Daily Local News (West Chester, PA)
Stress, notmasks, has negative impact on dental health
The coronavirus pandemic has disrupted daily life and brought additional stress into the community. It may also be impacting dental health, but the reason has little do with with wearing masks.
There is no scientific evidence that the regular wearing of masks causes more tarter and plaque buildup on teeth, despite rumors that say otherwise.
“I would have to say that is a rumor that has to be dispelled,” said Dr. Jordan Hottenstein, Central Berks Dental Center in Leesport. “I can’t see how there’s any scientific or biological validity to that and I have not seen that clinically first hand.”
Fellow dentists agreed with Hottenstein. Dr. Malini Moni, chief dental officer at Berks Community Health Center, has not seen buildup due to masks in her patients and did not find any scientific literature thatwould suggest there being any truth to the rumor.
“I didn’t find anything convincing enough or significant that would tell us there was a direct correlation between a face mask and plaque buildup,” she said. “A face mask gives 100% oxygen supply so the good bacteria in your mouth always get the oxygen that they need. It is proven that the oxygen saturation that goes into your lungs, even when you wear amask, is the same as without wearing a mask as long as you are breathing regularly.”
Dr. Andrea Smith, Berks Prosthodontics inWyomissing, pointed out that many professions require wearing a mask for hours each day, including dentists, and there has been no evidence of more buildup on teeth as a result. What people may be experiencing is more dry mouth as a result of not staying as hydrated throughout the day due to wearingamask. Drymouth
can lead to extra buildup, which brushing and flossing will remove.
“I don’t see how there would be any difference with buildup of calculus or cavities if there hasn’t been some other shift in their life as far as not having time any more and not bushing their teeth,” Smith said.
Malini and Hottenstein echoed Smith’s thoughts in saying the extra buildup would be due to error on the individual’s part when it comes to oral hygiene rather than a mask.
“The only way I could say a mask would really be a hindrance to oral hygiene would be if it limits someone’s oral hygiene,” Hottenstein said. “I think at the end of the day, especially when it comes to buildup and oral hygiene, it comes down to the work that people put in.”
Hottenstein added that missed appointments due to the pandemic or other reasons could lead to dentists
seeingmore buildupon patients’ teeth.
Throughout the pandemic some people have not been in favor of following guidelines from health experts to help stop the spread of the virus, including wearing a mask when out in public. Smith believes the idea of “mask mouth” caught on as a reason people have given for not following the guidelines.
“Certainly a mask is really important to wear now with the spread of COVID19 so that’s not a good excuse because that’s not a real reason,” Smith said.
Stress leaving an impact
While masks have been ruled out as having a negative impact on dental health, another pandemicrelated factor may be causing a rise in patients experiencing tooth damage.
“I think one of the things that is real for dental consequences
of COVID- 19 would be potentially more stress,” Smith said. “People are just stressed more so that if you do clench or grind your teeth, maybe that’s happening more which leads to potentially more broken teeth.”
Even before the additional stress brought on due to the pandemic, Hottenstein and Smith were regularly seeing a number of patientswith tooth damage for reasons other than decay. When people are stressed, they may grind their teeth or clench their jaw which causes damage to those areas. This is a trend within the dental community.
Hottenstein said one of the things that surprised him when he graduated from dental school in 2009 was the amount of teeth he fixes due to broken teeth, previous fillings, stress- related fractures or attrition compared to actual decay. This has become the bulk of the work done atHottenstein’s
practice.
“It is a lotmore common than I ever anticipated,” he said. “I bet I go days without finding decay, but I never go any day without fixing a tooth that’s broken from a previous restoration or a filling that’s gone bad or something else. I would say that the vastmajority of the teeth I fix actually don’t have decay on them.”
Neither dentist is certain if they have seen an increase in these kinds of patients in their own practices since reopening after a brief shutdowndue toCOVID19 restrictions, but it is certainly a possibility as the pandemic has added more stress to the community.
“As far as people having more grinding, clenching and stress- related things, I think overall as a society we’re kind of all getting stressed out,” Smith said. “I do think that in many, many of patients you see signs of increased forces on their teeth. Not just fractured teeth, but you can actually have bone loss that’s not associated with inflammation. You can have little notches at the gum line of your teeth where because of that stress the enamel at the gum line just kind of fractures off. You can also have gum recession on teeth without inflammation.”
All of those situations are related to people grinding their teeth or clenching their jaw, most of the time due to stress, according to Smith.
“The current situation we’re in, that could certainly contribute to someone continuing to grindtheir teeth,” Hottenstein said.
Prevention
Preventing a trip to the dentist for a stress- related issue is not as easy as brushing and flossing daily. There are times when people are not even aware they are grinding their teeth or clenching their jaw.
“It’s hard because during the day you can try to become aware of it and try to do some relaxation techniques, but overnight there’s not much you can do,” Smith said.
For patients who grind their teeth at night, Hottenstein and Smith prescribe night guards which can help prevent the teeth fromtouching or distribute the force of impact throughout the mouth rather than in just one area. Therapies are available for jaw issues as well which can help alleviate pain.
The best way to prevent stress- related actions that cause tooth damage is to reduce stress, which is not an easy task even without a pandemic.
“I would say that figuring out the reason for it or the mechanism behind it, that’s number one,” Hottenstein said.
In the instances when it is not possible to reduce stress and stop the stressrelated behaviors, dentists will continue to help their patients with their dental needs including tooth damage.