Do you have trouble grinding your teeth? Here’s how to control it.
The condition, called bruxism, can apply up to 200 pounds of force to the teeth. “The bite force of grinding can be up to six times greater than normal chewing,” says Ada Cooper, dentist and spokesperson for the American Dental Association. It is therefore not surprising that he can wear down or even break the teeth. And for older people – whose teeth may be more fragile – bruxism can be particularly troubling.
Bruxism can occur day or night. Stress can be a big factor, whether in times of acute tension or during sleep, when high levels of stress hormones can still be circulating after a tough day, Cohn says. Habits such as drinking alcohol and smoking also increase the likelihood. “Smokers are about twice as likely to grind their teeth as non-smokers,” says Cooper. Certain medications, such as certain antidepressants and antipsychotics, can also increase the risk.
Conditions that affect the central nervous system, such as dementia, Parkinson’s disease, or stroke, can cause or exacerbate bruxism. And this often goes hand in hand with disorders of the temporomandibular joint, which cause pain around the jaw. Finally, there’s obstructive sleep apnea (OSA), where the upper airway repeatedly becomes blocked during sleep, resulting in many pauses in breathing at night. This can cause people with OSA to “unconsciously overcompensate and grind their teeth when pushing their jaw forward to open the airway,” says Manar Abdelrahim, a dentist at the Cleveland Clinic. (If you are told you have OSA, ask to be evaluated for bruxism.)
A cracked tooth, crown or filling can be a clear signal that something is wrong, but there are less dramatic signs to watch out for. People with sleep bruxism, for example, may wake up with jaw or neck pain, a headache, stiffness in the jaw, ringing in the ears, or marks on the edge of the tongue where she presses against clenched teeth. If you notice them, see your dentist, who will check for tooth wear, fractures, and gum recession. But “if the only evidence is the wear and tear on your teeth, you might not have active bruxism,” Cohn says. Chronic severe heartburn is a common cause of tooth wear in the elderly.
A video recording in a sleep lab or electromyography can definitively diagnose sleep bruxism. For the latter, electrodes attached to the skin check the repetitive movements of the jaw muscles.
Although bruxism can be difficult to remedy, the following may help:
- A plastic mouthguard: “Wearing a guard at night is usually the first line of defense,” says Abdelrahim. “A guard puts space between the upper and lower teeth to protect them and allows the jaw muscles to relax.” Protection personalized for you ($324 to $788) is generally more effective than an over-the-counter product and is sometimes covered by insurance. Neither breaks the habit, but will prevent further damage to the teeth.
- Botox: Injections of botulinum toxin into the jaw muscles that control chewing can reduce the pressure you put on your teeth.
- Stress reduction: Relaxing activities (like yoga and meditation) can help. The same goes for increasing your behavioral awareness. A word of advice: “If during a stressful moment you feel your teeth touching, gently allow your jaw to open and the teeth to move away from each other,” advises Cooper.
- Physical therapy: A physical therapist trained to treat bruxism can teach you exercises to stretch, strengthen, and relax neck and jaw muscles, which can reduce muscle tension that can lead to twitching and grinding.
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