Shingles, maskne, migraines and quarantine fatigue: The stress of the pandemic has manifested in a variety of physical ailments. The latest evidence of this is a rise in cracked teeth.
“We
have seen an increasing amount of fractured teeth in probably the past
six months,” said Dr. Paul Koshgerian, an oral surgeon with The Oral
Surgery & Dental Implant Specialists of San Diego.
have seen an increasing amount of fractured teeth in probably the past
six months,” said Dr. Paul Koshgerian, an oral surgeon with The Oral
Surgery & Dental Implant Specialists of San Diego.
For
Koshgerian’s office, before the pandemic, treating one cracked tooth
per day or every other day was normal. These days, two visits per day
for fractured teeth have been the norm; on the worst days, he might see
five cases.
Koshgerian’s office, before the pandemic, treating one cracked tooth
per day or every other day was normal. These days, two visits per day
for fractured teeth have been the norm; on the worst days, he might see
five cases.
Derek
Peek — leader of Eastern Iowa Endodontics and diplomate of the American
Board of Endodontics — found that in August and September, his office
had already treated twice as many cracked teeth in comparison to those
respective months last year, even with fewer patients this year.
Peek — leader of Eastern Iowa Endodontics and diplomate of the American
Board of Endodontics — found that in August and September, his office
had already treated twice as many cracked teeth in comparison to those
respective months last year, even with fewer patients this year.
Covid-19
doesn’t make teeth more fragile, but the “anxiety that surrounds
everything that’s going on — Covid, the rioting, the protesting, the
looting (and) the general state of the country — has gotten everybody’s
thermostat dialed up a couple notches,” Koshgerian said.
doesn’t make teeth more fragile, but the “anxiety that surrounds
everything that’s going on — Covid, the rioting, the protesting, the
looting (and) the general state of the country — has gotten everybody’s
thermostat dialed up a couple notches,” Koshgerian said.
“In
the oral surgery or dental realm, often that translates to people
bruxing their teeth,” he added, describing the condition in which people
involuntarily gnash, grind or clench their teeth. Bruxing can damage
fillings or crowns, or crack teeth.
the oral surgery or dental realm, often that translates to people
bruxing their teeth,” he added, describing the condition in which people
involuntarily gnash, grind or clench their teeth. Bruxing can damage
fillings or crowns, or crack teeth.
When to call your dentist
Symptoms
of bruxism include pain when teeth are together and/or brushed,
swelling indicative of infection, lingering pain and/or cold or broken
pieces of teeth, Peek said. If the sides of your face feel sore when you
awaken, you might be grinding your teeth at night, Koshgerian said.
of bruxism include pain when teeth are together and/or brushed,
swelling indicative of infection, lingering pain and/or cold or broken
pieces of teeth, Peek said. If the sides of your face feel sore when you
awaken, you might be grinding your teeth at night, Koshgerian said.
“Also,
if people have partners,” he added, “oftentimes the partners are the
ones that tell the patient themselves that clenching is happening
because it’s audible to the person that may be sleeping or cohabitating
with the person.”
if people have partners,” he added, “oftentimes the partners are the
ones that tell the patient themselves that clenching is happening
because it’s audible to the person that may be sleeping or cohabitating
with the person.”
If you’re experiencing symptoms, calling your dentist early on — before the problem worsens — is best. There are ways to safely attend an appointment, since offices have implemented safety precautions like social distancing and screening during the pandemic.
If
a tooth “is considered non-salvageable by the dentist, oftentimes it’s
referred to an oral surgeon for treatment,” Koshgerian said.
a tooth “is considered non-salvageable by the dentist, oftentimes it’s
referred to an oral surgeon for treatment,” Koshgerian said.
Treating cracked teeth
When
you visit an oral surgeon’s office, Koshgerian said, she’ll take X-rays
to visualize your mouth, but will also take your oral history to
pinpoint any underlying issues.
you visit an oral surgeon’s office, Koshgerian said, she’ll take X-rays
to visualize your mouth, but will also take your oral history to
pinpoint any underlying issues.
Previous
dental work can make teeth become more prone to fracture or breaking.
Car accidents, chewing popcorn seeds or some other event may crack teeth
— but in the absence of that knowledge, bruxism might have caused the
injury.
dental work can make teeth become more prone to fracture or breaking.
Car accidents, chewing popcorn seeds or some other event may crack teeth
— but in the absence of that knowledge, bruxism might have caused the
injury.
The treatment hinges mostly on how the tooth structurally broke, made clear by understanding a little odontology 101:
- The crown of a tooth is the visible part.
- The root anchors each tooth into the bone of the jaw.
- Enamel covers the crown.
- Underneath enamel is dentin, which makes up the body of the tooth, both the crown and the root.
- At the core is a hollow chamber called the pulp, where the nerve and blood vessel are.
If
the crack travels through the enamel and into the dentin without
entering the pulp, it can be fixed with a root canal. “However,”
Koshgerian said, “if the crack goes through that hollow chamber and it
communicates through the root of the tooth, there’s no way for the root
canal to be able to save it because you can’t seal off that crack
underneath the gum because you can’t see it.”
the crack travels through the enamel and into the dentin without
entering the pulp, it can be fixed with a root canal. “However,”
Koshgerian said, “if the crack goes through that hollow chamber and it
communicates through the root of the tooth, there’s no way for the root
canal to be able to save it because you can’t seal off that crack
underneath the gum because you can’t see it.”
ental implants could replace broken teeth, but a dentist won’t start
with implants if less intrusive measures might work: Wearing a
customized mouth guard during the evening is one common way to protect
teeth from bruxism, Koshgerian said. “Instead of teeth grinding together
and wearing the teeth down, there’s a soft or hard splint” that acts as
a barrier.
with implants if less intrusive measures might work: Wearing a
customized mouth guard during the evening is one common way to protect
teeth from bruxism, Koshgerian said. “Instead of teeth grinding together
and wearing the teeth down, there’s a soft or hard splint” that acts as
a barrier.
‘Stress comes out at night’
Stress
has been the driver of the increase in cracked teeth, Peek said, and
stress usually “comes out at night when people clench or brux their
teeth.”
has been the driver of the increase in cracked teeth, Peek said, and
stress usually “comes out at night when people clench or brux their
teeth.”
During the daytime when you’re fully conscious, you can likely feel yourself tensing up and decide to relax, Koshgerian said.
“But in the absence of that control in the evening when you’re sleeping, you don’t have that mechanism,” he added.
“So
that parasympathetic activity, which causes relaxation in the muscles,
oftentimes is absent.” The sympathetic response, which makes the muscles
contract, “kind of takes over and they go unchecked, which causes quite
a bit of strain in the muscles, and the teeth pay the price for that,”
Koshgerian said.
that parasympathetic activity, which causes relaxation in the muscles,
oftentimes is absent.” The sympathetic response, which makes the muscles
contract, “kind of takes over and they go unchecked, which causes quite
a bit of strain in the muscles, and the teeth pay the price for that,”
Koshgerian said.
Other stressful circumstances — divorce, moving, deployment — have also been known to increase bruxism, Koshgerian said.