THE stresses of the Covid-19 pandemic have seen a rise in bruxism – involuntary teeth grinding and clenching – which leads to a host of health issues.

Musgrave dentist, Dr Eubulus Timothy, listed several symptoms of bruxism: headaches, jaw ache, shoulder pain, lower back pain, numbness in the hands, lack of concentration and insomnia.

“Bruxism is when you grind your teeth, clench your jaw or fix your mandible forward,” he said.

While a certain degree of jaw clenching is normal under temporary stress, such as lifting a heavy object, Timothy says current times are full of stresses.

“Excluding the pandemic, there are so many pressures and worries. We worry about our personal information being stolen, job security, worry about our children – all these add to stress levels.

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“When you put the pandemic on top of that, depression and anxiety set in. We now know that the suicide rate increased by 200% in South Africa during the pandemic. People feel pressure and don’t know where to turn. Schizophrenia cases have increased – there’s so much happening in the mind,” said Timothy.

“When this happens, there’s a tendency for people to brux. When I was studying, bruxism affected men in their 40s and 50s. Today, we are finding bruxism affects young women in their late teens and 20s, – it affects all ages,” he said.

Retrain the brain In earlier years, bruxism was treated with a plate that was worn in the mouth to reduce the impact of grinding and clenching. “The plate would be worn for the rest of the patient’s life. We are trying to stop that. We have new knowledge of how the brain behaves; it’s called neuroplasticity. The brain has the ability to re-learn continuously,” said Timothy. Neuroplasticity reveals how the nervous system responds to certain stimuli, allowing patients to change their behaviour. This knowledge is coupled with the facial feedback hypothesis of Charles Darwin and William James which is looked at to treat bruxism today. “We are learning to treat bruxism differently. First and foremost is to relax the muscle. There are two muscles that are normally involved – the masseter and the temporalis. After relaxing the muscle, we try to reposition the mandible. We add composite on the teeth to take the pressure off the joint. Almost immediately, the pain goes away,” said Timothy. The composite acts as a stimulus that reconditions the brain. “The brain and the muscle will have this conversation, and every time the patient comes in, we will add a little more composite. Slowly, the brain gets the message that the teeth can’t grind anymore,” said Timothy.

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Treating stress While this treatment addresses teeth grinding, it is crucial to address the underlying cause of bruxism – stress. “I suggest my patients take up Pilates, yoga and breathing exercises. I try to encourage them to learn a new instrument, painting or some sort of art. This changes the way they behave, and the mind adapts,” said Timothy. It is important to realign oneself to overcome stress. “Neurons that fire together wire together. For example, when I see Ponds cream, I think of my grandmother and immediately remember how she smelled and how she walked. One neuron was fired, and it fired all these other neurons in the brain. This also happens for people with childhood traumas or PTSD – there are little triggers that bring back negative feelings and increase stress,” explained Timothy. If left untreated, bruxism is a debilitating disease. “Teeth get worn away; patients don’t sleep well. If you feel tired or down and you have headaches or a sore body – visit your dentist and find out if you grind,” said Timothy. “A quick examination will reveal if bruxism is the culprit.”

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