Last month, we talked a bit about one of the common dental effects of stress: bruxing – a fancy word for habitually clenching or grinding your teeth. The unnatural pressure it puts on your teeth can lead to things like tooth fracture, gum recession, tooth sensitivity and pain through the jaw, head, neck and shoulders.
But does all stress lead to bruxism? For instance, if you’re worried about a major presentation you have to give, you may notice that your jaw is sore afterwards due to clenching. Is that bruxism?
The key is whether such clenching is habitual – something you regularly do, over and again, over a long period of time. Isolated stressors can contribute to isolated instances of clenching or grinding. But just as stress only becomes really problematic when chronic – ongoing, a slow burn – so, too, with bruxing. The effects of situational clenching or grinding may be annoying; the effects of bruxism can be damaging.
Many people brux mainly during sleep, which commonly raises the question: How can I tell if I’m bruxing or not? Well, how did you feel this morning? Did you wake up feeling fine and relaxed? Or was your head throbbing? Your neck so stiff, it felt like it had been braced with steel? Did you feel as though you’d been punched in the head – and you’re certain you hadn’t actually been punched in the head?
Pain is one of the most common symptoms of nighttime bruxing, with headache being the most common manifestation. (It’s estimated that bruxers are three times more likely to experience them!) Pain in the jaw, neck, shoulders and muscles is also common, as is neck, shoulder and muscle stiffness. Disrupted sleep is usual, as well.
If you’ve noticed any of these signs in yourself and sleep with a partner, ask them to keep an eye – and ear – out for your jaw. (Yes, you can sometimes hear the grinding!) Their observations may confirm whether you are bruxing or not.As noted, bruxing can cause problems in the mouth, as well as surrounding structures. For one, long term grinding wears down the teeth, contributing to gum recession and enamel erosion. These, in turn, raise your risk of developing cavities. The pressure and abrasion also make your teeth more vulnerable to fracture.
Additionally, TMJ problems may develop – painful dysfunction in the joints your lower jaw hinges on.
It’s important to know that stress is far from the only trigger for bruxing. Many people report that they started grinding their teeth when they were kids, before they felt any kind of significant, ongoing stress at all. For bruxing can sometimes be an adaptive behavior – a way of dealing with misalignment or malocclusion, where the upper and lower jaws or tops of the teeth don’t meet comfortably.
Fortunately, there are effective ways to deal with bruxism. It’s important, however, that the causes be diagnosed accurately. Only then can you get the right treatment. If alignment is the issue, for instance, orthodontic treatment may be needed. If stress is the culprit, strategies for managing it more effectively are key. Others have found physical therapy to be of help.
In most if not all cases, splint therapy is apt to be called for, as well – at minimum, the use of a night guard to cushion and protect your teeth from the pressures of bruxing.
The main thing is to treat it as early as possible to minimize long term consequences. The point was driven home by research published last fall in Cranio. Studying bruxism in children, researchers at the University of Buenos Aires found that the
presence of TMD, unilateral chewing, and high tongue tip position at rest were all significantly higher [in children with bruxism]. Frequency of oral habits was higher in bruxers, who showed significantly increased gum chewing, and lip, cheek, and object biting compared to nonbruxing controls.
The earlier we can identify the issues, the more readily we can help you deal with them and reduce the risk of long term problems arising from this kind of nightly (or daily) grind.