https://www.smh.com.au-By Julia Naughton
Gritting your teeth more this year? You’re not alone.Credit:iStock
Are you paying more attention to your teeth this year?
In the midst of the pandemic, dentists across the country reported increased visits from patients with broken fillings and cracked teeth. Many of them, the result of tooth grinding – also known as bruxism – prompting heightened awareness in an area of oral health seldom talked about.
“Everybody grinds their teeth a little bit at night, it’s normal and we do it subconsciously – usually during dream sleep,” says Dr Tami Yap, a lecturer in oral medicine at Melbourne University. “If sleep is fragmented, you’re not getting solid sleep cycles, or you have a period of stress where your mood is impacted into the nighttime, you will probably grind more.”
Tooth grinding becomes a problem when teeth become worn down or broken or if it’s causing sore facial muscles.
Since it’s a natural process, explains Yap, there isn’t a simple way to “switch off” tooth grinding. But there are certain things you can do to manage it, starting with your sleep hygiene.
“You want to make your sleep as good as it can be, and if there is a concern about your breathing at night, for example, you may be snoring, or you may notice you’re constantly tired during the day, it’s important to get a sleep test,” says Yap, adding that this will rule out any underlying sleep disorders like obstructive sleep apnoea and gastro-oesophageal reflux.
For the majority of people though, treating tooth grinding is more about preventing the ill effects of it.
The link between stress and tooth grinding
“Since last March, we’ve seen a 40 per cent increase in the numbers of cracked teeth needing complex dentistry as a result of tooth grinding,” says Dr Gamer Verdian from the Dental Lounge in Sydney’s CBD.
Clues you may be grinding can include a whole range of things, from your genetics, temperature sensitivity and a sore jaw, to tension headaches and, in the case of author Susan Orlean – and thousands of others in the past year – an unwelcome nugget of tooth in your mouth.
“Just broke off a giant chunk of my tooth. I guess I HAVE BEEN GRINDING MY TEETH LATELY,” the journalist and author tweeted on January 28, echoing the discoveries of dentists around the country in recent months.
Dr Elizabeth Milford, a dentist and the scientific relations consultant for Oral-B, points to increased anxiety, a lack of exercise and poor sleep habits as triggers for tooth grinding; all of which became increasingly apparent during the pandemic.
“The result is that many people have experienced tooth-grinding for the first time, or a worsening of the habit,” she says, adding that treatment can involve jaw exercises, relaxation techniques, and a custom-made dental appliance to decrease pressure on teeth.
A night guard for use while sleeping is often recommended by dentists, but it will not cease tooth grinding completely explains Dr Mikaela Chinotti, the Australian Dental Association’s oral health promoter.
Yap adds that Botox (injected into the muscles that close the jaw in order to reduce the strength of the grinding) is another preventative treatment option, but it is costly and just as it does in other areas of the body, will eventually wear off.
Daytime grinding vs. nighttime grinding
Yap says it’s important to make the distinction between tooth grinding during the day and at night.
“Daytime grinding is considered a behaviour or something that is choice-led as opposed to what happens at nighttime, which occurs when all of your body’s systems are switched off,” she says.
Essentially, certain behaviours can influence grinding at night – for example, smoking, heavy alcohol intake, recreational drugs and stress and anxiety may exacerbate it – but to a much lesser extent than the role our behaviours play in daytime grinding.
Daytime grinding generally occurs when we’re busy; whether it’s rushing the school pickup or when we’re deeply engrossed in a task. Triggers include our mood, habits and stress levels.
“When we are worried or highly stressed, we are physiologically perceiving a low-grade thread,” explains Yap. “And when this happens, stress hormones run around the body and the sympathetic system is engaged because the body is prioritising you to fight or flight.
“You’re then going to have a lot more tension through all of your muscles, whether it’s in the face or the rest of your body,” she says.
The result tends to be people holding their teeth together, which is a bit like clenching your fist.
“And if you were clenching your fist, it would be very clear you shouldn’t be doing that. Similarly, if you’re touching your teeth together at times other than eating, you’re going to be loading your teeth more, and you’re going to get cracks, and possibly muscle pain.”
Treatment requires a holistic approach
Yap focuses on educating her patients about the need to consciously choose the correct position for the mouth and jaw, and consider what the muscles are doing in the face to reduce daytime grinding.
“Teeth should only be touching when you’re eating, maybe when you phonate certain words and sometimes when you swallow,” she says. “That amounts to a few minutes a day, the rest of the time the teeth should actually be apart.”
Yap warns of advice promoting instructions like “put your tongue to the roof of the mouth” as it only creates another holding position for people.
“The best thing to do is focus on your breathing which sounds wishy-washy, but you’re trying to check in to your parasympathetic state – so, being more aware of how your mood and your stress is impacting changes in your body,” she says.
Breathing apps like Headspace, Smiling Mind and Calm will help with not only jaw position but mood and mental health, adds Yap.
Verdian also recommends yoga and pilates for his patients who grind their teeth.
Prescribing mindfulness as a preventative measure for tooth grinding can attract a varied response. Patients in dentistry, similar to the experience in medicine, value interventions that are tangible and produce immediate results.
But experts agree that such behavioural modifications, like checking in with our breathing, mood and jaw position, will pay off in the long run by reducing the amount of patients presenting with cracked and broken teeth.
“I usually say to my patients, ‘I need to prescribe you a “shoulder angel” that will tell you to stop clenching your teeth’,” says Yap with a laugh, adding that a little self-awareness often goes a long way.
Julia Naughton is the National Lifestyle Editor.