Grinding your teeth? Don’t worry, so is everyone else
Lauren Libbert explains how the current rise in stress and anxiety is fuelling dental problems
When Sam Espensen was forced to close her business during the national lockdown this spring, the stress soon began to take its toll – on her teeth. “I noticed the back of my jaw aching, then I caught myself clenching my teeth really hard,” says Sam, 47, who owns a bottle shop and mobile bar for events, and lives in Bristol.
“The pain kept moving around my mouth and into different teeth, and my jaw was clicking in and out on one side. I realised I was doing it at night, too, as the pain was excruciating in the mornings. It gets to the point where it overtakes everything and I have to take ibuprofen every four hours.”
Bruxism – excessive teeth grinding or clenching – affects 10 per cent of the UK population, but dentists are reporting a huge increase in cases as a result of the pandemic.
Sudden, dramatic changes to our lifestyles, economic uncertainty and separation from family and friends have led to high levels of stress and anxiety, manifesting in an increase in cracked and worn teeth. The problem has been compounded by dental surgeries opening only for emergency work, meaning many are struggling to see their dentist.
“We’re now seeing so many more people with crowns bitten off, teeth worn down to their stumps, fractures, chips in teeth and bleeding gums, all because they’re grinding their teeth more,” says Dr Kailesh Solanki, owner of the Kissdental practices in Manchester and an advisory dentist at dentalphobia.co.uk.
“Most people don’t have a clue they’re doing it but will come to me because they’re experiencing intense jaw pain or headaches. People are so worried about the future, and this tension and stress goes straight to the teeth.”
Therapist Helen Mclean has seen an influx of Covid teeth-grinders this year. “My clients will often be at their wits’ end with pain or cracked teeth and can’t get to see a dentist,” she says. “Clenching teeth is a way to deal with the pain, by pushing it down. It’s the anxious feelings starting to bleed out.”
Elaine Brand, 61, has developed such a problem with grinding that one of her fillings has chipped away and her teeth have receded from her gums, requiring more fillings to plug the gap
between teeth and bone.
“I’ve been a grinder for a few years but it’s become so much worse over the last few months,” explains Elaine, who lives in Bushey, Herts, and has two grown- grown-up up sons.
“Before I go to sleep, I just think about all the corporate functions and has been made redundant – not being able to mix socially in large numbers, people dying unnecessarily, and I worry that life might never get back to normal.
“Everything feels different now. I think twice about going out, socialising, shopping – nothing is the same. Sometimes I’ll wake up and my teeth are clamped down tight. My dentist has made me a gum shield but as it’s quite soft and rubbery it
actually makes me want to bite down even more, so I don’t wear it on a regular basis. It’s all such a worry.”
Bruxism is made worse by stress and is also associated with sleep disorders. Whirring thoughts at night lead to insomnia and restlessness – and more grinding.
“When we get stressed there is an increased release of the hormone ne cortisol, and nd the ‘fight or flight’ response se leads us to clench ch our teeth,” ,” says Dr Sameer meer Patel, clinical nical director at Elleven lleven Dental Wellness. “Ninety-five per cent of my patients who grind their teeth do it at night and don’t always know it. Often my patients who are grinders will complain they’re not sleeping well as grinding can lead to not having enough REM sleep. It’s a vicious cycle.” The current surge in tooth trauma may also be linked to another
byproduct of the pandemic: more people working from home, craning over makeshift workstations and doing damage to their posture.
“Poor posture in the day leads to grinding at night as our back, neck and jaw are all connected,” says physiotherapist Krina Panchal. “I’ve seen a 50 per cent increase in the number of clients coming to me with headaches in the temple area and jaw pain, and it’s because they’re working from dining tables or, even worse, on their beds, looking down onto their laptop and straining their necks, “Bad posture causes the vertebrae to rotate which affects the joint that connects the jawbone to the skull – and can change the position of your teeth so you grind more.
“I just have to look into a client’s mouth to see tooth wear or imprints of teeth on their tongue – classic signs they’ve been grinding or clenching.” So how can Covid grinders break the habit?
Mouth guards are the treatment of choice for dentists, but Dr Patel insists they have to be custom-made and hard in order to work, as soft ones can simply be chewed through.
“The guards should deprogramme you from grinding as the muscles can no longer clamp down together,” says Dr Patel, adding that regular preventive check-ups are essential to spot the grinding earlier rather than later.
Panchal advises checking your posture, and if necessary setting up a proper workstation with computer screens at eye level so your shoulders aren’t hunched and neck isn’t bent. “People have also been drinking more alcohol and caffeine during Covid which makes you grind more, so think about reducing your intake,” she adds.
Experts agree it’s also important to address the stress causing bruxism, and to find ways to relax.
“I work to get to the root cause of the grinding – what is causing this unconscious behaviour – and try to
‘Often my patients will complain they’re not sleeping well. It’s a vicious cycle’
understand it and heal it so it’s no longer an issue,” says therapist Helen Mclean.
Awareness of grinding plays an important part in tackling it she says. “Many people are unaware of how their body is reacting and don’t know they’re holding on to tension,” she says. “To establish a better mind-body connection, set a timer on your phone to go off at regular intervals throughout the day to check in with your body and see if you’re holding tension and when and where it’s happening.”
Mclean also recommends doing regular release exercises throughout the day – tensing then releasing the muscles of your upper back, shoulders, jaw and face so that everything becomes more relaxed. As winter approaches and infections continue to rise, good sleep hygiene and a daily destressing ritual before bed is also important.
“Try to do a 10-minute meditation every evening to help destress,” says Dr Solanki.
“And make sure you have a good bedtime routine. Avoid blue light from your phone, switch devices off at least an hour before bed, read, take a hot bath – do whatever you need to do to relax, and you’ll have better sleep and the night time grinding should ease.”