A Dentist Sees More Cracked Teeth. What's Going on?
New York Times September 19
Here are the highlights of a relevant article about emotional well-being.
- "I am busier than ever. I've seen more tooth fractures in the last six weeks than in the previous six years."
- "I noticed an uptick in phone calls: job pain, tooth sensitivity, achiness in the cheeks, migraines. But when I reopened my practice in early June, the fractures started coming in."
- "One obvious answer is stress. Pandemic related anxiety is affecting our collective mental health. That stress in turn leads to clenching and grinding which can damage the teeth."
"Two additional factors: Americans are suddenly working from home.
- "The awkward body positions that ensue can cause us to hunch our shoulders forward, curving the spine into something resembling a C-shaped. Poor posture during the day can translate into a grinding position at night."
- "Most of us aren't getting restorative sleep we need."
"I listen to patient after patient describes sudden restlessness and insomnia. These are all hallmarks of an overactive or dominant sympathetic nervous system which drives the bodies fight or flight response. All that tension goes straight to the teeth. You'd be surprised how many people are unaware that they are clenching and grinding."
- "Awareness is key. Be mindful and try to stop yourself from grinding when you catch yourself doing it."
- "If you have a night guard or retainer, try popping them in during the day. I'd rather you crack a night guard than crack a tooth."
- "It is imperative to set up a proper workstation. Your shoulders should be over your hips and your ears should be over your shoulders. Computer screens should be at I level; try to mix up with some standing whenever possible and incorporate more movement."
- "At the end of the workday, I advise my patients to "wiggle like a fish". Lie down on the floor on your back with your arms extended straight above your head and gently wiggle your arms shoulders hips and feet from side to side. The goal is to decompress and elongate the spine as well as reliefs and relieve some of the tension and pressure.
- "Consider taking a 20 minute Epson salt soak in the evening.
- Focus on breathing through your nose and relaxing, rather than thinking about work, scrolling through emails or contemplating your kids back to school schedule."
- "Right before bed, take five minutes to quiet your mind. Close your eyes, suction your tongue to the roof of your mouth and breathe in and out through your nose. Deep breathing is one of the most effective ways to send a light stimulate the vagus nerve which controls the body's parasympathetic nervous system."
"The more relaxed your body, the more likely you are to wake up with less tension in the jaw.
"If you do nothing else, get a night guard."
And, if your patient continues to grind, crack their appliance, or cannot follow your instructions and treatment plan consider that their stress is not about the pandemic or ergonomics.
These people have deeper anxiety problems, and they can be temporarily treated with anxiety and antidepression medications.
They will "eventually" thank you for drawing this possibility to their attention. Of course, most patients will deny that they have deeper emotional issues, but at least you told them "a truth." You may have to wait a while for their gratitude to surface.
Ultimately, if their stress existed before the pandemic, it's unlikely to be relieved with the above palliative treatment recommendations. Psychotherapy is the next resort.
Of course, no one likes to hear that, because everyone wants to believe they are in total control.
Living in denial is just another contributing factor to cracked teeth.