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The condition, known as bruxism, can put up to 200 pounds of force on the teeth. “The bite strength of grinding can be up to six times greater than normal chewing,” says Ada Cooper, dentist and spokesperson for the American Dental Association. No wonder then that it can wear down teeth or even break them. And for older adults — whose teeth can be more fragile — bruxism can be especially troubling.
In these trying times, dentists are seeing more and more people with teeth grinding and clenching – also known as bruxism
Bruxism can occur during the day or at night. Stress can be a significant factor, either at moments of acute tension or during sleep when elevated levels of stress hormones may still be circulating after a difficult day, Cohn says. Habits such as alcohol and tobacco use also increase the likelihood. “Smokers grind their teeth twice as often as non-smokers,” says Cooper. Certain medications — such as some antidepressants and antipsychotics — can also increase the risk.
Disorders 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 in the jaw area. Finally, there is obstructive sleep apnea (OSA), which is a condition in which the upper airway becomes blocked over and over again during sleep, leading to numerous breathing pauses at night. This can cause people with OSA to “unconsciously overcompensate and grind their teeth as they thrust their jaws forward to open the airway,” says Manar Abdelrahim, a dentist at the Cleveland Clinic. (If you are told you have OSA, ask to be tested for bruxism.)
Untreated sleep apnea can worsen markers of heart health and diabetes
A broken tooth, crown or filling can be a clear signal that something is wrong, but there are less dramatic signs to look out for. For example, people with sleep bruxism may wake up with a sore jaw or neck, headache, a stiff jaw, ringing in the ears, or marks on the edge of the tongue where it presses against clenched teeth. If you notice these, contact your dentist, who will check for tooth wear, fractures, and receding gums. But “if the only evidence is wear and tear on your teeth, you may not have active bruxism,” says Cohn. Chronic severe heartburn is a common cause of tooth wear in older adults.
A video recording in a sleep laboratory or an electromyography can definitively diagnose sleep bruxism. In the latter, electrodes attached to the skin check for repetitive jaw muscle movements.
Need a quick stress reliever? Try one of these surprising science-backed strategies.
While bruxism can be difficult to fix, the following can help:
- A plastic mouthguard: “Wearing a guard at night is usually the number one line of defense,” says Abdelrahim. “A guard creates space between the upper and lower teeth to protect them and allows the jaw muscles to relax.” A guard made just for you ($324 to $788) is usually more effective than an over-the-counter product and will sometimes covered by insurance. Neither breaks the habit but prevents further tooth damage.
- Botox: Botulinum toxin injections into the jaw muscles that control chewing can reduce the pressure you put on the teeth.
- Stress Reduction: Relaxing activities (like yoga and meditation) can help. Here’s how you can raise your awareness of the behavior. One tip: “If you feel your teeth touching in a stressful moment, gently open your jaw and let your teeth float away from each other,” says Cooper.
- Physical therapy: A physical therapist trained to treat bruxism can teach you exercises to stretch, strengthen, and relax the neck and jaw muscles, which can reduce muscle tension that can lead to clenching and grinding.
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