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Dentists reported a 69% increase in patients clenching or gnashing their teeth during a pandemic, according to the American Dental Association (ADA). And most of these people probably don’t know they do. “It’s almost completely unconscious behavior,” said Vicki Cohn, president of the American Academy of Sleep Medicine’s Dental Assembly.
A condition called bruxism can apply up to 200 pounds to the teeth. “The strength of a bite when digested can be up to six times greater than normal chewing,” said Ada Cooper, a dentist and spokeswoman for the American Dental Association. So it’s no surprise that it can wear out or even break your teeth. And for the elderly – whose teeth may be more fragile – bruxism can be particularly worrying.
In these difficult times, dentists see more people with gnashing of teeth and clenching of jaws – also known as bruxism
Bruxism can occur during the day or at night. Stress can be an important factor either in times of acute tension or during sleep, when elevated levels of stress hormones can still circulate after a hard day, says Cohn. Habits such as alcohol and tobacco use also increase the likelihood. “Smokers are about twice as likely to gnash their teeth as non-smokers,” Cooper said. Some medications – such as some antidepressants and antipsychotics – may also increase the risk.
Conditions that affect the central nervous system, such as dementia, Parkinson’s disease or stroke, can cause or worsen bruxism. And it often goes hand in hand with temporomandibular joint disorders that cause pain around the jaw. Finally, there is obstructive sleep apnea (OSA), in which the upper airways become blocked repeatedly during sleep, leading to multiple pauses in breathing at night. This can cause people with OSA to “unknowingly overcompensate and gnash their teeth as they push their jaws forward to open their airways,” said Manar Abdelrahim, a dentist at the Cleveland Clinic. (If you are told you have OSA, ask if you will be assessed for bruxism.)
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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 an inflamed jaw or neck, headache, stiff jaw, ringing in the ears, or scarring around the edge of the tongue where it presses against clenched teeth. If you notice this, visit your dentist, who will check for tooth wear, fractures and recession of the gums. But “if the only evidence is the wear and tear of your teeth, you may not have active bruxism,” says Cohn. Chronic heartburn is a common cause of tooth wear in the elderly.
Video recording in a sleep lab or electromyography can definitively diagnose sleep bruxism. For the latter, the electrodes attached to the skin are checked for repetitive movements of the jaw muscles.
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Although bruxism can be difficult to treat, the following can help:
- Plastic mouth guard: “Wearing security at night is usually the number one line of defense,” said Abdelrahim. “The grand places space between the upper and lower teeth to protect them and allows the jaw muscles to relax.” A fuse customized for you ($ 324 to $ 788) is usually more effective than an over-the-counter product and is sometimes covered by insurance. Neither will break the habit, but it will prevent further damage to the teeth.
- Botox: Botulinum toxin injections into the jaw muscles that control chewing can reduce the pressure you put on your teeth.
- Stress reduction: Relaxing activities (such as yoga and meditation) can help. This can increase your awareness of the behavior. Tip: “If you feel your teeth touch during a stressful time, carefully allow your jaw to open and your teeth to move away from each other,” says Cooper.
- Physiotherapy: A physiotherapist trained to treat bruxism can teach you exercises to stretch, strengthen and relax the muscles of the neck and jaw, which can reduce muscle tension, which can lead to contraction and digestion.
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