As ocorrências atendidas nos primeiros meses do isolamento, quando as clínicas serviam apenas a urgências, foram desse tipo, e a tendência segue desde então. A principal hipótese é a de que o estresse e as diferentes emoções que vêm a tona neste momento de crise social, econômica e psicológica provoquem problemas bucais.
Giuseppe Romito, professor titular de periodontia na Faculdade de Odontologia da USP, explica que uma das formas de questões psicológicas se manifestarem em nosso corpo é com o apertamento dos dentes.
“Se o dente está fraco, a sobrecarga o quebra. Se o dente estiver forte, ele pode não quebrar, nem desgastar, mas vai mudar de posição, começar a ter movimentação dentária. O terceiro [caso mais comum], quando o dente é forte e a raiz aguenta [a movimentação], vai estourar na articulação”, explica.
Sob condições normais, a musculatura da mandíbula é ativada apenas para falar e se alimentar, permanecendo em repouso nos outros momentos, com os dentes desencostados.
Da mesma forma que o estresse pode causar gastrite ou dores nas costas, ele também pode fazer com que, inconscientemente, apertemos os dentes durante o dia e a noite -ou provocar o ranger de dentes durante o sono, conhecido como bruxismo.
“Em momentos como este, a pessoa nem se dá conta que está realizando esse estresse no dente e acaba levando à fratura, pelo limite de resistência mecânica”, explica a doutora em materiais dentários pela USP e especialista em próteses e disfunções têmporo-mandibulares Ana Romito.
Em geral, o dente quebrado é o primeiro efeito dessa tensão muscular. Se o osso resistir ao estresse, explicam os especialistas, sua raiz pode ficar sobrecarregada, e o dente ficar mole ou se movimentar.
Outro reflexo podem ser as dores musculares, tanto na mandíbula quanto em partes do corpo relacionadas. Também é comum pacientes manifestarem mais de um desses sintomas.
“Os nossos medos, inseguranças, vulnerabilidades, fantasias de iminentes perdas, aparecem em formas e sintomas que chamamos de conteúdos manifestos, que são dores de estômago, pesadelos, bruxismo, fantasias de ter sido infectado, irritabilidade pelo confinamento”, explica a psicóloga Mônica Fortunato Friaça.
Ela mesma conta que teve de tratar de um dente mole durante a pandemia, com um quadro de apertamento e ranger dos dentes.
“Às vezes você tem dor de ouvido cuja causa o otorrino não descobre, e é o apertamento, que leva a uma tensão muscular em cadeia. Pode ser tanto ascendente, causando dores de cabeça, quanto descendente, levando a dores na nuca, ombro e coluna”, explica Ana Claudia.
“Comecei a sentir dores na junta da mandíbula ao bocejar, meu quadro foi piorando a cada dia, até chegar no estágio de não conseguir comer e de irradiar a dor para o maxilar”, diz Flayza Franco, 21, estudante de psicologia.
“A Flayza estava com uma dor de ouvido que eu fui apalpando até ver que ela estava com sinusite e uma tensão de ombro. Como tinha a dor de ouvido de um lado, tensionou o ombro para cima [do outro lado] para compensar. E daqui a pouco [poderia] virar dor de ciático”, conta a sua dentista, Maria Isabel Carreira.
Os tratamentos podem e devem ir além da questão odontológica, explica a dentista, que tem psicólogos e fisioterapeutas parceiros para indicar aos pacientes.
“Tem muitos tratamentos multidisciplinares, eu tento ao máximo esgotar as possibilidades de diagnóstico.” Ela compara cadeira do dentista a um divã, tantos são os casos em que a raiz do problema de um paciente é psicológica.
Como na maior parte das pessoas o tensionar dos músculos é inconsciente, o tratamento mais abrangente utiliza técnicas de recondicionamento dos hábitos e conscientização, para que o paciente se dê conta da força que está aplicando e possa relaxar.
“De modo geral, qualquer coisa que minimize o estresse [ajuda], porque o fator emocional é determinante. Exercícios aeróbios, por exemplo. Para quem tem muita contratura, dores articulares, a gente não aconselha a realização de exercícios de força, porque se você levantar um peso e tiver esse hábito, você pode apertar os dentes”, explica Ana Claudia.
Outro fator importante, lembra Romito, é que ao mesmo tempo que a pandemia fez com que alguns aumentassem os cuidados de limpeza, outros descuidaram da saúde bucal. “Muitos problemas pioram ou não estão sendo tratados porque as pessoas têm medo de ir ao dentista. Mas é seguro.”
Fonte: FolhaPress
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