It has been a long-held opinion of both dentists and public alike that teeth-grinding, called Bruxism by the dental profession, can be an outward sign of stress and anxiety. This may be the case for many people, but other factors may also contribute to the condition.
What is teeth-grinding?
If you suffer from teeth grinding or its partner-in-crime, jaw clenching, you will either be very well aware of what it is – as will your loved ones – or you may not even know that you do it.
The Bruxism Association likens the condition to chewing with no food in your mouth, so the teeth are grinding together with nothing to buffer the action. This can wear through the protective tooth enamel relatively quickly, leaving the softer parts of the tooth exposed, to be ground away even faster.
Dentists believe that the potential for tooth damage is at its greatest when jaw clenching and grinding are combined, usually at night.
Most people grind their teeth or clench their jaw at some points in their lives, but about 8-10% of the population do it regularly, causing severe dental damage in some cases. Other symptoms can include pain and restriction of movement in the jaw itself, and headaches or migraines.
Bruxism is often thought of as a childhood condition, but it’s actually most commonly seen in 25 to 44-year-olds. Sufferers of Parkinson’s disease are also susceptible to it.
Why do people grind their teeth?
There are generally two types of teeth grinders – or ‘bruxers’ as the Bruxism Association calls them – those who do it during the day, predominantly jaw clenching only, and those who do it in their sleep, clenching and grinding in tandem.
Sleep-bruxers often don’t know they grind their teeth and will only find out when their partner tells them or when their dentist picks up the signs of damage at a dental check-up. Daytime jaw clenching can also become an unconscious habit.
Sleep grinding and clenching is often much stronger than when the sufferers are awake and can be extremely noisy. Bed partners of some bruxers have reported the noise to be similar in volume and disturbance to snoring.
Causes of Bruxism
As previously mentioned, stress and anxiety can be prime causes of a teeth grinding condition. Various studies on the subject over the past six years have found some interesting data. Jaw clenching and grinding the teeth can actually be the body’s way of relieving stress through aggression by managing stress responses and hormone levels, rather like shouting or hitting something can relieve feelings of tension.
Not facing up to issues and stressors – bottling up anxieties – can increase the intensity of the grinding as the body is forced to find an outlet for them. It has been found that almost 70% of teeth grinding cases can be traced to a stress-related cause.
Job-related anxiety is highest on the list of sleep-affecting stressors contributing to bruxism. This is especially true in today’s working environment, as both workers and employers find themselves increasingly available no matter where they are. As mobile communication continues to become an indispensable part of everyday life, it is harder to leave work-related stresses behind at the workplace.
Interestingly, higher educational achievement is also a documented cause of teeth grinding. This is due to the anxieties fostered in students who are regarded as high achievers by continually being expected to do exceptionally well.
Bruxism rarely appears on its own with no other triggering condition. Sleep disorders, for instance, can greatly increase instances of teeth grinding.
Conditions such as sleep apnoea (prolonged breathing pauses during sleep), insomnia, snoring, sleep talking and other disorders which regularly disturb sleep can trigger nocturnal teeth grinding when the bruxer is in the lighter stages of the sleep cycle. The more often the bruxer comes up to the upper levels of sleep during the night, the more often grinding is likely to occur.
This creates a vicious circle of stress leading to disturbed sleep, leading to further stress because of fatigue, leading to more disturbed sleep. The mechanism the body chooses to relieve the situation may well be teeth grinding.
There are other possible causes of teeth grinding, however. High caffeine intake, smoking, and heavy consumption of alcohol have also been identified as contributing factors. Ironically, the use or abuse of medication to counter sleep problems, mental disorders, depression and anxiety can also be triggers. Use of so-called recreational drugs such as cocaine and ecstasy can also increase the likelihood of teeth grinding.
All these factors tend to stimulate mental arousal, which can lead to difficulties falling and remaining asleep, which in turn can cause the issues mentioned above. The reported instances of bruxism are significantly higher in people who include some or all of these elements in their lifestyle.
Bruxism may occur simply as a result of your teeth being too crowded in your jaw, making it uncomfortable or awkward for you to close your mouth properly. Misaligned teeth can have a similar effect. Some adults report that bruxism began when they had teeth extracted, particularly wisdom teeth right at the back of the mouth.
Children often begin grinding their teeth as their first set appears, and again when these are replaced by their adult teeth. Usually the behaviour stops when the second teeth have settled down. The reasons for this seem to be both the adjustment to a new tooth alignment and becoming accustomed to the increased numbers of teeth in the mouth.
Approximately one in five children up to 11 years old grind their teeth, although reports state that the figure may be higher, as many parents fail to spot the signs. As with adults, bruxism may appear, or get worse, in times of particular stress such as exams.
Traditionally, teeth grinding has been treated with a variety of appliances such as night teeth guards supplied by dentists. These are similar to the guards worn for some contact sports, but tend to be less bulky and uncomfortable to wear. The shields are made from different materials depending on the exact problem and can consist of soft rubber, acrylic or a laminate.
They cushion the sets of teeth and reduce the noise grinding causes. This helps to ease the sleep disruption for both the bruxer and their partner, reducing the vicious circle of stress and sleep deprivation. Guards and shields can also relieve strain on jaw muscles and joints, reducing facial pain and tendency to stress headaches.
There are some drug therapies for bruxism, but generally these have been found to be no more effective than mouth guards and can have serious and unwanted side effects. These tend to be emotional and psychological in character and can increase withdrawal, raise the possibility of overdose and ultimately the risk of suicide.
So, it would seem that stress and anxiety do indeed play the largest role in the likelihood of a person becoming a teeth grinder. Obviously, the ideal cure would be to reduce the stress load at the root of the condition, but many people struggle to break the cycle which causes the stress. However, something as simple as regularly getting a good night’s sleep can be all it takes.