Volume 7 • 2020 • Issue 6

“I don’t want to just fix a tooth,” says Dr. Abrams, “I want to get to the root of the problem.” When he asks patients about how they’d been feeling, many described stress during COVID-19, trouble sleeping, and both muscle and tooth soreness. In many cases, instead of simply diagnosing a fractured lingual cusp, Dr. Abrams found his patients suffered from stress-related grinding parafunction. He coined a term for it: COVID-19 bruxism. Dr. Abrams read what research he could find about stress and the pandemic. He found a systematic reviewthat suggested that post-traumatic stress and depression are more common in the general population during the pandemic. 1 A letter to the editor in theMay 2020 issue of the Journal of Applied Oral Science documented the interaction between COVID-19, bruxism and TMJ disorders. 2 “It struck me that this is an opportunity for our profession to show that we are essential health care providers,” Dr. Abrams says. “We see our patients regularly and we build trusting relationships with them. If our patients are suffering from stress-related illnesses, we can be first responders. We can ask questions. We can point them toward appropriate care.” Dr. Abrams tries to talk to his patients not only about the circumstances of their dental problems, but also about their lives. He asks them about their stress levels and about specific symptoms of stress that often correlate with bruxism. He talks about his own stress- relief strategies, such as long walks. He has found that more often than not, patients are open to conversations that include topics that go beyond their dental health. “It’s important to listen and be responsive to each person’s individual story,” he says. Dr. Abrams thinks that it might be beneficial for dentists to get training in responding to stress-related health problems that may arise in the dental office. “It makes sense to me that we treat the health of the whole person,” he says. “I think it’s a real value proposition for the profession. A broken cusp could be a catalyst for better mental health.” Investigating an Increase in Tooth Fractures During COVID-19 During the threemonths that his Toronto dental office was closed due to the pandemic, Dr. Stephen Abrams and his colleagues tracked their emergency calls. “Half of them were due to fractured or broken teeth,” Dr. Abrams says. When he returned to practice, he noticed that the fractures tended to be on non-functional cusps. He wondered why so many people were fracturing their teeth without the usual kind of trauma. Dr. StephenAbrams President QuantumDental Technologies Co-Founder Cliffcrest Dental Office References 1. Vindegaard N, Benros ME. COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain Behav Immun. 2020 May 30;S0889-1591(20)30954-5. 2. Almeida-Leite CM, Stuginski-Barbosa J, Conti PCR. How psychosocial and economic impacts of COVID-19 pandemic can interfere on bruxism and temporomandibular disorders. J Appl Oral Sci. 2020;28:e20200263. For more with Dr. Abrams on ‘COVID-19 bruxism’ visit CDA Oasis: bit.ly/2Yaq8Nq 31 Issue 6 | 2020 |