This condition, called bruxism, can exert up to 200 pounds of force on the teeth. “The grinding force can be up to six times greater than a regular chewing,” says Ada Cooper, MD, a dentist and spokeswoman for the American Dental Association. So it is not surprising that teeth erode or break. And for older adults, whose teeth may be more fragile, bruxism can be especially unpleasant.
In these trying times, dentists are seeing more people with bruxism and bruxism – also known as bruxism.
Bruxism can occur during the day or at night. Stress can be an important factor, either in moments of acute stress or during sleep, where elevated levels of stress hormones may continue to circulate after a hard day, Cohn says. Habits such as alcohol and tobacco use also increase the likelihood of developing it. “Smokers are twice as likely to have their teeth polished than non-smokers,” Cooper says. Certain medications — such as some antidepressants and antipsychotics — can also increase the risk.
Conditions that affect the central nervous system, such as dementia, Parkinson’s disease, or stroke, can cause or worsen bruxism. It often goes hand-in-hand with TMJ disorders, which cause pain around the jaw. Finally, there is obstructive sleep apnea (OSA), in which the upper airway is repeatedly obstructed during sleep, causing breathing to stop during the night. This can cause people with obstructive sleep apnea to “unintentionally overcompensate and grind their teeth as they push their jaw forward to open the airway,” says Manar Abdel Rahim, M.D., a dentist at Cleveland Clinic. (If you have been told you have obstructive sleep apnea, ask for a bruxism evaluation.)
Untreated sleep apnea may worsen indicators of heart health and diabetes
A cracked tooth, crown, or filling may be a clear indication that something is wrong, but there are less dramatic signs to watch for. For example, people with gnashing of teeth may wake up with a jaw or neck in the afternoon, headache, jaw stiffness, ringing in the ears, or marks around the edge of the tongue as it is being pressed against clenched teeth. If you notice this, see your dentist, who will check for tooth wear, fractures, and receding gums. “If the only clue is your teeth erosion, you may not be experiencing active bruxism,” says Cohn. Chronic severe heartburn is a common cause of dental erosion in the elderly.
Sleep lab video recording or electromyography can definitively diagnose bruxism. For the latter, electrodes attached to the skin check for repetitive movements of the jaw muscles.
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While bruxism can be difficult to treat, the following may help:
- Plastic mouth guard: “Usually wearing a guard at night is the first line of defence,” Abdul Rahim says. “A guard places space between the upper and lower teeth to protect them and allows the jaw muscles to relax.” Your custom guard ($324 to $788) is usually more effective than an over-the-counter product, and is sometimes covered by insurance. Neither of them breaks the habit, but it prevents further tooth damage.
- Botox: Injecting botulinum toxin into the jaw muscles that control chewing may reduce the pressure it puts on the teeth.
- Reducing stress: Relaxing activities (such as yoga and meditation) may help. So your awareness of the behavior can be increased. Tip: “If, during a stressful moment, you feel your teeth touching, gently let go of your jaw and have the teeth floating away from each other,” Cooper says.
- physical therapy: A physical therapist trained in treating bruxism can teach you exercises to stretch, strengthen, and relax your jaw and neck muscles, which may reduce muscle tension that can lead to contractures and stridor.
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