Cracked Teeth: Is Covid to Blame?
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Have you heard the news? COVID-19 is causing cracked teeth. Not the virus itself, but stress related to the virus, working and going to school remotely, social distancing and everything that goes with it. No doubt the political climate is in that mix somewhere, too.
Pandemic stress, quarantine fatigue, mask burnout, online overload – whatever you want to call it, it’s an additional stress that people across the globe are experiencing. Stress comes out in many different ways and each person responds differently, but we’re definitely seeing a trend of stress-related issues in dentistry.
How Covid Has Affected Dentistry
The initial impact on dental practices was the American Dental Association’s guidance to categorize emergency and non-emergency dental care and postpone elective procedures to mitigate the spread of COVID-19. This was a necessary step and one that most people were aware of.
It’s the aftereffects and the stress-related conditions that are now hitting the industry in some unexpected ways. Dr. Nicholas Davis of Newport Beach, California, notes, “Dental stress has manifested itself in the increase of bruxism (grinding) and clenching. As a result, I have noticed an increase in fractured teeth, broken restorations, TMD issues, headaches, and neck and shoulder problems. Almost on a daily basis, I am seeing patients with some sort of stress related tooth, joint, or muscle issue.”
Some patients are aware of their stress levels and clenching, and while others are completely unaware that they’ve adopted these habits, even when they’re clenching their jaws in the office. Check yourself right now. Are you clenching, biting, do you have neck or jaw tension, maybe a low-grade headache? If you can force awareness of your stress habits, you might be able to stop them from becoming dental emergencies.
But it’s not just cracked teeth that’s bringing people into their dentist’s office. Dr. Jeff Lineberry of Mooresville, North Carolina, says he’s also concerned about his patients’ gums. “We’re definitely seeing an increase in people with gum conditions getting worse along with an increase in decay rates. The combination of not coming into the office due to the pandemic, poor eating habits, and frequent mouth breathing due to masks adds to the negative impacts of stress on the body.”
This is where the effects are far far-reaching. How many of you had an appointment delayed due to COVID-19, and then decided to cancel or skip your next dental check-up or cleaning, just to be safe? Have your dietary habits changed? Do you find you’re mouth breathing more because the mask makes it more difficult to breathe through your nose? All these things could cause chipped or cracked teeth and other dental issues.
How to Treat Covid-Related Dental Concerns
The overarching theme we heard from dentists is that treating the stress is a primary concern. Whether you practice mindfulness, begin a yoga habit, or seek professional medical help, addressing the feelings you’re having now is as important as treating the symptoms they are causing.
Dr. Salvatore Lotardo of New York and President of the American Academy of Cosmetic Dentistry (AACD) echoes this sentiment: “The key to any treatment plan is understanding the cause of the current condition. This allows you to arrive at the correct diagnosis and develop a treatment plan that will have a predictable, long-term, successful outcome. So, on the surface, treatment of a cracked tooth may seem simple; restore the crack with a crown or other appropriate restoration and that is it. However, if the underlying cause has not been addressed, your treatment is susceptible to failure.”
Dr. Davis suggests that there are several ways your dentist can help you manage stress-related dental concerns if you can catch them before damage is done to the tooth. “The best single service is to fabricate a night guard appliance for the patient. This is one of the least prescribed but most beneficial services that dentists can provide for their patients. For patients with strong overactive masseter muscles, Botox works great to decrease the intensity of the clenching habit. For acute issues, 800 mg of Ibuprofen 3 times a day with food can also help (not to exceed two weeks).”
Preventing Stress from Causing Dental Problems
One thing you’ve probably noticed is that AACD member dentists are not just interested in giving you a crown and sending you on your way. The bigger picture includes preventing problems in the first place by managing stress.
As Dr. Lineberry reminds us, “Stress management is something that is vitally important. When my patients suffering from stress related issues that cause them to seek dental care, I encourage them to see their regular providers. I also suggest vitamins and nutritional support, which are important overall, but studies are clear about how, when we increase vitamin D, C, and zinc, we increase our resistance to Corona.” He also strongly suggested prioritizing sleep as a remedy to stress and as a natural way to boost immune function.
Similarly, Dr. Davis suggests, “Daytime awareness of keeping the teeth apart and breathing through the nose are very effective in minimizing daytime bruxism. Encouraging patients to exercise, do yoga, walk, or take some time to meditate are useful stress relieving methods. Getting adequate restful sleep is also needed to replenish the bodies’ natural healing capabilities. To control stress, it is easy to say, ‘Don’t worry, everything will be alright’, but it is more difficult to implement. Find your ‘peace’ by looking for the ‘good’ in everything, think positive, and SMILE more.”
Finally, Dr. Lotardo stresses how important early intervention is. “If you have pain when chewing, muscle or jaw joint pain, worn or loose teeth, be sure to see your dentist as soon as possible. Left untreated, patients can have long -term consequences that may result in more cracked teeth and potential loss of teeth.”