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Stress and bruxism


13 May 2010

Under pressure

Everyone under stress and frustrated by a world that can sometimes feel like it is spinning out of control is vulnerable to bruxism, but those working in high pressure jobs seem to be particularly at risk at the moment. As if he doesn’t have enough to worry about with running the country, Gordon Brown is having problems with the condition as well, with recent reports suggesting that the stress of government is getting to him and he is gnashing his teeth with frustration.

We have all had plenty of recession stress in recent months and this is having an impact on the nation’s teeth and health. As the stress levels increase, so does the number of cases of bruxism in the population. Dentists are reported to be busier than normal dealing with cracked teeth, loose fillings and other dental consequences of bashing the teeth together.

There are other symptoms though. For example, clenching and gnashing teeth throughout the night puts enormous pressure on the jaw joint and surrounding musculature. Sometimes, this can send the muscles into spasm causing excruciating headaches, especially when waking up. Damage to the temporomandibular joint (jaw joint) can often occur when we grind and clench regularly. This can mean constant jaw pain (which sometimes gets misdiagnosed as ear ache). Even if you know that you grind your teeth, you, your GP and even your dentist might not make the connection with bruxism.

According to the results of a survey carried out by the Bruxism Association, many sufferers end up going on abortive consultations with ENT and other specialists before getting a diagnosis for bruxism. Headaches and neck and shoulder pain, also side effects of bruxism, can be misdiagnosed in the same way.

Given the huge forces at work when we grind our teeth, it’s not surprising that our neck and shoulder muscles suffer the consequences. Muscle relaxants can sometimes be prescribed to help ease the tension, but these are really only meant to be a short term measure.

If the bruxism sufferer clenches and grinds whilst asleep, the chances are that they are not getting the restful stage three or ‘delta phase’ sleep that we all need in order to stay healthy. Researchers classify bruxism as a sleep disorder because it has most potential to disturb good sleep patterns.

Many bruxism sufferers report insomnia, disturbed sleep and poor quality sleep. But it is not only the bruxism sufferer that has to endure it. Often, sleep partners will be disturbed too. Constant thrashing around and the sometimes loud grinding noises emitted by the bruxer which can sound like a pneumatic drill in the still of night can keep everyone awake and irritable the next day. 

Although bruxism has not had a lot of attention before, it is now getting much more focus from the media, healthcare professionals and sufferers themselves. Thanks to the internet, the subject is talked about in a wide range of discussion forums. For example, there is a dedicated site for bruxism suffers that has been set up by the Bruxism Association, a not for profit organisation registered with the Department of Trade and Industry.

People want to know what is out there to help them and are interested when any new solutions come along. For example, there is a current buzz around botox. In preliminary trials, it shows some promise at relieving bruxism, but it looks like more work needs to be done to confirm its efficacy.

Treatments

Hypnotherapy is a well documented approach to dealing with bruxism. Many practitioners have developed hypnotherapy programs specifically for bruxism sufferers. They work by inducing a relaxed state of mind and awareness of the condition and go on to help address the underlying causes, which may include complex and deep seated emotional and physiological factors. For some people, this is enough for them to break free from the habit but for the chronic bruxer, the battle with bruxism can take months or years and in some cases, may never be overcome.

Some dental experts believe that abnormalities in the way the teeth fit together (malocclusion) can cause or trigger bruxism. Striving for perfect occlusion is not without controversy though. Grinding away healthy teeth is seen by some experts as an invasive and costly procedure to correct malocclusion with little evidence to support its efficacy as a treatment for bruxism.

Many dentists prefer to fit a dental guard to protect teeth and dental work from the ravages of grinding instead. Prices vary from around £50 to £700 in Harley Street. More recently, ready to wear devices have become available without prescription and these have been found to provide the same level of protection as custom guards, usually at a lower price point and without the hassle of having to make several visits to the dental surgery to have impressions made and the device fitted.

We seem to be some way off finding a magic cure for bruxism. In the meantime, reducing stress levels and protecting the teeth is probably the best option. Clinical hypnotherapists are now providing specific programs for bruxism sufferers and products to help with sleep hygiene are readily available. Dental guards from a dentist can cost hundreds of pounds and take a while to have fitted, but there are other ready to wear guards now on the market, that offer the same protection and benefits at a more affordable price. Ready to wear dental guards are now approved and available in pharmacies without prescription. These devices provide immediate protection for the teeth, with many bruxism sufferers reporting a reduction in jaw pain and headaches as well.

Phillip Toye of PI in Partnership


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