COVID-19 Stress, Your Health, and Your Teeth

29 Mar COVID-19 Stress, Your Health, and Your Teeth

Whether you’ve worried about your and your family’s health, job or business security, or accessing services you count on, you’ve likely experienced a whole lot of stress in this past year. The hypothalamus, the mission control room in your brain, has been busy sending out repeated “fight or flight” stress hormones. Every time it does your breathing quickens and your body kicks into emergency preparedness enabling you to act quickly. Our bodies give us these cortisol and adrenaline boosts to protect us. However, most of us have had ongoing stress responses for nearly a year now. That state of constant stress can be really hard on your overall health. Your teeth are also negatively affected, but there are things you can do to protect your family’s oral health–even during this long COVID pandemic.

Symptoms of COVID-Related Stress

COVID-related stress hits some harder than others. If someone in your family is at a higher risk for severe illness due to age or underlying medical conditions, or has lost a job, or your job puts you at a higher risk because you’re a health care worker, first responder, or essential worker—you’re under a lot of sustained stress. The CDC has identified common responses to COVID stress, and if you’re experiencing these symptoms, you like many are in COVID-coping mode:

• Changes in sleep patterns.
• Changes in eating, hygiene, and oral care habits.
• Increased use of alcohol and other substances.

Any one of these stress responses can damage your health, and they certainly can have a detrimental effect on your oral health. In fact, dentists across the nation are seeing the results of COVID-stress in the increased numbers of caries, cracked teeth, gum disease, TMJ, and bruxism.

Sleep and Your Teeth

When you sleep, your body recovers and repairs from all that the day threw its way. According to the National Sleep Foundation, adults need 7 to 9 hours of sleep. Growing bodies need more: toddlers between 11 and 14 hours, preschoolers between 10 and 13 hours, school-aged children between 9 and 11 hours, and teenagers, 8 to 10 hours. Things that negatively influence uninterrupted sleep include depression, anxiety, alcohol, and certain medications.

When you sleep, your teeth respond to what your brain processes. Clenching and grinding your teeth is a common involuntary reaction to anger, fear, or stress. According to a poll of the American Dental Association members, dentists are seeing a startling rise of stress-related oral health problems: a 59 percent increase in bruxism (teeth grinding and clenching), a 53 percent increase in chipped and cracked teeth, and a 53 percent increase of the painful temporomandibular disorder (TMD).

Sleep Strategies that are Good for Your Teeth

Get to the dentist!

First, if you know you grind your teeth at night, you need to make a dentist appointment without delay. Even if you’re not sure about your night-time oral habits, if you commonly wake up with a dull headache, jaw soreness or facial pain, you need to consult your dentist. It’s important to have your dentist assess any damage clenching and grinding may have caused. You may need a protective bite guard to sleep in. Don’t delay this. Long term, bruxism can lead to loss of enamel, broken teeth, and even tooth loss.

Adopt habits conducive to good sleep.

The Mayo Clinic provides tips to improve your sleep, even in stressful times.

1. Stick to a consistent sleep schedule as much as possible.
2. Don’t eat or drink before bed. Don’t go to bed on a full stomach. Stimulants like nicotine and caffeine take hours to wear off and should be avoided. Likewise, even though alcohol (a depressant) can initially make you sleepy, it’s likely to disrupt your sleep later in the night.
3. Create a restful environment that is cool, dark, and quiet. Got a spouse that snores? Use earplugs. Put away your electronic devises before bed.
4. Limit your daytime naps to no more than 30 minutes.
5. Get some exercise, preferably outside. Don’t, however, exercise close to bedtime.
6. Implement some stress management strategies like organizing, prioritizing, and delegating so you don’t have to replay all you need to get done while you’re trying to go to sleep. Consider meditation, which research shows is effective in easing anxiety.

Stress Eating and Your Teeth

If you packed on “the COVID 19” (as in pounds) in 2020, you’re not alone. Studies abroad and in the United States show that pandemic stress eating has increased childhood obesity rates and worsened diets. One survey from Ball State University found that about 31% of those surveyed reported that their diet had worsened during the pandemic. Although power-slamming a chocolate cake might be tempting when you’re low, that eating isn’t solving stress. In fact, in a study published in the October issue of European Journal of Investigation in Health, Psychology, and Education, researchers found that stress levels are actually much higher for those engaging in unhealthy eating practices. That study verified that nearly 1/3 of study subjects reported that not only had their diet tanked during the pandemic, but those who struggled with unhealthy eating during the pandemic felt even more stressed because of their poor eating.

For our children and teens, pandemic stress eating is wreaking havoc on oral health. With school and sports programs suspended, kids are spending a lot of time indoors at home. Teens, especially, are staying up later and operating outside of their usual routines. And that includes their oral care routines. That change in routine has all too often resulted in increased consumption of highly processed and high-caloric foods. Snacks, sugary drinks, and diets higher in carbohydrates are on the uptick, and frequent sugar intake causes dental biofilm accumulation, which contributes to the “development of caries lesions and periodontal disease.”

Routines Protect Your Family’s Health and Teeth

Routines are key to coping with COVID stress. Dr. Amy Shriver of Blank Children’s Hospital in Des Moines, Iowa says that “Routines can help us feel a little more in control when we’re in this scenario when there’s a lot that we can’t control.” In fact, routines protect not only your overall mental and physical health, but also your teeth and gums. Departing from usual self-care routines increases your risk for heart disease and other stress-related illnesses. One of the most important things you can do for you and your family is to intentionally reincorporate and follow your usual self-care and oral care routines.

Recommit to Your Usual Oral Care Routines

• Brush twice daily and floss at least once a day. (Even though it’s all too easy to skip your morning brushing or snub your floss packet late at night when you’re tired, think of it as reinvesting in yourself and your family.) And don’t forget to tend to your gum line.
• Make sure you’re eating a balanced diet that includes veggies, fruits, whole grains, and low-fat dairy. Limit foods packed with sugar and starch, for these stick to your teeth.
• Drink plenty of water every day, especially after having something sweet.
• Use soft-bristled toothbrushes and fluoride toothpaste. If your toothbrush is old and ratty looking, replace it.
• Try to avoid bad habits like ice chewing or crunching on hard snacks.
• Outdoor activities reduce stress, but don’t forget to protect your teeth. Ensure your kids wear mouthguards for activities like mountain-biking, roller skating, and skateboarding. These are perfect “social distance” activities, but your kids will be safer with a helmet and mouthguard!

Alcohol and Other Substances.

Let’s not kid ourselves. COVID stress has increased alcohol and substance use. One study published on the JAMA Network found that March 2020 national sales of alcohol were up 54% over the previous year, and online sales had increased 262 percent from 2019. Legal cannabis use is also on the rise. Some states have seen as much as a 20 percent increase in cannabis sales, and a Harris Poll for Curaleaf reports that “42% of adults aged 21+ who have ever consumed cannabis have started or increased their consumption since the beginning of the pandemic.”

There are many downsides to using alcohol or cannabis to cope with COVID stress. In terms of your oral health, increased use of alcoholic beverages like white wine, beer, and the new cider drinks, can cause erosion of enamel. More tannic red wines are likewise acidic, and overuse can result in staining and pain and sensitivity. Other hard alcohols like vodka and whisky can cause dry mouth, and mixers are often high in sugar.

Dry Mouth (Xerostomia)

Dry mouth can be brought about by stress; it can also be caused by using drugs (prescription and recreational) or alcohol. As one might expect, anti-depressant prescriptions have risen throughout the pandemic by as much as 22 percent over the previous year. Anti-anxiety prescriptions are up 34 percent. Both can cause dry mouth. Alcohol, because it is a diuretic, can also increase dry mouth. Cannabis use, whether smoked, vaped, or ingested as an edible, likewise causes “cotton mouth.”

The American Dental Association warns that reduced salivary flow can lead to problems like tasting, chewing, swallowing, and even speaking. Saliva is your body’s way to fight bacteria that form to create dental plaque—the root of tooth decay and gum disease. When you have dry mouth—regardless the reason–you have an increased risk for dental decay, tooth demineralization, tooth sensitivity, and/or oral infections.

Talk to your dentist about your alcohol and cannabis use, and make sure your dentist knows what prescriptions you take. You can mitigate some of the dry mouth these cause by chewing sugarless gum. Brushing twice a day with fluoride toothpaste likewise can relieve some of the adverse effects of dry mouth. The ADA also lists the simple ways in which you can relieve dry mouth. These include:

• Sipping water or sugarless, non-caffeinated drinks.
• Sucking on ice chips (but don’t chew the ice).
• Use lip lubricants often–every 2 hours.
• Limit your alcohol, tobacco, recreational drug, and caffeine intake.
• Consider using an ADA-approved oral rinse for dry mouth.

Safety at the Dentist

Whatever comes in 2021, you’ll want to keep your teeth healthy. We at Renae Wilson, DDS Cosmetic and Family Dentistry are here to help you do just that. We work hard to ensure your safety (as well as our staff’s) by wearing full protective gear, ensuring all surfaces and dental tools are sterile, spacing out appointments, and talking with you to learn about your health and any symptoms you might be experiencing that could indicate exposure to COVID-19.

Your teeth were there for you during a tough year, now it’s time to ensure they’re healthy and ready to go for 2021 and beyond! Give us a call, and in the meantime, do what you can to destress. Your teeth will thank you.