Krrch, krrch, krrch!

How to counter your pandemic stress pain from teeth-grinding, jaw-clenching

I have been a frequent visitor to my dentist’s office since it reopened after lockdowns during the initial stages of the pandemic. First came a cracked tooth, then a cracked filling. Both were painful enough to wake me up at night.

It was bad luck, I figured, or maybe just the reality of middle age. My dentist, Jennifer Herbert, suggested otherwise. Ever since the pandemic started, she says she has seen a surge in problems related to tooth-grinding and jaw-clenching. Perhaps, she suggested, pandemic stress was the culprit for my tooth woes, too.

“It’s astronomical,” she says. “I’ve seen more patients with problems from grinding in the last few months than I have in the rest of my career.”

The technical term for disordered teeth-grinding and jaw-clenching is bruxism, and the behavior falls into two categories, says Gary Klasser, a specialist in orofacial pain at the Louisiana State University Health Sciences Center’s School of Dentistry in New Orleans.

There is bruxism that happens while awake and bruxism that happens during sleep. Each has its own causes and potential solutions, but both appear to be common. Sleep bruxism, which is more well- studied, occurs in an estimated 5% to 8% of adults (and in up to 50% of children, although it usually goes away as they get older). But benign clenching and grinding into adulthood is far more common than that.

For most people, jaw movements during sleep don’t cause problems. But as clenching and grinding become more powerful and more frequent, people can start to experience symptoms such as jaw pain, headaches, temperature sensitivity in their teeth or damage to teeth or fillings.

During a 24- hour period, studies suggest that our teeth should be pressed against each other for a maximum of about 10 minutes, Klasser says. Any more than that can become a problem.

There is no official data about whether the stress of the pandemic has produced a spike in bruxism and related teeth damage, he says.

For example, plenty of studies have shown that nighttime teeth- grinding commonly occurs in people who experience stress, anxiety, depression or other psychological issues. But most studies have been correlational, which leaves open the possibility that nighttime grinding might be the cause of disrupted sleep and that sleep-disruption, in turn, messes with mood and emotions during the day, says Sylvia Kriebig, a research psychologist at Stanford University in California, who studies the bodily effects of emotions.

It is also well-established that stress, fear and other emotions can ramp up activity in the amygdala, the part of the brain that regulates emotions, causing responses such as sweaty palms, a racing heart and muscle contractions that could include jaw- clenching. But studies haven’t directly linked jaw contractions to those emotions.

Regardless of cause, if you start to notice symptoms from clenching and grinding, there are things you can do to mitigate the potential negative consequences, experts say.

Daytime bruxism is a behavior that can benefit from relaxation, mindfulness exercises, and techniques derived from cognitive behavior therapy, Klasser says. He tells patients to set a timer to go off every hour. When you hear the alarm, he says, pay attention to the position of your mouth, and remind yourself to relax. There should be a bit of space between your teeth, with your lips gently touching and your tongue sitting passively on the floor of your mouth. Doing this every day for four to six weeks can train your jaw to be relaxed instead of active.

Some evidence exists that clenching during the day can carry over into the first couple of hours of sleep, Klasser says. So teaching yourself to relax your jaw might help early in the night, too.

For bruxism that persists through the night, many dentists recommend oral appliances, also known as mouthguards or splints. Cheap mouthguards are available at drugstores, but Klasser says that custommade devices, which are firmer, are usually worth the investment.