Sir, with increasing levels of unemployment, isolation and changes in normal routine during the pandemic, impacts on mental health are unavoidable.1 Elevated levels of stress and anxiety have a well-established link to bruxism,2 a common factor that predisposes a tooth to crack and fracture.3
Consequently, there has been an increase in patients presenting with features of toothwear, attributed to grinding and jaw clenching. Studies have illustrated increasing levels of bruxism and temporomandibular disorders in those suffering with an aggravated psycho-emotional status.4 Having diagnosed several patients attending in pain with tooth fractures, the prevalence of such pathology has also been seen increasingly in dental practices.5
Conducting a thorough examination, looking for early signs of toothwear and taking a detailed social history can play an important role in establishing a patient's risk of bruxism and tooth fracture. In patients suffering from stress and demonstrating evidence of bruxism, giving advice on how to cope with anxiety, signposting to national agencies and providing interventions such as mouth guards can help to minimise the risk of toothwear and fractures.
World Health Organisation. Mental health & COVID-19. Available at: https://www.who.int/teams/mental-health-and-substance-use/covid-19 (accessed 5 February 2021).
NHS. Overview: Teeth grinding (bruxism). Available at: https://www.nhs.uk/conditions/teeth-grinding/ (accessed 5 February 2021).
Lubisich E B, Hilton T J, Ferracane J. Cracked teeth: a review of the literature. J Esthet Restor Dent 2010; 22: 158-167.
Emodi-Perlman A, Eli I, Smardz J et al. 2020. Temporomandibular disorders and bruxism outbreak as a possible factor of orofacial pain worsening during the COVID-19 pandemic - concomitant research in two countries. J Clin Med 2020; 9: 3250.
Roth M. Coronavirus is leaving more people with cracked teeth, dentists say. The Independent 30 September 2020. Available at: https://www.independent.co.uk/news/world/americas/coronavirus-cracked-teeth-pandemic-stress-b704417.html (accessed 20 February 2021).
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Dadnam, D., Dadnam, C. & Al-Saffar, H. Pandemic bruxism . Br Dent J 230, 271 (2021). https://doi.org/10.1038/s41415-021-2788-3