Dentists are reporting a surge in teeth grinding and cracking in recent months linked to ongoing pandemic stress.
The Irish Dental Association (IDA) said while there is a lack of hard data, conversations with patients relating to coronavirus anxiety and a rise in cases of damaged teeth point to a growing problem.
"I would probably get a patient a day talking about it; I would have had one a week," before the pandemic, said Dr Caroline Robins, head of the General Practitioner Committee at the IDA, who noted an obvious pattern in patient conversations in recent months.
“It’s hard to put a number on it but it’s definitely there. I have only worked since half past eight this morning and [by lunchtime] I have already had two [patients with related damage],” she said.
One of those, a childcare worker, complained her teeth “feel bruised”, while another had possibly split her tooth in half.
Clinically termed bruxism, the act of grinding or clenching teeth is generally an unconscious behaviour linked to stress and anxiety. It is common and difficult to measure, not least because many people do it unknowingly in their sleep.
The problem tends to escalate sharply in times of upheaval – 10 years ago the IDA reported a similar "dramatic increase" linked to the economic downturn. At that time as many as one million people in Ireland were believed to be grinding their teeth.
In the United Kingdom at around the same time, dentists were putting the problem down to job insecurity, a concern that is once again to the fore.
“There is a lot of anxiety out there, a lot of stress,” said Dr Robins. “Whether it’s your job, your level of exposure to the virus, are you a frontline worker. There is all manner of things.”
Last October, a study in the Journal of Clinical Medicine noted that pandemic-related "health threats, economic uncertainty and social isolation" were capable of causing bruxism. Examining the experience of almost 1,800 patients in Poland and Israel, it concluded the pandemic "has caused significant adverse effects on the psychoemotional status of both" causing an "intensification" of the problem.
While in Ireland the HSE estimates between 8 and 10 per cent of the population are affected by bruxism, the study put levels of associated pain in Poland and Israel at 49 and 24 per cent respectively, post-lockdown.
"Our teeth are strong but they can crack if you are putting all that pressure on them," explained Dr Lisa Creaven, a Galway-based dentist and co-founder of Spotlight Oral Solutions who says the issue is increasingly under discussion among colleagues.
“What you are doing is putting all the enamel under pressure and all the muscles of your jaw, head and neck.”
Normally people’s upper and lower teeth should only be in contact for about 21 minutes a day, she explained, but this is greatly increased by clenching and grinding.
“It’s definitely associated with certain types of personalities. You don’t see it in very chilled out people; you see it with worriers and thinkers.”