In a February survey Conducted by the American Dental Association, 76 percent of general dentists said the prevalence of teeth grinding, or bruxism, among their patients had increased compared to pre-pandemic times. About two-thirds reported seeing an increase in problems related to broken and cracked teeth, as well as headache and jaw pain symptoms, according to the survey. Meanwhile, about 30 percent of respondents said they noticed more tooth decay and periodontal diseasean infection of the tissues surrounding the teeth, in their patients.
Brad Guyton, Chief Dentist for Delta Dental of Virginia, said the increase in common problems such as tooth decay was not as severe as many dentists feared, perhaps because many dental offices did not stay closed for long.
“If we had been closed for six months, that could have been devastating, not only for the dentists and their businesses, but more importantly, for the patients who had to come in,” Guyton said.
But even though dentists were able to reopen early in the pandemic, concerns about the coronavirus continued to keep many patients away, making home dental care “even more important,” said Domenica Sweier, a clinical professor at the University of Michigan School of Dentistry.
“Most people, I think, tried their best in a very unusual situation,” said Ada Cooper, a spokeswoman for the American Dental Association and a consumer advocate with a private dental practice in New York. “Even so, there is no substitute for regular visits to the dentist.”
As the pandemic subsides, Here are some tips on brushing your oral care habits and dealing with bruxism.
If you are fully vaccinated and have insurance, there is no reason not to return to the dentist. But even if you haven’t had your shots or are concerned about unvaccinated people in your household, dentists say it’s essential to get back on track with appointments and do so safely.
Before the pandemic, dental offices were already implementing “state-of-the-art infection control,” Cooper said. “We have always taken special care to protect patients from viruses and other pathogens.”
Many dentists have since stepped up safety precautions, and more than half of the country’s population is now at least partially vaccinated. But resuming regular dental appointments doesn’t mean you can relax your personal care schedule, experts said. “We can do the best cleaning in the world, but if you don’t brush and floss at home, this gum disease will remain active,” said Zainab Mackie, a dentist in Detroit.
Dentists have long urged people to avoid overeating refined carbohydrates and sugars. But that has been a challenge during the pandemic, said Tien Jiang, an instructor in the Department of Oral Health Policy and Epidemiology at Harvard Dental School, who noted that working from home has led to an increase in snacking. In addition, more Americans have also engaged in stress eating.
The reason snacking can lead to tooth decay is that your mouth contains bacteria that feed on food and release acid, Sweier said. This lowers the pH in your mouth and can cause enamel desalination, a precursor to cavities.
“The more times during the day you contribute to lowering the pH,” he said, “the more times you make your teeth susceptible to cavities.”
In addition to cutting back on snacks, Sweier recommended watching your eating and drinking habits. Avoid snacking on food or drinking sugary or acidic drinks during the day, she said. If you do have a snack, Sweier suggested rinsing your mouth with water afterward or chewing sugar-free gum, which can help stimulate saliva flow.
You should also stay hydrated with water, Jiang said, noting that dry mouth can lead to a higher risk of tooth decay.
Oral care is highly individualized, so choose toothbrushes, toothpastes, floss and rinses that you’ll use consistently, dentists say, as long as you use them as recommended. (The American Dental Association endorses products with it Seal of Acceptance.)
Advanced electric toothbrushes have sensors that indicate when you’re applying too much pressure and timers to keep track of how long you brush, which can be helpful. But whether you prefer a manual or electric toothbrush, make sure it has a soft bristle head and replace it when you notice the bristles are scratched or falling out.
The type of toothpaste and mouthwash you should use depends largely on your oral health needs, experts said. If you are more prone to tooth decay, fluoride toothpastes and mouthwashes may be better.
Mouth guards to protect your teeth from grinding or clenching should ideally be custom-made by a dental professional, experts said. Over-the-counter mouthguards can vary in softness and may encourage users to grind even more, Jiang said. Additionally, people’s teeth have unique contact points that general guards don’t take into account.
“You could actually stress certain areas of your mouth more than if you had a custom fit,” he said.
Brush your teeth for two minutes at least twice a day or after you eat. Focus on each quadrant of the mouth and be sure to brush where your teeth meet your gums. Brush in a circular motion and be careful not to press too hard.
“There can be erosion of the tooth surface or the tissue” if you brush too hard, Guyton said. Aggressive brushing with improper technique can create notches in your teeth, potentially making them more sensitive or leading to gum recession. “Some people feel that the harder you rub, the better off you are. It’s not the right way to do it,” he said. “Be kind but diligent and time is more important than intensity.”
If you use an electric toothbrush, “let the brush do the work,” Sweier said. “Try not to brush it and actively use it, but ride it like a train on a track.”
And remember to brush your tongue, experts said. Tongues have “little cracks along them, so it’s so easy for bacteria to sit there and build up,” Mackie said. In addition to bad breath, not cleaning your tongue well can also lead to persistent dental health problems, he said. “Even if you brush your teeth, bacteria from your tongue can go to your teeth and then you’ll find you still have these problems.”
It is equally important to floss at least once a day, especially at night before bed, and to use the correct technique. Avoid squeezing the floss between your teeth, because that can injure your gums, Cooper said. Instead, “sink it between the teeth, let it float very gently under the gum line on either side of that tooth and the tooth next to it.”
If you are not taking good care of your mouth and teeth, you will start to see or feel it.
Untreated grinding or clenching can cause headaches, jaw pain and increased tooth sensitivity. You may also wake up with pain in the temporomandibular joint, where the jawbone connects to your skull and surrounding muscles.
Bleeding or inflamed, swollen gums are other signs that there may be problems with your oral health, Guyton said. “When you brush your teeth and it bleeds a little, that’s not normal. This could be a sign of gingivitis or something more important.”
But it can be very difficult to self-diagnose dental conditions or know for sure that your oral care regimen is working, Cooper said.
“Going to the dentist is really the best way to catch problems before they become big issues,” she said. “Often, from the time something starts bleeding, when something starts hurting, the problem requires much more treatment than would have been necessary if the problem had been identified and treated early by visiting your dentist on a regular basis.”
Emily Guskin contributed to this report.
