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When Kate Faith was released in March at the start of the coronavirus pandemic, her stress level skyrocketed. She was concerned that she could make ends meet as a single parent for her 1-year-old daughter and that her family and friends could contract the virus. The 37-year-old’s sleep worsened, and the added stress caused Faith’s long-standing habit of gritting her teeth and clenching her jaw to intensify.
“I’ve had to clench my jaw and keep grinding my teeth since college, but because I have a night watchman, I usually just work on it,” said Faith, who lives in south Philadelphia. “But it got worse in March. I never thought I’d do so much damage to my teeth.”
Dentists across the country say they have seen an increase in excessive teeth grinding or clenching known as bruxism since the pandemic began. Chronic tooth grinding wears down the tooth enamel, the outermost protective layer of the tooth, which in severe cases leads to tooth fractures or even the loss of teeth. It can also cause muscles around the jaw to sore.
Many dentists attribute the recent surge in bruxism to increased stress, which has been linked to bruxism in a number of studies, but not as a direct cause.
The increase came as no surprise to Thomas Sollecito, Chair of Oral Medicine at the University of Pennsylvania’s School of Dental Medicine.
“I would be surprised if there wasn’t a climb,” he said. “The stress and distress of events in the world will affect things like someone’s sleep and clenching and crunching. If we are constantly under that stress, the frequency and intensity of clenching and grinding will just stop.”
The most common thing people might notice when they excessively grind or clench their teeth is tension headaches, which can feel like dull pain or pressure on the forehead or the back of the head, Sollecito said. In particular, excessive use of muscles that close the jaw can cause temporary headaches that can be felt in the temples on the side of the head.
“People may also notice more discomfort with normal activity,” Sollecito said. “You might feel pain even if you chew routinely because your muscles have had more ‘movement’ from clenching and grinding.”
Although Jennie Spotila has struggled with the effects of bruxism in recent years due to the increased stress from personal issues, she said the pandemic made the problem significantly worse. Just before COVID-19 dental offices closed, Spotila, a 52-year-old disability activist who lives in Montgomery County, was given a temporary crown for breaking a tooth while grinding.
“I was afraid to go to the dentist again, so I didn’t go back until June to get the impression for the permanent crown,” said Spotila. “And in the meantime, I had cracked another tooth in the first few months after the pandemic. My dentist jokingly asked, ‘Were you under a lot of stress?’ and I thought, ‘Um, yeah.’ “
On the recommendation of her dentist, she was given a night watchman and began wearing it while she slept to reduce grinding. But Spotila said she now catches herself grinding or clenching or teeth during the day too.
“I’m just trying to stop and consciously relax the jaw,” she said. “I know this is a stress-related problem. Up until the last few years I have never gritted my teeth before.”
Hai Qing, a dentist who practices in Bucks County, said he recently saw a handful of patients with joint problems, a sign of excessive teeth grinding or clenching. Qing recalled a patient who, after being asked to take more responsibility at work during COVID-19, broke her night watchman from excessive grinding.
Qing said it is important for the patient’s saliva to become acidic as this can make bruxism worse.
“Bruxism causes more serious damage when the saliva becomes acidic in a short period of time,” he said. “We try to control this by looking at their eating habits and making adjustments. We also want to make sure patients don’t have fragile or weak teeth so we can protect them too.”
When Faith saw her dentist in April, she mentioned that her grinding had gotten worse. Her teeth began to develop sharp edges on the sides because she had ground the centers. She was given a prescription for an anti-inflammatory drug that was supposed to relieve the pain. But things haven’t gotten better.
“When I saw my maxillofacial and migraine doctor in June, I told him I couldn’t take it any longer,” Faith said. “I would wake up in the morning and my jaw would be pounding with grinding all night, even though I wear my night watch to protect my teeth.”
In late September, she was planning a temporomandibular joint (TMJ) arthroscopy at Thomas Jefferson University Hospital, an operation that would relieve pain and restore full jaw movement. Faith said she also hopes to get acupuncture for her jaw, a treatment that has alleviated her pain in the past once she finds a new job.
“I feel better, but my stressors haven’t really subsided,” said Faith. “I’m still in the circumstances I was in March. I have to find a way to deal with the stress, but I don’t know how to keep this from happening again and again at night until things get better . ”
COVID bites: Broken teeth, another scourge of the coronavirus
© 2020 The Philadelphia Inquirer
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