Why teeth grinding has been on rise since COVID

Also known as bruxism, the condition doesn’t pose serious risk, but researchers say it can be a byproduct of deeper issues

When Toronto dentist Dr. Anand Iyer reopened his office to general patients at the tail-end of the COVID-19 pandemic, he was shocked at the number of people complaining of overnight teeth grinding.

“I was like, ‘Holy crap, I cannot believe the number of (dental) guards we’re ordering,’ ” Iyer, a general dentist and the owner of Bitehaus Dental in Hillsdale, said. “And you would expect, hopefully, nightguards to last up to a couple of years — but within six months they would tear through it.”

Demand was so great, and his patients’ grinding so strong, his practice began manufacturing their own dental guards in-house. He’s attributing the flood of patients partly to spiking levels of anxiety and medication usage in recent years.

“I feel like maybe there’s some area specificity. Like, I think Toronto people just work, work, work like crazy,” Iyer continued. “Maybe the at-home working has been contributing to more stress — I’m not sure. But I’ve definitely seen a massive uptick.”

While teeth grinding, also known as bruxism, usually isn’t so serious a health risk by itself, researchers tell the Star it can be a byproduct of deeper issues.

Here’s why dentists like Iyer are reporting an uptick in bruxism — and why it matters.

Is teeth grinding on the rise?

Dr. Michael Glogauer, the head of dentistry for the University Health Network, head of dental oncology at the Princess Margaret Cancer Centre and a professor of dentistry at the University of Toronto, said he’s seen a similar spike in bruxism at his practice — as well as more serious dental issues.

“I’ve looked at the data from my own clinic and I definitely noticed that … we’ve seen a 20 to 25 per cent increase in the number of patients coming for fractured teeth” in the three years post-pandemic compared to the three years before, Glogauer said.

Like Iyer, he attributed the increase largely to stressors ranging from global issues like the COVID-19 pandemic and outbreak of numerous wars, to local ones like the cost of living crisis and a lack of affordable housing.

Meanwhile, prescriptions for antidepressants continue to climb, with a recent report finding the number of total mental health prescriptions jumped 7.4 per cent in Canada from 2019 to 2021.

These, alongside usage of recreational drugs, tobacco and caffeine (some of which are also on the rise) have been associated with bruxism, Glogauer explained, and may be partly responsible for the recent numbers.

But researchers like Dr. Gilles Lavigne, a professor of dental medicine at the Université de Montréal and a leading expert on bruxism, said stress and medication may not paint the full picture.

“Education has a big impact,” he said, noting that over the last five to 10 years, public awareness of tooth and jaw disorders including teeth grinding had grown by leaps. This led more people to get checked out, leading to more diagnoses of preexisting conditions — especially after COVID-19, which led more people to become health-conscious.

What causes teeth grinding?

According to Lavigne, an estimated eight to 12 per cent of Canadians experience nighttime bruxism, although it can also happen when we’re awake. There are a great many factors linked to its appearance, but doctors still don’t fully understand why it happens, he explained — especially as bruxism can have different causes and implications for different people.

That said, studies show a possible but not exclusive relationship between stress and teeth grinding. It’s also known certain antidepressants and illicit drugs like cocaine can cause some to clench their teeth more, Lavigne said, although this isn’t the case for everyone.

Studies also show awake teeth grinding, which is associated with clenching your teeth as a habit, can be a learned behaviour, he continued — for example, children of parents with bruxism are two to three times more likely to develop it themselves.

Dr. Iacopo Cioffi, an associate professor of dentistry at U of T noted: “Some studies suggest that this may be a stress coping mechanism, clenching the teeth during the day.” During the night, sleep disorders like insomnia have been associated with its occurrence, studies show.

Research also suggests a correlation between sleep-related breathing disorders like sleep apnea and bruxism, a phenomenon Iyer says he’s been seeing more of in his practice.

Bruxism may point to serious health issues

According to Cioffi, increased teeth-clenching, in rare cases, could be a sign of underlying neurological issues — “Some neurological conditions can be associated with increased motor contraction of the jaw muscles,” he said. Severe examples can include brain cancers and Parkinson’s disease.

Lavigne added that on rare occasions, it can also be a sign of sleep epilepsy, which may occur in children. “It’s why in children, it’s important to know why they are grinding,” he said.

Another example of a “very rare” disease that causes bruxism and “tooth tapping” is called REM behaviour disorder, a neurodegenerative sleep disorder that eventually results in Parkinson’s-like symptoms.

“It’s why dentists have to be aware what’s going on (to cause teeth grinding),” Lavigne said, and why it might be a good idea to get checked out — even if he agrees that “bruxism (by itself ) does not kill people.”

Health consequences of grinding your teeth

While it might not fatal, teeth grinding can lead to debilitating jaw pain and fractured teeth, Glogauer explained.

For these patients, there are muscle relaxants that can reduce jaw movements and help the muscles heal — but these are short-term solutions, he said. Bruxism can be chronic, and may be “quite difficult to manage” over the long term.

Teeth protection like nightguards or other splints can provide direct protection and are often prescribed for nighttime grinders. Physiotherapy or cognitive behavioural therapy can also help, depending on the cause of one’s bruxism, Glogauer continued.

But usually, unless the root cause of one’s teeth grinding is resolved, the condition will keep happening, Lavigne explained, stressing the importance of seeing a health professional — especially as some of the causes can be life-threatening.

If you’re waking up with a sore jaw, headache or tender teeth, or your partner reports hearing your teeth grinding away at night, it may be time to see your dentist, Glogauer said. They can usually pick up on bruxism during regular visits.