Stress, Anxiety, and Teeth Grinding
A recent survey with the UN’s International Labour Organisation (ILO) found that upon examination of workplace stress in a number of growing countries, levels of anxiety, burnout, and depression are ‘spiraling out of control’. Could stress as a result of growing chaos and tension in everyday life be responsible for eliciting an increased frequency of teeth grinding and clenching? Does bruxism really have a connection deep into the human psyche?
What is bruxism?
In healthy individuals, masticatory muscle activity and performance are divided into two categories- functional (involving chewing, speaking, and swallowing) and parafunctional (including oral habits such as teeth grinding, jaw clenching, nail-biting, lip, and cheek biting). Oral habits such as teeth grinding and clenching can cause a stir in the health of the oral cavity and may even lead to temporomandibular joint disorders, the derangement of the jawbones. Bruxism is an oral habit that involves the spasmodic or rhythmic grinding, gnashing, clenching of teeth, or a combination of all three in other than chewing movements. Bruxism can be diurnal or nocturnal in appearance and usually affects individuals between the ages of 20 to 50, gradually decreasing with age.
A wide spectrum of factors have been associated and interlinked with the incidence of bruxism and its progressive worsening. ‘Caffeine high’ due to excessive consumption of caffeine, recreational drug intake, and alcohol have been commonly linked to bruxism. However, on the other hand, bruxism has also been observed to have a psychological aspect connected to it. Stress, anxiety, and depression have shown to act as initiating, predisposing, and perpetuating factors of bruxism, although the exact relationship remains unclear.
Can stress cause bruxism?
The human brain is a complex organ in-built with various defense and offense mechanisms. An aspect of the human brain known as the “emotional brain” controls vital emotions and reactions. This is present in the limbic system, completely separated from the neocortex, the part of the brain responsible for sensory perception, reasoning, and motor commands. If a person is “under stress”, external factors (stressors) that disrupt the harmony of the emotional brain are engaged in this phenomenon. The central nervous system assesses this stressor and concludes on a ‘pathologic chronic stress’.
Signals reach the limbic system and trigger the release of adrenaline. This leads to faster breathing and heartbeat, a higher muscle tension, and an increased sugar level and blood pressure. But why is this important to note in context of bruxism? A 2019 study showed that people who suffer from bruxism have higher levels of stress hormones in their bodies. Additionally, recent research has found that before a person enters a grinding episode, their brain activity and heart rate may rise, implying that their brain is recognizing a stressor or stressful emotion. This instigates the point that stress may in fact be related to bruxism.
It has been proven that compulsive, controlling, and aggressive individuals are more vulnerable to develop bruxism. Teeth grinding during the daytime may exhibit completely different predisposing factors and emotions than that performed at night. Sleep bruxism has been heavily linked to stress and anxiety. In a 2010 study, participants who self-reported neurotic tendencies (high frequency of negative feelings) without a proper clinical diagnosis were more likely to report bruxism.
How to reduce bruxism by reducing stress?
While custom teeth night guards and medications help reduce the incidence of bruxism or it’s destructive side-effects, there are also some integrative medicine techniques that can help cut down bruxism from its roots. Stress-related bruxism can be corrected by the use of various relaxation or stress-reduction methodologies that help lessen daily stresses and alleviate the incidence of bruxism. Here are some useful techniques to help prevent bruxism and stress:
JAW EXERCISES AND MINDFUL TEETH PLACEMENT
Open your mouth as wide as possible and touch tongue to the front teeth. This action helps relax the jaw muscles.
You can also try putting your left thumb under your upper front teeth and putting your right index and middle fingers on top of your lower front teeth. Now gently pull the jaw apart using your hands, not your jaw muscles.
Do not allow your upper and lower teeth to make contact during chewing.
To prevent the teeth from touching, say the letter “n” to position the tongue and keep your mouth in this relaxing position to avoid clenching.
These simple jaw exercises help release the stress and pressure put on it and can help you relax.
COGNITIVE-BEHAVIORAL THERAPY (CBT)
CBT is a behavioral therapy that allows people to change the way they think about a particular emotion. Replacing negative triggers from common stressors to positive perceptions, this therapy helps people relax and stay calm in the midst of situations where they would otherwise be stressed or overwhelmed. For it to succeed, it needs the individual’s complete and active involvement. It focuses on present-day challenges, thoughts, and behaviors.
Furthermore, few studies have evaluated the effectiveness of CBT for patients suffering from myofascial pain (MFP) due to teeth grinding and clenching. These studies demonstrated that upon exposure to 6 sessions of CBT, as many as 32% of the participants experienced symptom improvement through palliative treatments only, such as resting the masticatory system, habit awareness and education, home physiotherapy, and reducing excessive caffeine consumption.
Massaging your jaw can help your jaw muscles relax, reducing the tension and pressure in the joint area. It is important for you to identify pressure points around your masseter muscle Additionally, you can hold a warm, warm moist, or cold towel against your jaw to promote
muscle relaxation. The masseter muscle hangs from the underside of your cheek on the side of the face. In order to massage it, place your thumb or fingertip in the notch on the underside of the cheekbone, about an inch in front of your ears. Pressing firmly inwards and upwards in the area helps relieve pain and stress from your jaw. Additionally, holding a warm towel against your jaw can also promote muscle relaxation.
For many, clenching and grinding of teeth are directly related to the struggles with being able to properly combat and manage stress. Relaxation activities such as meditation and yoga can help relieve much of the stress and tension from your body. Tai chi, deep breathing exercises, massage, progressive muscle relaxation are some of the other techniques to help you let go of the pent-up stress and pressure in your body. As you let go of the stress and anxiety, you will be rewarded with an improvement in the incidence of bruxism and its harmful consequences which can include hypertrophy of the oral muscles and destruction of the oral tissues.
Stress can be a huge contributor to your bruxing habit. For you to be able to effectively deal with teeth clenching and grinding, make sure you first begin by taking care of your emotional and mental well-being. Contacting a counselor and taking part in behavioral therapy practices can help keep your stress and anxiety in control, thereby keeping bruxism under wraps!