We have been highlighting various anxiety symptoms lately here on AnxietyConnection. In a previous post we discussed Globus Hystericus, which is an anxiety induced sensation of having a lump in one’s throat unrelated to a medical cause. We also talked about a related symptom of gagging. In this post we are going to explore how anxiety can manifest in grinding one’s teeth or otherwise known as "bruxism." According to the Columbia University College of Dental Medicine as many as 30 to 40 million children and adults have bruxism. While everyone grinds or clenches their teeth from time to time, untreated bruxism can eventually cause harm to one’s teeth, especially in wearing away the enamel. Other unwanted side effects of bruxism can include jaw and neck pain, headaches, tinnitus (a ringing in one’s ears), earaches, and gum problems.
Grinding one’s teeth can take place during the day or night, but most often occurs during sleep. Most sufferers are unaware that they are grinding their teeth. Some of the signs that you may suffer from bruxism are waking up with a headache, sore or stiff jaw muscles, and general facial pain.
Causes of Bruxism include:
"¢ Stress and Anxiety
In one frequently cited study, lead researcher, Maria Giraki, of Heinrich-Heine-University in Dusseldorf, found an association between stress and sleep bruxism. This study, published in the March 2010 issue of the journal Head & Face Medicine, found that bruxism was more prevalent among study subjects who reported more daily stress and stress at work. Researchers of the study suggest that the people with higher levels of teeth grinding use inadequate methods to cope with stress such as escapism.
"¢ Dental Problems
One cause for bruxism, unrelated to anxiety or stress, is poorly aligned teeth. When your upper and lower teeth do not meet properly when you bite down, you may react by grinding your teeth. If your dentist suspects that your teeth grinding is caused by dental problems he or she will check the alignment of your teeth, your bite, and will probably take X-rays of your teeth and jaws.
"¢ Medication Side Effects
If you are experiencing the need to clench or grind your teeth during waking or sleep hours you may want to check your medications for possible side effects. There are studies to show that certain medications can trigger this behavior. For example medications given to treat ADHD may have the potential side effect to cause bruxism in some patients. A 2007 study conducted by Johnson & Johnson Pharmaceutical Research and Development not only tested the effectiveness of the medication, Concerta, to treat adult ADHD, but also reported on the frequency of side effects. In this study, 6.4 percent of study subjects taking Concerta experienced bruxism.
Another study on ADHD medications published in the 2004 Fall edition of The Journal of Pediatric Dentistry concluded that: "Subjects affected by ADHD and pharmacologically treated showed higher occurrence of bruxism compared to subjects affected by ADHD not taking medicines and controls; and within the ADHD group taking medications, CNS-stimulants have been associated with such side effect more frequently than the other drugs."
In addition to stimulant ADHD medications, some antidepressants may also increase your risk for developing bruxism as a side effect. In 2000 The Journal of The American Dental Association cited a study which showed that some SSRI antidepressants including Prozac, Paxil, and Zoloft may cause bruxism and associated medical ailments such as headaches.
Treatment for Bruxism
If you are finding that you are experiencing the symptoms of bruxism the first step is to seek the guidance of your dentist to rule out any related dental problems such as misaligned or loosened teeth. If dental issues are the culprit, your dentist may suggest procedures appropriate for your condition such as orthodontics or crowns.
If dental causes have been ruled out you may want to check the possible side effects of your medications. In the cases where an SSRI antidepressant was found to be the cause, the addition of the non-SSRI antidepressant Buspar was found to decrease symptoms of bruxism. Other medications cited in the literature as possibly effective in treating teeth grinding include Inderal (Propranolol), and Neurontin (gabapentin). In extreme cases Botox (Botulinum toxin) injections may relax the jaw muscle.
One of the most common preventive treatments for bruxism is to be fit for a mouth guard or bite splint which you can wear at night to protect the surface of your teeth from night-time grinding. A mouth guard can also help alleviate the pain associated with bruxism.
Other reported remedies for decreasing teeth grinding behavior include reducing tobacco, alcohol and caffeine consumption.
Ways to Reduce Anxiety-Related Bruxism
When your teeth grinding is attributed to anxiety there are some things you can do in addition to such preventive measures such as being fitted for a mouth guard. A qualified counselor or therapist can teach you ways to decrease your overall stress and anxiety. Your therapist may guide you through Progressive Muscle Relaxation techniques in order to relax your jaw and mouth muscles. Biofeedback exercises may help those individuals with daytime bruxism to become more aware of their jaw tightening and teeth grinding behaviors. In some cases anti-anxiety medications may be given temporarily to give the mouth and jaw muscles a chance to relax especially during sleeping hours.
You don’t have to suffer needlessly with bruxism. There is treatment and help. Discuss your treatment options with your dentist, doctor, or therapist.