Do you grind your teeth at night?
If you wake up with a painful jaw, neck, or shoulder, you might blame an awkward sleep position or just dismiss it as an unrelated headache. Then you wonder why you go through the day feeling tired and stressed.
The fact is, teeth grinding, or bruxism, sometimes disguises itself as other physical ailments. You may have frequent headaches. You may be plagued by chronic fatigue. Perhaps you suffer with ringing ears, or tinnitus.
But what’s really going on?
A Rise in Stress
It’s no surprise that the general populace faces more stress than it once did. We live in a world of 24/7 activity. Employers demand more. You may work even before you arrive on the job—or long after 5 pm. Your kids participate in a dizzying array of activities.
When you’re constantly on the go, there’s less time to unwind before jumping into the next activity. And all those demands can take a toll on your body, particularly on your jaw and neck.
Here’s how the body reacts to stress:
- Muscles tense in a “fight or flight” pattern.
- Chronic muscle tension leads to headaches (tension/migraine) or musculoskeletal problems.
- The respiratory system works harder during stress. In excess, stress can bring on hyperventilation or panic attacks.
- The heart also works harder than usual, increasing heart rate and muscular contractions.
- A stressed cardiovascular system produces high blood pressure over time. It may also lead to a heart attack or stroke.
- Chronic stress may lead to inflammation of the arteries and elevated cholesterol levels.
- The endocrine system overproduces stress hormones (cortisol and epinephrine).
- The liver reacts to increased stress hormones by producing too much blood glucose. Over time, increased glucose may lead to diabetes and obesity.
- The gastrointestinal system processes “stress” as nausea, stomach pain, ulcers, reflux, constipation, or diarrhea.
- The jaw and neck clench when the body is under repeated stress, which leads to teeth grinding (particularly at night).
- The body may not be able to “turn off” from excess stress, causing sleeping difficulties. Increased visual stimulation (viewing smartphones, tablets, computers, or media before bedtime) exacerbates this problem.
Most dentists see a lot of stressed-out patients. By natural correlation, dentists also see an increasing number of patients with bruxism. In this case, stress causes “primary” bruxism. But stress is only part of the story.
Although stress is a big cause of teeth grinding, it’s not the only cause. Some bruxism patients may not be aware of excess stress at first. They don’t feel excess stress at work or clenching during the day. All they know is that they’re tired. These patients may suffer from “secondary” bruxism as a result of sleep difficulties.
In cases such as this, dentists may recommend their bruxism patients participate in a sleep study. Here are a few sleep-related problems that may relate to teeth grinding:
- Sleep apnea
- Type-A sleep (brain is too vigilant, even during sleep, so this personality wakes easily)
- Partial complex seizure or other related disorders
- Crowded teeth and tongue (may relate to sleep apnea)
- Overstimulated visual cortex from electronic use prior to bedtime (may cause restless sleep)
- Side effects from medication (particularly SSRIs that also impact sleep patterns)
Implications and Recommendations
Whether your bruxism comes from unalleviated, chronic stress or from a sleeping disorder, the result is the same: teeth damage and other related health problems.
Even if you’re not aware of the problem, your dentist is. Here’s what most dentists pay attention to:
- Underlying stress levels—even those patients may not notice
- Daily habits – work, recreation, electronics use, sleep, diet, etc.
- Related disorders – TMD, tinnitus, headaches, chronic fatigue, overcrowded teeth, and poor jaw alignment
- Self-management – coping techniques, social interactions, adjusted workloads, and other strategies
If your dentist decides that dental problems correlate to bruxism, he or she will work with you to eliminate the underlying factors. In some cases, that may mean creating a customized dental guard to wear at night. In other cases, it might mean you need braces or a retainer.
However, if your bruxism has nothing to do with jaw malocclusion or other dental issues, you may just need to pay more attention to your stress levels. Here are a few strategies you can use to lower the stress and get better sleep:
- Schedule some time off. Leave some blank spaces in your calendar (and do the same for your kids).
- Get a massage—or go for a leisurely walk.
- Consider counseling if you have unresolved psychological issues that impact your daily routine.
- Adjust your life choices – quit smoking or drinking alcohol in excess. Reduce caffeine use and drink more water instead.
- Use a CPAP machine – if you’ve been diagnosed with sleep apnea, your CPAP is your best friend.
- Participate in yoga or reikki – regardless of your choice, it helps to plan relaxing activities with friends and family.
Finally, talk to your dentist if your teeth grinding doesn’t go away. Each case is different, so you may need to adjust your strategies until you find a method that works for you. That’s the best way to unwind and stop the grind.