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“Understanding the Surge in Reports of Teeth Grinding During COVID-19: Exploring the Causes of Bruxism”

Upon reopening his Toronto dental practice amid the waning days of the COVID-19 pandemic, Dr. Anand Iyer was taken aback by the surge in patients lamenting nighttime teeth grinding. “I was like, ‘Holy crap, I cannot believe the number of (dental) guards we’re ordering,'” remarked Iyer, a general dentist and owner of Bitehaus Dental in Hillsdale, to the Star. “And you would expect, hopefully, nightguards to last up to a couple of years — but within six months they would tear through it.”

The demand was so pronounced and the grinding so intense that his practice began crafting their own dental guards on-site. Iyer attributed the influx of patients in part to escalating levels of anxiety and medication use in recent years. “I feel like maybe there’s some area specificity. Like, I think Toronto people just work, work, work like crazy,” he noted. “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, or bruxism, typically isn’t a severe health risk on its own, experts tell the Star it can be indicative of deeper issues. Here’s why dentists like Iyer are noticing a rise in bruxism, and why it warrants attention.

Is teeth grinding becoming more prevalent? Dr. Michael Glogauer, head of dentistry for the University Health Network and a professor at the University of Toronto, observed a similar surge in bruxism at his practice, alongside more serious dental problems. “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 prior, Glogauer stated.

Like Iyer, he attributed much of the increase to stressors ranging from global events like the COVID-19 pandemic and various wars to local issues such as the affordability crisis. “I think life and everything that’s going on right now, and during the past four-plus years has definitely led to increased stress. So it’s not surprising that, as a result, teeth grinding has gone up,” he remarked.

Meanwhile, prescriptions for antidepressants continue to climb, with a recent report showing a 7.4 per cent increase in total mental health prescriptions in Canada from 2019 to 2021. These, along with the use of recreational drugs, tobacco, and caffeine (some of which are also rising), have been linked to bruxism, Glogauer explained, potentially contributing to the current trends.

However, experts like Dr. Gilles Lavigne, a dental medicine professor at the Université de Montréal and a bruxism expert, suggest that stress and medication might not fully explain the situation. Lavigne emphasized the impact of education, noting a significant rise in public awareness of tooth and jaw disorders in recent years, leading more people to seek diagnosis for pre-existing conditions — particularly after the COVID-19 pandemic, which heightened health consciousness.

According to Lavigne, around 8 to 12 per cent of Canadians experience nighttime bruxism, although it can also occur during wakefulness. While stress appears to be a common factor, studies indicate a complex array of causes and implications. Some antidepressants and illicit drugs like cocaine may exacerbate teeth clenching, but not universally so. Awake teeth grinding, often associated with habitual clenching, can be learned behavior, with children of parents with bruxism being more likely to develop it themselves.

Moreover, research suggests links between bruxism and sleep-related breathing disorders like sleep apnea, a phenomenon increasingly observed by practitioners. Lavigne highlighted the significance of mouth breathing, which can influence palate development and contribute to bruxism.

Furthermore, Lavigne and Dr. Iacopo Cioffi, an associate dentistry professor at U of T, underscored bruxism’s association with serious health conditions. In rare cases, increased teeth clenching could indicate underlying neurological issues or even neurodegenerative disorders like Parkinson’s disease or sleep epilepsy, particularly in children.

While not fatal, bruxism can lead to debilitating jaw pain and fractured teeth, noted Glogauer. Without addressing the root cause, which can be challenging, the condition may persist, highlighting the importance of professional evaluation and treatment. Nightguards, muscle relaxants, physiotherapy, and cognitive behavioral therapy are among the management options, but vigilance is essential, as some causes can pose life-threatening risks.

If you’re experiencing symptoms such as jaw pain, headaches, or tender teeth, or if your partner notices nocturnal teeth grinding, seeking dental care is advisable, emphasized Glogauer. Left unchecked, bruxism can significantly impact quality of life, underscoring the urgency of intervention.

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