Did you wake up with a sore jaw?

Not to panic.

It could have just been because you slept in an awkward position. Or, maybe from physical activity the previous day. In any case, if you know precisely why your jaw hurts, then there’s no need to worry. However, if you are always waking up with unexplained jaw pain, morning headaches, dental discomfort, and visible indentions in your tongue, you might be a chronic teeth grinder.

Teeth grinding is a grind

Many people may grind their teeth from time to time, sometimes unconsciously when they are under immense stress or during periods of intense concentration.

Types of bruxism

Types of Bruxism - Teeth Grinding - Willow Pass Dental Care - Concord, CA dentist

However, it’s the teeth grinding that people aren’t aware of that causes the most problems over time. It is estimated that there are well over 30 million people in the US who suffer from chronic teeth grinding, also known as bruxism. A considerable majority of these individuals suffer from persistent teeth grinding at night while they are sleeping. As a result, many people with bruxism remain unaware that they are suffering from the disorder.

Bruxism left untreated can result in major dental concern.”

Dr. Reza Khazaie, DDS, Prosthodontist

Bruxism, which often manifests while the sufferer is asleep, is the involuntary movement of the jaw musculature while the upper and lower teeth are in contact with one another. As a result of that contact, an eerie grinding noise is often made as the two sets of teeth scrape against each other.

Bruxism can cause facial pain, a sore jaw, morning headaches, as well as physical damage to the teeth and gums. Unfortunately, because the majority of those with bruxism are unaware of their conditions, many merely chalk up their morning facial pain and headaches to a bad night of sleep. Some may even self-medicate with painkillers or other over-the-counter drugs without genuinely treating their underlying bruxism and without ever finding long-term relief from their pain or truly understanding the underlying causes.

Many people never realize that they have the disorder until their partner tells them about it. Others find out after visiting a dentist or a sleep expert who notices unusual wear patterns on their teeth. In any case, once diagnosed many of these sufferers want to know what the underlying cause of their conditions is.

They will be disappointed to find out that there is no single agreed-upon cause of bruxism. Instead, there are a variety of risk factors ranging from genetics to mental stability to the physical shape of a person’s teeth and jaw that may play a role in triggering bruxism.

Tooth grinding sound effect

The underlying cause of bruxism

The real reasons behind bruxism and other forms of jaw pain that all fall under the broad category of Temporomandibular Joint (TMJ) disorders are not well understood. At least, they can’t be pinpointed medically. However, based on well-understood medical research and a fair bit of anecdotal evidence, the causes of bruxism can be primarily sorted into two distinct categories: stress triggers and physical imbalances in the jaw or mouth itself.

5 Psychological Bruxism Triggers

The existence of psychological triggers for bruxism is well understood although the exact link in causation is not. Scientists know, for example, that even rats suffer from bruxism when introduced to stressful conditions. However, the exact mechanism behind why the body reacts to specific stressors or emotions with jaw clenching is still a mystery.

  1. Stress: Stress, along with anxiety, are the two most cited non-physiological reasons for bruxism. According to the Bruxism Association, 70 percent of all cases are caused by stress or anxiety. Of course, many ailments are said to stem from underlying stress or anxiety. Furthermore, dealing with stress is far more difficult than just telling someone to “relax”. Chronic stressors such as an unsafe neighborhood or chronic illness cannot merely be relaxed away. Nonetheless, most experts in the field recommend mindfully managing stress levels as best as can be maintained.
  2. Anxiety: Worrying, or feeling anxious, is also one of the most highly cited triggers for bruxism in many patients. Like stress, dealing with anxiety can be difficult and may require a combination of addressing external stressors and managing internal reactions.
  3. Depression: Depressed patients assessed with the Beck Depression Inventory (BDI), the Hospital Anxiety Depression Scales (HADS), and the Hamilton Anxiety Rating Scale (HAMA) were found to be statistically more at risk for bruxism.
  4. Emotional imbalance: Diurnal, or daytime, bruxism is often attributed to anger or tension. Clenched teeth are often associated with frustration and other negative emotions that can cause jaw muscles to clench uncontrollably.
  5. Neuroticism: As strange as it may sound, personality characteristics are known to predispose some people to be more susceptible to a variety of diseases. Studies appear to support the idea that bruxism and chronic teeth grinding may be just another physical manifestation of specific physiological and emotional imbalances.

5 Physical Bruxism Triggers

  1. Medication: Bruxism is a well-known side effect of many prescription drugs and medications. Interestingly enough, this is particularly true of psychotropic medications, such as antidepressants and mood stabilizers, which help patients deal with known physiological triggers of bruxism. Popular drugs such as Prozac, Zoloft, and Paxil may all trigger involuntary teeth grinding.
  2. Gastroesophageal Reflux Disorder (GERD): Many studies link Gastroesophageal Reflux Disorder directly to bruxism. In fact, along with sleep apnea, Gastroesophageal Reflux Disorder and bruxism are often linked together. Patients with one condition often have the other two as well. One thing all three of the linked conditions share in common is a tendency to disrupt a person’s sleep, resulting in fatigue, headaches, and other signs of sleep deprivation.
  3. Imbalanced bite: Many dentists and dental health specialists believe that bruxism is the direct result of an imbalanced bite. The idea is that an imbalanced bite may allow teeth that would otherwise not be in contact to rub against each other. Or, when triggered by stress, an imbalanced bite may result in far worse damage to dental enamel as a result of the imbalance.
  4. Airway blockages and sleep apnea: Like Gastroesophageal Reflux Disorder, sleep apnea tends to disrupt a person’s sleeping patterns and is closely tied to bruxism.
  5. Genetics: Like many diseases and disorders, there is evidence to support the notion that bruxism may be partially hereditary.

The real underlying causes of bruxism and teeth clenching may vary from one case to the next. One patient’s bruxism may be purely a stress response while another patient may have an unbalanced bite and concurrent sleep apnea. To get a better picture of bruxism and how to treat it, it is essential to talk to a qualified dental specialist. Patients should consider dental procedures that actively improve dental aesthetics and protect teeth.

Depending on the type and severity, any of the treatments mentioned above could work alongside essential preventative self-care practices such as mindfully managing stress and engaging in healthy and relaxing activities such as exercise. Mild bruxers with mostly healthy teeth can use mouthguards to protect their teeth. Those with abraded or damaged teeth, including children, may require full crown restoration to help protect compromised teeth and prevent further degradation from constant grinding.

Finally, those with severely damaged teeth may also opt for a dental implant-based solution such as conventional dental implants or All On 4 dental implants. It is important to note, however, that aesthetic restorations must still be protected from bruxing.