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Sore Jaws, Cracked Teeth COVID Collateral Damage

woman with sore jaw close up

Sept. 18, 2020 -- Stella Acosta is one of those patients a dentist loves. Even with a busy schedule, she never missed her every-3-month dental cleaning, a schedule she and her dentist decided was best to prevent problems.

But that was before the pandemic. "I was due to go in when COVID hit," says Acosta, 61, of Seal Beach, CA, a CPA who also teaches accounting at California State University, Fullerton. Then, in mid-March, the American Dental Association recommended dental offices close for all but emergency and urgent care, and that included Acosta's dentist.

She was taking it all in stride -- or so she thought -- until her tooth grinding, which has been a minor issue, suddenly became major. "I noticed more pain in my jaw area," she says. Then, one by one, as she was eating, three teeth cracked. "Two actually broke in half," she says.

This week, she will see her dentist to start tooth repair and to get measured for a mouthguard to lessen the grinding, which can lead to cracked teeth.

While the American Dental Association hasn't done a survey to verify an increase in dental problems since the pandemic started, reports of pandemic-related dental problems are common, and sales of mouthguards to prevent people from grinding their teeth are up.

"We can defer care for a while, but deferred care becomes critical care at some point. The bacteria don't know there is a pandemic," says Matthew Messina, DDS, a consumer advocate for the American Dental Association and an assistant professor of dentistry at The Ohio State University College of Dentistry, Columbus

A combination of delayed care and stress have led some dentists to see cracked teeth, sore jaws, and cavities, dentists say.

Stress can affect teeth, says Laurence Rifkin, DDS, a cosmetic and restorative dentist in Beverly Hills, CA, who treats Acosta. Rifkin says he's noticed more of his patients coming in with cracked teeth in the past few months. More are also complaining of sore jaws, he says, perhaps from clenching or grinding.

New York prosthodontist Tammy Chen, DDS, wrote in TheNew York Times recently that she's seen ''more tooth fractures in the last six weeks than in the previous six years." On a bad day, she sees more than six patients with the problem, she writes.

Besides delayed care and stress, Messina blames lax oral hygiene for some of the dental issues. "People get out of their routine," he says, and that often includes the oral hygiene habits.

With work-at-home routines common, snacking is probably more common than it was when days were spent onsite working. And, with mainly Zoom or phone meetings to attend, no one's the wiser if you skip toothbrushing.

"If you are staying home all the time, there may be a postural change, as you are hunched over your computer." That can affect your teeth, he says, and worsen grinding.

Rodney Raanan, DDS, a prosthodontist in Beverly Hills, CA, says he has definitely noticed more patients needing cavities filled and mouthguards to minimize grinding. When he reviewed his records from July 1, 2020, to mid-September, he found a 36% increase in ordering of night guards to stop grinding, compared to the same months last year. He has seen a 120% increase over the same two periods for fixing cracked teeth, by such treatment as crowns or bonding, and an 18% increase in treatments for cavities. "I would say, for a good percentage of these, if they had continued to come in for their prophylactic appointments, [the problem] could have been prevented."

Sales of mouthguards are up, says Joseph Hafner, president of TeethNightGuard.com, a division of Sparkling White Smiles Dental Lab in Milwaukee, WI. From April 2020, to present, he says, "we've had an increase of about 15% in sales of our custom dental guards," compared to the same period last year. There's no way to prove the need is COVID-related.

Scott Asnis, DDS, founder and CEO of Dental365, a dental care provider with 46 locations in the New York City metro area, says grinding isn't the only thing causing cracked teeth. "Cavities can weaken the enamel and cause it." Teeth can also crack if the bite is off or a filling is too big, he says.

His offices stayed open during the pandemic to provide emergency care and has seen 50,000 emergency patients since March. "The most common problems include cracked teeth, extensive decay, the start of gum disease, and TMJ pain, from grinding."

While some patients remain fearful of returning to the dentist, Messina says dentists have long taken infection control seriously.

The American Dental Association (ADA) and CDC have protocols in place for dentists to follow during the pandemic. Among the many recommendations are to clean and disinfect surfaces such as the dental chair, light, drawer handles, and countertops between patients. Dental staff wear protective equipment such as gloves, masks, gowns, and eyewear.

It's OK to ask your dentist if they follow ADA and CDC protocols, Asnis says.

WebMD Health News Reviewed by Brunilda Nazario, MD on September 18, 2020

Sources

Stella Acosta, CPA, Seal Beach, CA; adjunct instructor of accounting, California State University, Fullerton.

Matthew Messina, DDS, consumer advocate, American Dental Association; assistant professor of dentistry, The Ohio State University, Columbus.

Laurence Rifkin, DDS, cosmetic and restorative dentist, Beverly Hills, CA.

Scott Asnis, DDS, founder and CEO, Dental365, New York City.

Rodney Raanan, DDS, prosthodontist, Beverly Hills, CA.

Joseph Hafner, president, TeethNightGuard.com, Sparkling White Smiles Dental Lab, Milwaukee, WI.

American Dental Association: "Infection Control."

The New York Times: "A Dentist Sees More Cracked Teeth. What's Going On?"

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