Especially in the current economic environment, stress is a constant companion for many people. Regular stress, if not properly managed is associated with a variety of symptoms including headaches, reduced immunity, and a range of sleep disorders (Nadel, 2009) including sleep bruxism. Bruxism, or grinding teeth, is a particularly damaging correlate of stress as it can lead to facial pain, tooth degradation, and increasing sleep trouble, not only for the sufferer but also for those that sleep in the same room.
Stress Triggered Bruxism
Researchers report that stress is the most significant factor in predicting the frequency and severity of bruxism (Alhberg et al., 2003). Stressors such as daily problems, trouble at work, and physical problems have all been found to correlate with increased teeth grinding (Giraki et al., 2010).
Outside of daily life stress, bruxism has also been induced by experimentally triggering micro-arousal in sleepers (Kato et al., 2003). This suggests that tooth grinding is not only correlated with stress, but in fact, is caused by it. In today's fast-paced world, where employees are often expected to be "always-on" and job stress travels everywhere in a smartphone, bruxism and other stress induced symptoms are on the rise (Nadel, 2009).
The Vicious Cycle of Bruxism, Insomnia, and Stress
Another characteristic that often accompanies bruxism is an escape style of stress management (Giraki et al., 2010). Not dealing with daily stressors head on, increases the likelihood of tooth damage and facial pain.
This combination of chronic unmanaged stress and teeth grinding can fuel insomnia. Insomnia then leads to reduced daily function which can trigger further stress and continue the vicious cycle of stress, teeth grinding, and sleep difficulties. Meditation and other psychological methods of stress reduction may prove helpful in breaking the cycle, but relaxation alone may not be enough to save teeth from the damage of grinding.
Night mouth guards provide protection for the teeth and reduce pain and disruptive noise while the journey towards relaxation and stress management is in process.
Bruxism as Stress Relief
If the damaging effects of bruxism are controlled by mouth guards, there may be some benefit to teeth grinding.
Teeth grinding and other bruxism-like behaviours help to manage the levels of stress hormones and responses in the human body (Sato et al., 2008). The natural expression of aggression, through clenching and grinding teeth, modulates stress in the same way that a well-timed shout or scream can ease tension or fear in waking life. In fact, spontaneous rhythmic masticatory muscle activity (teeth grinding or clenching) occurs in all sleepers, but not to the extent seen in bruxism sufferers.
The damage to teeth and to sleep patterns caused by intense teeth grinding, however means that regular bruxism sufferers are likely doing more harm than good with their unconscious teeth grinding.
The Role of Custom Dental Night Guards
A custom dental night guard can help reduce the effects of bruxism to the same stress relieving and non-damaging level as experiences by non-sufferers. Professional mouth guards for grinding teeth are made of a range of materials from soft rubber to laminate to acrylic and provide a protective layer between the teeth that both prevents dental erosion and reduces the disruptive noise associated with teeth grinding. Night mouth guards can also provide cushioning to alleviate the facial pain that results from the clenching of jaw muscles in bruxism sufferers.
Sports mouth guards worn by hockey and football players can be large and awkward to wear, but custom dental guards are less bulky and are custom fitted to the sufferer's teeth. These smaller, more comfortable custom night guards allow for comfortable sleep and, by mitigating the effects of bruxism, can ease insomnia in both the sufferer and any bedmates.
Drug Therapy for Bruxism
Chemical treatments for bruxism have also been developed. Research suggests that gabapentin may improve sleep quality and reduce teeth grinding and clenching in bruxism sufferers (Madani et al., 2013), but the drug carries side-effects. Because gabapentin is a neurotransmitter analog, it can affect psychological and emotional states increasing the risk of suicide (Patorno, 2010), potentially leading to withdrawal (Tran et al., 2005), and creating the risk of damaging overdoes (Baselt, 2008).
The same research that found benefits in gabapentin use, also found that, in terms of muscle clenching, the drug was no more effective than using a night mouth guard (Madani et al., 2013) without the risk of psychological side-effects.
Conclusion
Regardless the choice of treatment, reduction of teeth grinding to more normal levels can reduce symptoms of insomnia, dental damage, and jaw pain. By reducing the symptoms of bruxism, custom mouth guards can help sufferers to reduce the stress associated with daytime tiredness, frequent facial pain, and worry about dental health.
Because stress is a major factor in triggering teeth grinding, this reduction of stress from symptoms can also help further reduce the symptoms themselves. The constant stress of work, family, and financial life can be a major trigger of bruxism. Subsequently, the symptoms of bruxism increase stress through physical pain, mental exhaustion, and marital tension resulting from disturbing a partner's sleep. Though prescription medications are available to treat teeth grinding, custom dental night guards are a safer, side-effect free way to break the cycle of stress, insomnia, and bruxism.
References:
Ahlberg, J., Rantala, M., Savolainen, A.,Suvinen, T., Nissinen, M., Sarna, S., et al. (2003). Reported bruxism may be related to stress. Journal Evidence-Based Dental Practice, 3, 145-146. doi:10.1067/med.2003:46.
Baselt., R.C. (2008) Disposition of Toxic Drugs and Chemicals in Man (8th ed.). Foster City, CA: Biomedical Publications.
Giraki, M., Schneider, C., Shäfer, R., Singh, P., Franz, M., Raab, W.H.M., Ommerborn, M.A. (2010). Head & Face Medicine, 6(2). http://www.head-face-med.com/content/6/1/2.
Kato, T., Montplaisir, J.Y., Guitard, F., Sessle, B.J., Lund, J.P., Lavigne, G.J. (2003). Evidence that experimentally induced sleep bruxism is a consequence of transient arousal. J Dent Res, 82, 284-288. doi:10.1177/154405910308200408.
Madani, A.S., Abdollahian, E., Khiavi, H.A., Radvar, M., Foroughipur, M., Asadpour, H., Hasanzadeh, N. (2013). The efficacy of gabapentin versus stabilization splint in management of sleep bruxism. Journal of Prosthodontics, 22, 126-131.
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Sato, S., Sasaguri, K., Ootsuka, T., Saruta, J., Miyake, S., Okamura, M., et al. (2008). Bruxism and stress relief. In M. Onozuka & C.T. Yen (eds.) Novel Trends in Brain Science (pp. 183-200).
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