COVID-19 JAW PAIN – PART 2

Last week I discussed clenching, which is vertical force put on teeth. Grinding or bruxism is lateral (excursive) forces put on teeth that cause teeth to rub together and wear. Both of these are very destructive to teeth, joints, and muscles.

Some people present with symptoms relating to these two issues, but more often than not, people do not have symptoms. We dentists know that patients who present with signs of tooth wear are riskier to treat. Riskier because the “issues” are often times, and maybe even most often, not treated. This is a significant reason for tooth structure breakdown and shorter life-span dental work.

There are many reasons people grind or clench their teeth. Sometimes these problems are preventable with simple lifestyle changes, and other times they need more aggressive treatment because they are coming from the central nervous system. They can also be caused by certain medications.

In today’s world, everyone is being pushed to their limits in just about every aspect that you can imagine. More is demanded with fewer resources and less time. All this becomes a source of stress, anxiety, and even depression for the population as a whole.

This “epidemic” of depression and anxiety spurred the development of newer medications with fewer side effects to help manage these conditions, and hence, the SSRIs (selective serotonin reuptake inhibitors) were born in 1988. Since then, recent reports show that the use of the SSRIs (i.e. Paxil, Zoloft, Prozac, Celexa, Effexor, etc.)  has increased more than 400 percent!

Dentists see the signs of clenching and/or grinding of the teeth on a regular basis, and some of it is the result of stress and anxiety. But another factor to keep in mind is that patients are now taking more anti-anxiety and antidepressants than ever before in history. It is often overlooked, but the SSRIs and even some of the SSNRIs (Selective Serotonin Norepinephrine Reuptake Inhibitors) often increase bruxism or clenching and grinding effects at night.

This can lead to an increased frequency of headaches, jaw pain and other symptoms of clenching/grinding. In my own practice, I have seen many patients who have presented with increased frequency and intensity of symptoms shortly after starting on these medications. I have found that sometimes a change in medication or reduction in the dosage with the help of the prescribing medical doctor can help, but sometimes there seems to be little to no improvement.

In recent studies, there is support for a theory of how these medications cause an imbalance in the brain, leading to a drug-induced bruxism that sometimes does not go away with a decrease or cessation of the medication and may even require other medications to help alleviate the bruxism.

So, if you are on any of these medications, the next time you see your dentist you should ask if you have any signs of tooth wear. And, by all means, if you are having any symptoms that you do not feel are normal, you should bring those up too.  If your dentist can show you pathological tooth destruction, you might want to keep in mind that not treating the underlying cause may contribute to unwanted future dental issues.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.