Sir, with increasing levels of unemployment, isolation and changes in normal routine during the pandemic, impacts on mental health are unavoidable.1 Elevated levels of stress and anxiety have a well-established link to bruxism,2 a common factor that predisposes a tooth to crack and fracture.3

Consequently, there has been an increase in patients presenting with features of toothwear, attributed to grinding and jaw clenching. Studies have illustrated increasing levels of bruxism and temporomandibular disorders in those suffering with an aggravated psycho-emotional status.4 Having diagnosed several patients attending in pain with tooth fractures, the prevalence of such pathology has also been seen increasingly in dental practices.5

Conducting a thorough examination, looking for early signs of toothwear and taking a detailed social history can play an important role in establishing a patient's risk of bruxism and tooth fracture. In patients suffering from stress and demonstrating evidence of bruxism, giving advice on how to cope with anxiety, signposting to national agencies and providing interventions such as mouth guards can help to minimise the risk of toothwear and fractures.