By: Genni Burkhart
COVID-19 has had a significant impact on the well-being of millions of Americans since the initial outbreak last year. Recent studies show this virus is taking a substantial toll on the nation’s oral health, with dental practices reporting a sudden rise in complications due to increased stress and delayed treatment in patients.
Perhaps now, more than ever, it is important for dental practitioners to identify the signs of stress in patients, encourage patient education, and emphasize the importance of keeping up with dental visits—all in an effort to successfully maintain the oral health and wellness of patients through the COVID-19 pandemic.
As the pandemic has interrupted the ability or desire to schedule routine dental care, patients that have delayed regular dental check-ups risk an increase of oral health issues. A survey done in February of 2021 by the American Association of Endodontists highlights the impact the pandemic is having, specifically on those working or studying remotely, and how this significant shift in daily life is also affecting their daily dental hygiene routine. Some of the notable findings of this survey include:
- 31 percent report snacking more on sugar.
- 28 percent report delaying dental visits.
- 1 in 4 of those surveyed reported they’ve delayed brushing their teeth until later in the morning, while 21 percent didn’t brush their teeth at all in the morning.
- 24 percent report flossing less frequently, while 23 percent report they are no longer flossing at all.
STRESS IS WREAKING HAVOC ON PATIENTS ORAL HEALTH
Studies are now indicating a much higher prevalence of stress-related oral health issues, and greater than initially thought. A September 2020 report from the ADA Health Policy Institute reports that more than half of dentists surveyed are seeing an increase of patients with dental issues linked to stress--including teeth grinding, clenching, and chipped or cracked teeth.
COVID-19 has also led to an increase in common mental health issues, including anxiety and depression. A recent meta-analysis of several articles focusing on the link between COVID-19 and stress or anxiety reveals that "COVID-19 not only causes physical health concerns but also results in a number of psychological disorders."
This spike in cases of anxiety and depression is likely due to increased stress. People are losing their jobs, dealing with the loss of loved ones, and struggling to maintain stability during such unpredictable times. Given all of this, the current heightened sense of unease corresponds directly with bruxism.
As stated in a recent article in the Washington Post by Emily Sohn titled, “In these trying times, dentists are seeing more people with teeth-grinding and jaw-clenching — a.k.a. bruxism," Sylvia Kreibig, a research psychologist at Stanford University in California, who studies the bodily effects of emotions, is quoted as saying, “Given that stress is more prevalent,” she continues, “this is a very solid ground for negative emotions to flourish and to affect our sleep and our well-being.”
With the rapid destruction that can result from bruxism, it begs an important question-should we be regularly educating patients on the ways stress can affect their dental health? The simple answer is yes, but the real challenge will be in convincing patients to schedule appointments while keeping them educated on the oral health problems their stress can cause during the pandemic.
In an effort to help prevent bruxism and stress-related jaw problems, patients can use Apps such as BruxApp and GrindAlert to notify them if they’re grinding their teeth by recording sounds throughout the day and at night when they are asleep and more likely to have jaw-related issues. The BruxApp goes so far as to offer users relaxation exercises to reduce jaw tension as a preventative measure, as well as recommendations on meditation and physical exercise to help reduce stress.
TO HELP YOU MUST BUILD TRUST
People who’ve previously been going to the dentist every six months are now neglecting their oral health because of COVID-19 office closures and infection fears, allowing small problems to turn into severe issues. As a result, earning patients' trust is more critical than ever.
The pandemic has inevitably caused some patients to become more cautious and aware of the steps needed to ensure their safety before returning for dental care. Patients are asking the following questions:
- Do I have to take off my mask for my appointment?
- Have these instruments been sterilized?
- Do you change your gloves between patients?
As dental professionals, having a consistent method of communication with patients through the pandemic is vital. Posting commonly asked questions and COVID-19 safety procedures on your website and social media channels, or through emails and newsletters will all act as valuable tools in alleviating anxiety and further instill trust with patients.
Perhaps one of the most obvious, and easiest, ways to encourage patient wellbeing during the pandemic is to spend more time listening to patients. Many of the studies mentioned here show the need for patient trust in physicians is at an all-time high. This can be done through answering questions on social channels, spending more time on the phone with patients, or scheduling virtual appointments to ensure their questions and concerns are answered before, during, and after appointments.
KEEP PATIENTS INFORMED
Continue to inform and educate patients that their health and well-being are also your number one priority. Consider that patients may be unaware of the potentially harmful effects of skipping dental appointments, as this risk far exceeds the risk of contracting COVID-19 from visiting your practice. Focus on being a trustworthy resource for your patients and remind them of the importance of regular dental care during the pandemic.
Help patients feel more comfortable by letting them know what to expect when they come back for an appointment. Steady declines in both new patient appointments and follow-up or check-up appointments could be due to various factors, but it has become common to hear from patients that the fear of catching COVID-19 has caused them to neglect their oral health. Interestingly, less than 1% of dentists in the US have actually tested positive for COVID-19, but many people are still choosing to skip regularly scheduled cleanings or even delay necessary treatments during the pandemic.
The health issues that COVID-19 poses go far beyond an infection with the virus. Even those patients not directly infected with the virus are showing signs of health problems related to the far-reaching impact of the pandemic. As medical professionals, recognizing signs of stress in patients while stepping up efforts to build trust and inform patients on the importance of oral health will go far in helping them maintain their oral health and overall well-being through COVID-19.
About the Author: With over 10 years as a published journalist, editor, and writer Genni Burkhart’s career has spanned across politics, healthcare, law, business finance, and news. She resides on the western shores of the Puget Sound where she works as the Editor in Chief at DOCS Education out of Seattle, WA.