The Relationship Between Bruxism and Stress

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Stress levels are the strongest predictor of bruxism, implicated in 70% of cases (The Bruxism Association). As the pace of life increases and cities become more densely populated, stress is an increasingly important concern.

Whether you are a high powered professional or a stay at home mom, stress about work, family, finances, or just daily life, all contribute to the likelihood that you will suffer from the adverse effects of bruxism.

Career Stress

We all have our own stressors, but if you are working in a fast-paced, high pressure profession, you are at even greater risk of stress induced bruxism. Law enforcement personnel, for example, have a 50% chance of experiencing bruxism–7 times higher than the general population (Carvalho et al., 2008). Similarly, Ahlberg et al. (2002) found that bruxism is closely related to stress levels in media professionals in time-pressured environments while IT professionals were found to suffer from bruxism at a rate of 59.2% (Rao et al., 2011).

Across sectors, the demand for long working hours in high stress, time sensitive environments, or over multiple timezones can drive stress levels higher and produce a range of harmful symptoms including bruxism.

Bruxism and How to Cope

Though bruxism is acknowledged to be a damaging behavioural pattern, there is evidence that it may also be a stress coping mechanism (Sato et al., 2008). In stressful environments where there is no healthy and socially acceptable way to express and diffuse stressful emotions, grinding and clenching may provide a discrete physical alternative.

You can expend the physiological and psychological tension in an imperceptible behaviour that has little to no effect on others in your environment. This idea is supported by findings that stress hormones decrease after an episode of bruxing (Sato et al., 2008), but unfortunately do not offer any mitigation of the dental and muscular harms caused by bruxism.

Researchers have also found that people who are more sensitive to stressors and produce more stress hormones in response to pressured situations are more likely to suffer from bruxism (Abekura et al., 2011). Thus, for some no amount of stress will lead to bruxism, but for others, a small increase in life pressures can drive a massive stress response and subsequently tooth grinding or clenching.

Relaxation Techniques

No matter what you perceive to be the objective levels of stress in your life, relaxation techniques can provide vital relief not only from bruxism but also from a range of other health complaints including migraines, tension headaches, anxiety, and insomnia. If you think you are grinding or clenching, you should first visit your dental professional but you may also find support and improvement in practicing the following stress reduction activities adapted from Suresh (2008).

Meditation

There are many ways to meditate from guided visualizations to zen buddhist meditations. You may wish to try a variety, but once you find one that works for you, it can make a world of difference in your stress levels (and bruxism).

Yoga

Like meditation, yoga comes in many forms. Unlike meditation however, it has a fundamentally physical expression which may be useful for working out bodily tensions and stress. Most yoga classes also involve a certain degree of meditation in addition to the yoga poses themselves, allowing you to try two forms of stress relief in one.

Relaxation Training

Often closely related to meditation, relaxation techniques can include muscle tense and release programs, breathing exercises, and a range of mental exercises. You may wish to speak to a therapist to find the program that is perfect for you.

Simplification of Life

Sometimes the best way to reduce stress is to reduce the amount of stressors in your life. Do a life audit and decide what things you need to do versus those that could be simplified. Remove the things that cause you stress and are not absolutely necessary, then replace them with either some much needed downtime, or activities that make you feel good.

Self Care/Social Support

Bruxism might be your body's way of telling you that things aren't going quite right in your life, so listen. Pay closer attention to what you need to maintain your physical and psychological wellbeing. This might involve healthier social interactions, reducing your workload, getting more hours of sleep per night, quitting bad habits like smoking, or improving your diet. An unhealthy over-stressed body will find a way to communicate it's discomfort but if you listen and care for yourself, you can take back your health and serenity.

Stress Relief and Bruxism

Though stress is a significant factor in bruxism, relaxation techniques are not always able to reduce symptoms. If left undiagnosed for too long, tooth grinding and clenching can become a habit rather than just a reaction to stress (Orthlieb et al., 2013). In these cases, reducing stress alone is not enough to reverse the habit.

Biofeedback

Once the habit of bruxism is established, it may be impossible to reverse it with relaxation alone. If you find yourself unable to find improvement through relaxation, biofeedback may help you to unlearn the habit of clenching or grinding. Biofeedback involves the placement of pressure sensors between the teeth which then tell you when you are grinding or clenching (Shetty et al., 2010). This mechanism allows you to feel when you are bruxing and actively try to relax your jaw and stop the behaviour.

Unfortunately, biofeedback requires professional instruments and in the case of sleep bruxism is usually conducted in a sleep lab which can be difficult to access and uncomfortable.

Dental Mouth Guards

When relaxation and biofeedback do not provide relief, the continued stress of enamel damage, expensive dental bills, headaches, and jaw pain can make your bruxism even worse. Though dental mouth guards do not provide a cure, they can help to prevent symptoms. If you are unable to manage your bruxism with behavioural therapies, a mouth guard can be the difference between an unstoppable downward cycle and a chance to manage the condition and protect your smile.

Though off the shelf mouth guards can be uncomfortable, a well fitted custom made mouth guard provides comfortable protection that will allow you to get a good night’s sleep and avoid the stresses of pain and insomnia.

Combined Treatments for Bruxism

Bruxism can be a painful and damaging result of the stresses of life. Especially amongst those who work in high pressure environments, tooth grinding and clenching may be a coping mechanism but it can also quickly become a habit that no amount of relaxation can alleviate. If you are suffering from the symptoms of bruxism, a custom dental mouth guard can protect you from symptoms while biofeedback and relaxation techniques can allow you to reduce the frequency and severity of your bruxism.

References:

Abekura, H., Tsuboi, M., Okura, T., Kagawa, K., Sadamori, S., & Akagawa, Y. (2011). Association between sleep bruxism and stress sensitivity in an experimental psychological stress task. Biomedical Research, 32(6), 395–399.

Ahlberg, J., Rantala, M., Savolainen, A., Suvinen, T., Nissinen, M., Sarna, S., Lindholm, H., & Kononen, M. (2002). Reported bruxism and stress experience. Community Dent Oral Epidemiol, 30, 405–408

The Bruxism Association. (n.d.). Causes of Bruxism. Retrieved from http://www.bruxism.org.uk/causes-of-bruxism.php?PHPSESSID=qgdgpcbl5ml6sppl843gehqjf0

Carvalho, A. L. D. A., Cury, A. A. D. B., & Garcia, R. C. M. R. (2008). Prevalence of bruxism and emotional stress and the association between them in Brazilian police officers. Brazilian Oral Research, 22(1), 31–35.

Orthlieb, J.-D., Tran, T.-N.-N, Camoin, A., & Mantout, B. (2013). Propositions for a cognitive behavioural approach to bruxism management. J. Stomat. Occ. Med., 6, 6–15.

Rao, S.K., Bhat, M., & David, J. (2011). Work, stress, and diurnal bruxism: A pilot study among information technology professionals in Bangalore City, India. Hindawi Publishing Corporation. doi:10.1155/2011/65489

Sato, S., et al. (2008). Bruxism and stress relief. In M. Onozuka & C. Yen (eds.) Novel Trends in Brain Science (pp. 183–200).

Shetty, S., Pitti, V., Babu, C.L.S., Kumar, G.P.S., & Deepthi, B.C. (2010). Bruxism: A literature review. J. Indian Prosthodont. Soc., 10(3), 141–148.

Suresh, S. (2008). Stress and coping strategies. Management and Labour Studies, 33, 482.