We have noticed a marked increase in broken teeth and sore jaws with TMJ (temporomandibular joint) problems since the pandemic of COVID-19 started and people were in lockdown; enough to warrant more than a passing thought. The need for mouth guards to prevent people from grinding and clenching their teeth is correspondingly up.

The Spanish Dental Association (Ilustre Colegio Oficial de Dentistas de Málaga, COEMA) hasn’t done a survey to verify this increase in dental problems since the pandemic started, but reports from colleagues of pandemic-related dental problems are common says Dr. Mikael Kahn. Mikael says, “Bacteria doesn’t take a break, nor does it know there is pandemic! One can postpone dental treatment for a while, but sooner or later it gets to a point where one can´t put it off any more.”

The combination of being in lockdown and therefore, delaying treatment, the stress of being without a job or wondering how one will pay one’s rent, or the fact that one has adverse working conditions, has caused the problems of broken teeth and sore jaws.

We are seeing the amount of stress people are under, having a severe impact on their teeth because of clenching and grinding. This in turn has created problems with their jaw and TMJ. Additionally, with people working from home more often than not they don’t have appropriate chairs to sit in for long periods of time and therefore, are hunched over at their computers. This in turn can increase grinding (bruxism).

In addition to stress and delayed care, we are seeing more cavities as people are snacking more because they are working from home and have ready access to foods that they would not ordinarily have at work. Consequently, people are also brushing less frequently. When people get out of their routines, many times the oral hygiene follows suit.

Having reviewed our records from the same period as last year from June to October, we have seen a 54% increase in the need for mouth guards, 87% increase in broken teeth treated either by composite repair or crowns and a 12% increase in treatment for cavities.

While we can´t say definitively that these statistics are a direct result of the lockdown we experienced in the spring, we can say that we have treated more broken teeth and TMJ problems than ever before during the same period.

What is tooth enamel?
Tooth enamel is that hard, shiny layer of material which protects your teeth against decay. It is the layer of material that you are to brush and floss on a daily basis. To be more precise, it is hydroxyapatite, a translucent calcium phosphate. Suffice it to say enamel is the hardest mineral element in your body, even harder than bone. Don´t be fooled though as it still can be damaged.

What causes enamel to be damaged or eroded?
• Poor oral hygiene
• Acidic food & drinks (lemon juice, limes, grapefruits, grapes, pineapples, pomegranates, blueberries) to name a few
• Soft drinks in excess
• High sugar and starch diet
• Teeth grinding – wears away the enamel and leaves the dentin exposed
• Medications (antihistamines, decongestants, high blood pressure medications (including diuretics & calcium channel blockers), antidepressants, sedatives, pain medications, antacids
• Dry mouth – xerostomia, where the saliva glands don´t make enough saliva to keep the mouth wet. Many times this is a side effect of medication or radiation therapy.
• Acid reflux that occurs more than a couple of times a week
• Gastrointestinal problems – repeated vomiting from GI problems or eating disorders

What does tooth erosion look or feel like?
When your teeth become rough and irregular, or serrated like a saw blade you know the enamel has eroded. Essentially you reshape your teeth. You can experience sever sensitivity to both cold and hot temperatures and to sweets. You can also feel a shooting pain through one or more teeth so much so that it makes your eyes squint.

Can tooth erosion be repaired?
Once tooth enamel is gone, it´s gone. Teeth need to be rebuilt with composite restorations, crowns or veneers. The advantage of composite restorations is that it is a comparatively inexpensive and a conservative way to restore teeth. The result is immediate. More extensively damaged teeth might necessitate a porcelain veneer or porcelain crown.

You only get one set of permanent teeth; therefore, you might as well look after them. They are not meant to bite off thread or to open a bottle cap in a pinch. Your teeth need to be healthy as they not only serve to make us look good, but they also aid in digestion. As your mouth is the beginning of the digestive system it stands to reason that if you have digestive problems then you look to the overall health of your mouth as well as your stomach to determine the problem.

Begin by looking at your teeth and see whether any of the above symptoms are similar to yours. If they are then you know what to do. Call your dentist for a check-up.

The effects of grinding teeth for many years

Ever wake up with a headache and it wasn´t from overindulging the previous night?

Do you ever experience any of these other symptoms?
• Migraines
• Tinnitus
• Painful facial muscles or jaw joints – TMJ
• Clicking, popping or grating sounds in your jaw
• Painful neck or shoulders
• Earache or a toothache or had many teeth hurting
• Broken or worn teeth

If you have answered yes to one or more of these questions, then you may suffer from a condition called, bruxism.

What is bruxism?
Bruxism is the habit of clenching or grinding ones teeth. This happens in the early part of the night when you are deep asleep. Sometimes it can be loud enough to wake up someone sleeping next to you. With some people they make no sound at all, and it is not until a dentist discovers wear on patient´s teeth that they know they are doing it at all.

What are the signs of bruxism?
Teeth that show signs of wear is one of the most obvious signs of bruxism. The force of the grinding can cause the teeth to break or fracture or even become shorter. It can damage dental restorations or cause veneers to pop off and teeth to become loose, as if the tooth is becoming “extracted”. Prolonged grinding can wear through the layer of dentin and cause teeth to become sensitive to cold and hot.

With lower front teeth you can sometimes see that the teeth have a sharp angle like a ski hill or they become irregular and chipped. The upper front teeth can come to be very thin. The molars or the big teeth can become flat and shiny and have the appearance of a skating rink. As you can tell, excessive grinding takes a toll on teeth.

What causes bruxism?
The causes of bruxism are not conclusive as many factors may be involved. One consistent theme that seems apparent though is that stress plays a big factor. In addition, an unbalanced bite, crooked or missing teeth may also be contributing factors. An unbalanced bite or a bite that feels like teeth are “high” can quickly become a TMJ issue. Furthermore if you don´t have back teeth, then the load is distributed on the front teeth only causing excessive wear on them.

What to do if you suffer from bruxism?
Consult your dentist to find the best solution for you. It could be a night guard that is worn while you sleep that prevents teeth coming into contact if you grind excessively and therefore, relieves some of the pressure of grinding and clenching. You will still grind and clench your teeth, but you will not be wearing away your teeth as you will be biting on the night guard instead.

Night guard

If you have broken teeth or have worn them excessively, they may need reshaping, rebuilding or possibly crowns.

Maybe you need to find ways to relax in your daily routine. It could be time to sit and read that book you have wanted to start, or to listen to your favorite tunes in peace and quiet. A nice warm bath at the end of a day is also a great stress reliever. What is your personal stress reliever? Remember what it is and try to make more time for it.

As continued grinding and clenching wear away the teeth, you might like to think about what is causing it in your own life. Whatever your answer, it is wise to see your dentist to discuss it and see what you can do about it.

Tooth sensitivity is a common dental problem that usually starts with a temporary sudden, sharp pain when eating, drinking or brushing your teeth and sometimes when exposed to cold air. At least 40 million adults suffer from sensitive teeth in the United States, according to the American Academy of General Dentistry.

5 Reasons for Tooth Sensitivity

1. Tooth grinding – Most people to some extent grind their teeth mainly at night and primarily when they are under stress. This grinding can wear away the enamel and leave the dentin exposed.

2. Receding gums – Brushing your teeth too vigorously or with a toothbrush that has hard bristles can wear away tooth enamel and expose dentin.

3. Chipped or fractured teeth – Broken teeth are a highway for bacteria and cause inflammation in the pulp of the tooth. More severe cases can lead to abscess and infection.

4. Acidic and sugary sweet foods – Citrus fruits and sticky sweet candy encourage enamel reduction.

5. Fillings – Sometimes after a composite filling, teeth become sensitive when biting down. This can be fixed with a simple bite adjustment.

Like anything else, you need a diagnosis. If the cause is not understood the symptoms may lessen, but they will not disappear. Proper diagnosis of the sensitivity is essential for treatment, and there is no single treatment that works for everyone.

Jaw and facial tension is a very common stress-related problem. The most easily recognized symptoms are unconscious grinding or clenching of the teeth, pain around the eyes, headaches, and neck pain. Chronic jaw tension can even cause shoulder pain and lower back problems.

Face & Jaw Treatment will give you powerful and effective techniques for relaxing your jaw and facial muscles. As tension disappears, you will also lose some of those unwanted lines and wrinkles. This is an excellent exercise to do before and/or after going to your dentist.   

You will need a comfortable chair or seat, or an exercise mat.

• Go slowly
• Make each movement small and easy
• Repeat each movement 4 times
• Relax as much as you can
• Rest briefly after each movement

Starting positions either seated or lying down

Seated:  Find a comfortable position. Rest your hand on your thighs. Your feet should be flat on the floor, shoulder width apart, directly below your knees.

Lying down: Lie on your back and rest your arms by your sides. Either stretch out your legs or bend your knees and rest your feet flat on the floor, shoulder width apart, directly below your knees.

1.    Very slowly open and close your mouth, just a little bit.

• Go slowly & make each movement small and easy
• Repeat each movement 4 times
• Relax as much as you can & rest briefly after each movement

2.    Simultaneously, open your mouth while tilting your head back a little. Then slowly close your mouth and bring your head back to the starting position.

• Notice that tilting your head back helps your mouth to open more easily
• To make this movement easier, relax your neck

3.    Open your mouth a little and keep it open. Slowly move your lower jaw to the right very slightly. Then let your jaw return to the middle, close your mouth and rest.

• Put your left forefinger on your chin so you can feel the movement of your lower jaw more clearly. Does your lower jaw move smoothly or does its movement seem rough and uneven at certain points?
• Go slowly and relax your jaw, so the movement can be smooth and easy.

And now, rest.

• Feel the right side of your mouth and jaw beginning to relax.

4.    Open your mouth a little and keep it open. Slowly move your lower jaw very slightly to the left. Then let your jaw return to the middle, close your mouth and rest.

• Put your left forefinger on your chin so you can feel the movement of your jaw more clearly.
• Does moving your jaw to the left feel different from moving it to the right?
• To make this movement smooth and comfortable, go slowly and move your jaw only a small amount.

Relax your jaw, neck and shoulders. Make each movement relaxed and easy.

Rest for a moment.

• Feel your jaw, mouth and entire face relaxing. As your jaw relaxes, headaches, neck and shoulder pain often begin to disappear.

5.     Open your mouth a little and keep it open. Alternately, slowly move your lower jaw to the left a little and then to the right a little. Move your lower jaw slowly from side to side.

•  Use as little muscular effort as possible.
• Relax your eyes. Notice how they are moving from side to side to side slightly, following the jaw movement.
• Rest often so the muscles of your face and jaw do not get tired.

6.    Open your mouth a little and keep it open. Slowly move your lower jaw forward a little so your lower teeth are slightly more forward than your upper teeth. Then let your jaw return to its normal position and rest.

•  Put your finger on your chin so you can feel the movement more clearly. When your jaw moves forward, does it move straight forward, or does it veer slightly to the right or left?

Go slowly and rest after each movement

7.    Open your mouth a little, move your lower jaw forward and keep it there. Slowly move your jaw to the right a little. Then let your jaw return to the middle and rest.

•  Relax your tongue and throat as much as possible.
• Breath freely.

8.    Open your mouth, move your lower jaw forward and keep it there. Slowly move your lower jaw a little to the left. Then let your lower jaw return to the middle and rest.

•  Relax your arms, stomach and legs.
• Does moving your jaw to the left feel different than moving it to the right?
  

Use as little effort as possible

9.    Open your mouth a little, move your lower jaw forward and keep it there. Then alternately, move your lower jaw slowly so the right a little and then to the

left a little. Move your lower jaw from side to side, gently.

•  Make this movement smooth and continuous.
• Relax your face and entire body as much as you can.
• Don’t let your jaw get tired.

Rest for a moment.

• Feel the ease and relaxation in your face and neck.
• Notice how relaxed and comfortable your mouth and jaw feel.

Measure your improvement: simply open and close your mouth a few times.

•  Let gravity and the weight of your lower jaw open your mouth gently.
• Notice that when your mouth and jaw are closed and relaxed, there is a slight space between your upper and lower teeth.
• Notice how much more easily and comfortably your mouth can open now.

When you stand up and walk around, enjoy your improvement!

You have just done a Feldenkrais exercise.   Do you want to try more ATM (Awareness Through Movement) lessons? This one is from Relaxercise by Mark Reese & David Bersin. You can also try Open ATM  http://openatm.org/ or visit the website of the International Feldenkrais Federation where you will find links to your national Feldenkrais Guild.   http://feldenkrais-method.org/en