to health problems.

“The COVID-19 pandemic has affected the lives of many, and has likely interrupted individuals’ good habits and daily routines,” said Dr. Aaron Burry, the association’s deputy CEO of professional affairs in a statement.

“More frequent snacking, consuming more sugary foods and beverages, not keeping up with regular dental visits, and not keeping up with regular brushing and flossing can lead to consequences,’ he said.

The dental association cited a March 2021 American Dental Association Health Policy Institute report where more than 70 per cent of dentists surveyed said they were seeing increases in patients who were teeth grinding and clenching, conditions associated with stress.

The not-for-profit association represents 163,000 dentist members and is the largest dental association in the United States.

McGill University published research last April that concluded good oral health reduced risks of death from COVID-19.

The researchers reported that COVID-19 patients with gum disease were 3.5 times more likely to end up in an intensive care units, 4.5 times more likely to require a ventilator, and almost nine times more likely to die compared with those without gum disease.

The Canadian Dental Association website suggests consulting with a dentist about bruxism and relaxation techniques to use during the day and before bedtime.

“Practice stress-reducing activities, such as staying physically active, yoga and meditation, deep breathing exercises, massage therapy, listening to music and or taking a bath,” says the website.

A nutritious diet and limits on caffeine and alcohol are also suggested as ways to reduce stress and ease teeth grinding, says the association.

Dirk Meissner, The Canadian Press