Bruxism can occur at night while sleeping or during the day. Sleep bruxism tends to be the worst of the two because a sufferer isn’t aware of the teeth grinding. But a clue to sleep bruxism is a constant headache or a sore jaw in the morning.
Some causes of bruxism are stress, too much caffeine and chewing on objects like pens or pencils. Gum chewing can be bad because it get’s the jaw muscles used to being clenched. Sleep disorders, crooked or missing teeth can also contribute to bruxism.
Your doctor can offer some options to reduce stress such as counseling, an exercise program or working with a physical therapist. The doctor might also prescribe medication to be used just before bedtime.
Your dentist can offer an immediate solution by fitting you with a mouth guard that will offer teeth protection during the night.
Bruxism is the designation used in reference of a clutch of involuntary symptoms, mainly the excessive grinding of teeth and clenching of the jaws in people.
A relatively common condition, affecting 8-31% of the population according to some estimates, it can be a very uncomfortable condition to be afflicted with, both for the person with the syndrome as well as for those around them.
I would like to let you know more about this condition- how to recognize it; its causes; its effects on those who suffer from it, as well as some of the treatments and remedies of proven efficacy that may be applied to manage, or, where it’s possible, permanently put a halt to it.
This ailment manifests in two main forms; night-time bruxism, which takes place during one’s sleep, unconsciously(sleep bruxism), and its opposite; daytime bruxism(awake). They have slightly differing characteristics In how they affect people.
When experiencing awake bruxism, one may wake up in no pain, but as the day goes on pain will begin to be felt and will progressively become more intense as the day goes on. Conversely, with sleep bruxism discomfort and pain is at its worst levels upon waking up, with a gradual diminishing as the day goes by.
There has been little correlation between stress and sleep bruxism but waking bruxism has shown some evidence of having links to stress conditions in the sufferer, although this hasn’t been conclusively determined.
Within the population demographics, awake bruxism has a substantially higher prevalence rate, falling within a range of 22-30% while sleep bruxism falls within 9.7-16%.
Across the gender divide, sleep bruxism will afflict men and women at equal levels while daytime bruxism shows considerably stronger prevalence amongst females.
Mental and emotional causes of bruxism
Bruxing may come about as one of the body’s ways of coping with negative emotions, anxiety, and stress. Human beings will experience four types of stress as classified by the America Institute of Stress:
Acute stress- which triggers the fight or flight response in us as the body prepares to defend itself against perceived imminent danger;
Chronic stress- which is the continuous stress we endure in our daily life related to our work, bills, children and such. We tend to generally live with this, accepting it as part and parcel of civilized life, but if left unchecked may reach levels whereby it begins to impact our mental and physical health.
Eustress – this counters our intuition regarding stress as it refers to stress types with positive connotations including milestone events such as the birth of a baby, making new friends, graduation, earning a promotion at work and others of this nature.
Distress – which is the inverse of eustress, bearing negative connotations. Financial constraints, work-related problems, emotional issues and legal problems are some distress inducing circumstances.
Parasomnias comprise sleep disorders that are characterized by unnatural or abnormal behaviors, dreams, and movements during our sleep. Examples include sleep enuresis(bedwetting), somnambulism(sleepwalking), the dramatically termed exploding head syndrome- whereby sufferers wake up hearing loud noises, somniloquy(sleep talking) and teeth grinding(bruxism) may be brought about by the following medical or psychiatric conditions; alcoholism; mood disorders such as depression and anxiety; as well as psychoses including schizophrenia.
Suppressed or repressed anger
Sigmund Freud, the de facto father of modern psychotherapy would state that the human being if they were to be actively aware of all their unconscious thoughts and memories, would be driven to insanity. Thus, he reasoned, the mind will bar certain thoughts, memories, and impulses from intruding into our consciousness as a mechanism of self- defense against ramifications that run counter to our innate self- preservation instinct.
The superego may do this to protect us, but in some instances, where the cause of the intrusive emotion, anger, in this case, is deemed so unacceptable to it- sexual abuse is an, unfortunately, common example- the cause itself may be buried deep within our subconscious, leaving us with a smoldering anger without a sense of its object. One is thus left with an inexplicable sense of anger.
This repressed or suppressed rage, if left to fester, will manifest itself in ways that are unhealthy to the individual, such as passive-aggressive behaviors, self- destructive tendencies, low self- esteem and chronic stress.
Physical causes of bruxism
Physiological factors may at the time be the culprit occasioning bruxism. These are more readily ascertained and thus are recommended as the first avenue of inspection in dealing with teeth grinding. Self-examination and determination are possible with some of these instances, but some will require specialist or professional assessment. They include;
This refers to the process whereby an infant child’s deciduous or ‘baby’ teeth begin to emerge through the gums of its mouth.
Interestingly enough, teething was in the past mistakenly considered one of the causes of infant mortality. Protracted teething or teething malformations may cause one to be susceptible to bruxism in their later years.
Heredity is not thought to be a major factor determining the occurrence of bruxism as although studies show that para-functional habits such as finger-nail biting, pencil chewing and mouth breathing are. Some professionals, however, classify bruxism as being among these and thus conclude that ones’ genetics has a role to play in determining your susceptibility to bruxism.
The pressure and hectic lifestyle people nowadays are forced to endure in their lives, the prevalence of depression, stress, and anxiety among the population has sky-rocketed.
With these conditions diagnosed, greater and greater numbers of people have resorted to medication in order to cope with these conditions. Popular in this class of medications are those known as SSRIs (selective serotonin reuptake inhibitors) such as Zoloft, Prozac, Celexa, etc.
Recent studies show evidence suggesting that taking these medications may lead to brain chemical imbalances, resulting in drug-induced bruxism, which is tenacious in that even when the drugs are no longer being taken, the bruxism persists, sometimes making necessary the prescription of separate drugs to deal with it.
There are numerous medical conditions whose areas of action or influence increase the likelihood of experiencing bruxism, with the reason being, for the most part, their proximity to the area. As such, the following conditions and syndromes may be manifested either as the cause of bruxism or as accompanying symptoms of it. They include;
Temporomandibular Joint Syndrome (TMJ)
This occurs at the joint connecting the human jaw to the skull, usually when it is injured or damaged. It is accompanied with pain in the temples, headaches, jaw-locking, as well as a popping and clicking of the jaw.
Click here to read about TMJ Exercises and Home Remedies that can help relieve your pain quickly and naturally.
Motor- control impairment
Some diseases or illnesses such as Huntington’s disease, Parkinson’s disease, and cerebral palsy impact the motor control of the afflicted person’s body, and with the masticatory muscles under this control, bruxism may the manifest itself as a side effect of the conditions.
Water makes up to 75% of a human being’s body weight and is critical for the efficient function of body systems. When the quantities of water that exit the body in various forms(sweat, urine, saliva, exhalation, bowel movement and such) is in excess of what the person is taking in through food and drinks, the person will eventually become dehydrated.
On an average day, a person will have to ingest considerable quantities of water in order to maintain proper levels of hydration. The specific quantities required will vary depending on a person’s individual weight, environmental conditions, activity levels or lifestyle, as well as whether the person may be experiencing conditions such as diarrhea, vomiting and excessive urine production caused by diabetes or kidney ailments.
The initial symptoms of dehydration are feelings of thirst that encourage increased water intake and a decrease in urine output as the body tries to conserve the fluid. If the dehydration persists, more symptoms may begin to appear such as lightheadedness, heart palpitations, weakness, muscle cramps, and dry mouth. Severe dehydration, if allowed to set in, will lead to eventual coma, organ failure, and ultimate death.
Muscle cramps, here mentioned as symptoms of dehydration, are suspected in some quarters to be among the triggers of bruxism in people, specifically, when the masticatory muscles spasm and cramp periodically and thus move the sufferers’ jaws.
Consensus used to hold that misaligned teeth were invariably attributable to genetics; that is to say; if one or both of your parents had the genes for crooked teeth in their family, then that would be the direct cause of their manifestation in their offspring.
With recent advances in our understanding of the condition, we acknowledge that misaligned bites and jaw discrepancies may be developed in our childhood years and that ways of mitigating the phenomena effectively exist and are successful if implemented early enough in the persons’ life.
Some of these causative habits and tendencies include;
Mouth breathing, whereby the persons’ tongue does not rest in its natural position between the upper rows of the teeth, against the palate and thus counterbalance the inward pressure of the cheeks, with the result of the upper teeth rows taking on a triangular shape.
Losing a tooth will result in an imbalanced masticatory load within the mouth, pushing teeth adjacent to the gap towards the side of the defect.
Possible solutions to teeth grinding factors
The American Heart Association suggests to us four simple ways of dealing with stress in our lives:
First is Positive Self-talk; an optimistic internal dialogue, telling yourself ‘I can get through this’, for example, will go a long way in calming us down in times of anxiety and provide relief from stress. Getting ourselves in the habit of engaging in positive self- talk at every opportunity- when we get up out of bed, before we go to bed, before we embark on a challenging task or whenever we find negative thoughts encroaching into our mental space goes a long way in managing the stress in our lives.
Second is the use of what they term Emergency stress stoppers. They may vary in suitability depending on the situation, and include taking 10 seconds before speaking, going for a walk, taking your time to react to stressful situations as well as practicing meditation and prayer in order to break harmful or negative cycles.
Third, they suggest that one find activities that make them feel good as a natural tool for stress relief. Pursuits such as reading a good book, listening to good music, playing golf and such like activities are effective.
Lastly, we are advised to take time each day to relax deeply and calmly. A very good method of doing this is through the practice of yoga, meditation or tai chi as these serve to relax the body as well as the mind.
There exist numerous procedures cataloged with the aim of dealing with the dental causes of disorders such as bruxism, with the most effective being;
Occlusal therapy: this is the non-invasive, reversible therapy that has the capacity to provide the sufferer relief and enable their medical practitioner to obtain diagnostic information without undergoing the risks and problems associated with more intensive methods such as surgery and regimens extended medication.
Various types of splints are available, with the nature of the patients’ diagnosis determining which would be best suited to them.
Success in dealing with bruxism has been had, in some cases, by directing the sufferer to cease taking Selective Serotonin Reuptake Inhibitors such as Zoloft and Prozac although this should only be carried out under a doctors’ supervision.
It is always advisable when advising patients presenting symptoms of bruxism, to find out if they are on these medications before considering any course of action.
Sleep disorders or other health issues
Four categories of intervention may be applied in tackling sleep disorders. These are; rehabilitation and management; medication; behavioral and psychotherapeutic treatment or, if all else fails, other forms of somatoform or somatic disorder treatment.
Somatization refers to the process whereby psychological stresses a person may be experiencing lead to a manifesting of physical symptoms.
Should repressed anger be recognized as a factor, acknowledging and making conscious efforts towards accepting it and striving to be less judgmental of ourselves would be the first and most important step in addressing the situation.
Realizing the normalcy of the anger response will negate its harmful influence on one’s psyche. Should these feelings persist, psycho-dynamic therapy may be employed in order to uncover the root causes of the problem and hopefully determine a way of confronting and resolving it.