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American Dental Association

December 20, 2012, last updated December 3, 2014

By Alison Turner, Featured Columnist




When we think of someone grinding their teeth, we may think
of the stereotypes seen in cartoons or comedies when someone
grinds loudly because they are mad or nervous.  Comedy and
stereotypes aside, teeth grinding or clenching, known by the
experts as "bruxism", is a condition suffered by millions of
people in real life. For example, The Nemours Children’s Health
System, for example, reports that up to three of every ten
children will clench and grind their teeth, though many of them
outgrow the condition.  And a 2005 study from Children's
Hospital Dental Clinic in Boston found that up to 38% of
parents reported that their children grind their teeth.

There are two types of bruxism, "awake bruxism" and "sleep
bruxism".   As the same suggests, "sleep bruxism" happens
when you are asleep, and involves the involuntary muscles of
your jaw.  Awake bruxism is a voluntary movement that you
are aware of during your waking hours.

About 10% of all adults under the age of 65 suffer from sleep
bruxism, according to  2014 study from Imperial College
London.  "Awake bruxism" is estimated at a higher unknown
percentage and is more common among women.

For those who are not lucky enough to outgrow bruxism, it can
manifest in symptoms such as anxiety and stress, depression,
eating disorders, earache, headache, and insomnia  --
suddenly, teeth grinding isn't so funny. What makes us grind
our teeth, and are there any natural remedies that help?

Teeth grinding can happen to people during the day, and/or at
night -- however, the National Institutes of Health reports that
sleep-related bruxism is "often the bigger problem because it is
harder to control."  

Additionally, most people who grind their teeth at night don’t
know that they do so – because they’re asleep when it
happens.  Possible causes of teeth grinding during both day
and night include stress, and the shape and alignment of your
teeth and jaw.  

How can we treat bruxism?  Suggestions for treating the pain
resulting from clenching include applying ice to the sore jaw
muscles, massaging the muscles of the neck, shoulder and face,
and making an effort to relax the jaw muscles.  To prevent
damage to the teeth from grinding at night, there are devices
such as splints and mouth guards, or orthodontic work may be
advised.  For more ideas on how to decrease your risk of
bruxism, or how to stop clenching your teeth if you already do,
check out the studies below conducted by researchers from
around the world aiming to better understand bruxism.
























1.
Stress, Clench, and Grind

According to research in Japan, being stressed out may
increase the risk of clenching and grinding our teeth.

In 2011, researchers out of Hiroshima, including Hitoshi
Abekura with the Hiroshima University Hospital Clinic of
Prosthetic Dentistry,  analyzed the relationship between
bruxism during sleep and psychological stress.  The study
gathered data from 76 volunteers, whose sleep bruxism and
“stress sensitivity” was evaluated before and after an
“experimental stress task” that involved mathematical
calculations.  

Results showed that in those participants who do not grind
their teeth, salivary chromogranin A levels (stress indicators)
were “not significantly increased”: however, the salivary
chromogranin A levels in subjects who do grind their teeth
“were significantly increases after the stress task.”  

The team concludes that their findings “suggest that there is an
association between sleep bruxism and psychological stress
sensitivity.”  

Math is certainly stressful, but so are the holidays – and
Mondays for that matter, and the daily drive home from work.  
If you think that you have a large amount of stress in your life,
you may want to pay extra close attention to whether or not
you’re grinding your teeth at night: does your jaw hurt in the
morning?  Does the person sharing your bed hear you make
strange noises at night?  If so, it may be time to focus on
treating your stress, or to seek other options to prevent the
symptoms of bruxism from building up. (Read more about
foods that help you deal with stress.)

2.
Violins and Bruxism: A Jarring Harmony

Playing musical instruments is a safe activity, right?  There’s no
tackling, no running into other people, no getting hit by balls:
however, in 2008, researchers found that playing the violin
may be more dangerous than we thought – for the future of
our teeth.

In 2008, F.J. Rodriguez Lozano and other researchers  noticed
a pattern between violinists: many of them experience
bruxism.  Out of a group of 41 violinists, 73% were diagnosed
with bruxism, whereas in a control group of non-violinists, only
34% “suffered from this complaint.”  The researchers
determine violin playing as a “factor that predisposes or
triggers the appearance of signs and symptoms of bruxism.”  

The relationship between violin playing and bruxism may not be
convincing enough for you to let your kids off the hook for
practicing for that upcoming orchestra concert: however, if you
or your child plays the violin, you may want to be aware of the
possibility of bruxism – the sooner you start treatment, the
better.

3.
Intestinal Parasites – So Annoying, It Makes You Want to
Grind Your Teeth

In the United States, most of us are fortunate enough to not
have to worry about intestinal parasites on a daily basis:
however, these infections can still affect us as we travel, and
can be detrimental to people in many places in the world.  
Unfortunately, researchers in Iran have found that these
intestinal parasites may not only cause stomach problems, but
could also lead to bruxism.

In 2010, a group of researchers in Iran, including Maryam Haje
Norouzali Tehrani with the School of Dentistry at Isfahan
University of Medical Sciences,  investigated how bruxism may
be related to intestinal parasitic infections in children.  Parents
of 100 children (half with bruxism, half without) completed
questionnaires and performed “parasitological tests.”  Results
showed parasitic infections in 11 of the children with bruxism,
and only 8 of the children without, deeming the relationship
between parasitic infection and bruxism as “statistically
significant.”  The team concluded that “pathogenic parasites
may serve as the cause of initiation of bruxism habits among
children.

There are more immediate reasons to keep you or your children
away from intestinal parasites – diarrhea and stomach pain, for
example – but reducing the risk of future bruxism may be
another reason.  You can do this by paying extra attention to
hygiene while travelling, or, if you’re truly concerned, by
avoiding certain areas for travel.

4.
Hypnotize your Bruxism Away?

You are feeling very sleepy…you will not grind your teeth
anymore…did it work?  We all have our own reasons for
believing or disbelieving in the effects of hypnotism – and every
now and then science has something to add to the debate.  A
researcher in India, for example, has found evidence that
hypnotism may be a good way to stop all of that teeth
clenching.

In 2012, Shakir Quaid Johar with the Department of
Periodontics and Implantology at Pad D. Patil Dental College
and Hospital in Mumbai, India,  reported on a 26 year old
female patient who “reported pain in all her teeth due to
bruxism.”  

The patient had tried “all conventional dental treatments,” all of
which had failed.  Hypnosis was then tried, was successful, and
five years later, there is no hint of relapse.  Johar suggests that
this suggests that a “strong psychological component” may be
involved with bruxism, and that “psychiatric treatment and
hypnotherapy may be a choice of treatment.”  

Hypnotism may not be for everyone – but if you or a loved one
can’t seem to break their teeth grinding, it might be worth a try.

5.
Minor Head Injuries and Bruxism

Most of us know by now that a head injury – even a minor one
– may impact the victim for a long time after the incident.  A
few years ago, researchers found that one consequence of a
minor head injury, even from up to three years earlier, could be
bruxism.

In 2010, a group of experts from India, including Mittal Shivam
with the Jawaharlal Nehru Medical College,  studied how minor
head injuries affect long term sleep disturbances in adults.  40
patients who had suffered minor head injures three years
before the study, and 40 people without minor head injuries  
completed sleep questionnaires.  42% of people who had
experienced minor head injuries had complained of bruxism,
whereas only 5% of the subjects without head injuries had the
same complaint.

If you or someone you know has bruxism that seemed to come
out of nowhere, try to find out if a minor head injury lies
somewhere in the near – or far – history of that person.  It
could be that the one is not unrelated to the other.

6.
An Oxidant/Antioxidant Imbalance:  Could it Cause
Clenching?

Apparently our lungs do a bit more than fill up with air and
push it back out again.  If the oxygen concentration in our
lungs gets too high, it could be dangerous to the cells –
accordingly, the lungs have antioxidants to help ward off
certain oxidants that pose such a threat.   When this impressive
system glitches, one of the consequences, according to new
research from Turkey, could be sleep bruxism.

In 2012, a team of experts in Turkey including Dr.  Muhammed
Isa Kara with the Department of Oral and Maxillofacial Surgery
at Izmir Katip Celebi University,  evaluated the relationship
between sleep bruxism and “antioxidant/oxidant status.”  33
patients with sleep bruxism and 32 patients without were
enrolled in the study.  Their “venous blood” was collected, and
plasma samples were analyzed for oxidant and antioxidant
“status.”  In two out of three trials, patients with sleep bruxism
“exhibited an oxidative imbalance.”  The team concludes that
oxidant/antioxidant imbalance “may be related” to sleep
bruxism.  

It you suffer from sleep bruxism, you may want to get your
oxidant/antioxidant balance checked – this condition could lead
to other symptoms.  Similarly, if you know that your
oxidant/antioxidant balance is off, you might question whether
or not you have sleep bruxism (as mentioned earlier, it may be
hard to tell what goes on with your body at night).

7.
Put Out the Cigarette, Put Out Your Bruxism.

Cigarettes get a pretty bad rap these days – and let’s be
honest, why shouldn’t they.  A few years ago, researchers
found another of those hidden consequences of smoking (you
know, those ones that you never thought could come from
cigarettes, like
stroke or infertility ) – smoking may led to
bruxism.

In 2010, a group of researchers joining together from as far as
Finland, Missouri, and the Netherlands, including Katariina
Rintakoski with the Institute of Dentistry at the University of
Helsinki,  investigated the association of smoking with bruxism.  
Over 12,000 people responded to a questionnaire conducted in
1990.  

Results showed that weekly bruxism was associated with
“current smoking” of 20 cigarettes or more daily, so that
“nicotine dependence is associated significantly with bruxism.”  
If you clench or grind your teeth when you’re not smoking
(and if you usually are smoking, at, say, the rate of 20 or more
cigarettes a day), consider giving the puffing a rest: for the
sake of your teeth and jaw muscles, if for nothing else.

8.
How Can We Manage Bruxism in People with Autism?

People with autism often struggle with social interaction and
communication, as well as other behavioral symptoms which
may make “routine dental care very difficult.”  Unfortunately,
bruxism is a problem commonly observed in children with
autism.  However, experts in India suggest that there is no
reason to despair: autistic patients with bruxism can be treated,
and they found out how.

In 2008, M.S. Muthu and K.M. Prathibha with the Pediatric
Dental Center in Chennai, India, encountered a four year old
male with autism who “presented with complaints of pain and
sensitivity of the teeth.”  This child had “history of excessive
grinding and clenching of teeth.”  The team implemented “full-
mouth rehabilitation, including placement of stainless steel
crowns for all primary molars.”  After this treatment, there was
“significant decrease in the grinding habit over the next 2
months.”  The researchers in Chennai assure that “although
the communication and behavioral problems in children with
autism pose challenges for the dentist,” there is still hope for
“treatment with proper planning and a lot of patience.”

Update:

9.
Close the Bedroom Door to Reduce Bruxism. In 2005, a
study was conducted by Dr.  A.T. Cheifetz of the Children's
Hospital Dental Clinic in Boston. As we noted in the
introduction, this study found that 38% of parents reported
that their children grind their teeth during sleep. What the
study also found was that incidences of teeth grinding were
higher among children who slept with the bedroom doors open.

While the study did not elucidate why keeping bedroom doors
open was associated with increased rates of teeth grinding, we
can speculate that ambient noises from hallways may play a
role. Clearly more research is needed to shed light on this
fascinating connection. But in the meantime, try closing your
child's bedroom door after they fall aslepp.





Related Links:
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Breath

Break Through Your Diet Plateau

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Quinoa-The New Superfood?
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