Tag Archives: headaches

Not Sleeping Well? Could Be You’re Bruxing

Today, we usually think of clenching and grinding teeth as a sign of stress or anger. And it often is. Consequently, we’ve seen quite a rise in this behavior since the onset of economic turmoil in 2008. But the phenomenon itself isn’t new at all. Our ancient ancestors did it, too, with the earliest records of it – via clay tablets found in the Mesopotamian Basin – dating back to about 3000 BC. Our modern word for the habit – bruxism – comes from the other side of the Mediterranean, though: from the Greek word ebruxya, which literally means “to gnash the teeth.”

Though statistics remain a little sketchy, estimates say about 5 to 20% of us are bruxers, with the higher number likely being closer to right. The habit is especially common during sleep. In fact, it’s the third most common sleep disorder after insomnia and snoring.

What’s more, those with another sleep disorder are more apt to be bruxers, too. Other risk factors include smoking, high caffeine intake, high alcohol intake, medication use and, of course, stress. But because bruxism is a habit, it can – and usually does – continue even after its cause has been dealt with. Among the problems it can lead to:

  • Poor quality sleep
  • Worn down teeth and fillings or other restorations
  • Fractured teeth
  • Inflammation and receding gums
  • Loose teeth and premature tooth loss
  • Persistent headaches and chronic jaw, face, neck and head pain
  • TMJ disorder

TMJ stands for temporomandibular joint, and you have one on each side of your head. Together, they’re the hinge that lets you open and close your mouth – something than can be hard or painful to do if the joints are damaged or dysfunctional. (To see why this may be so, check out these videos showing what both healthy and dysfunctional TM joints look like in action.) You may experience clicking, grinding or pain in your jaw joints, or ringing or buzzing in your ears. “When the joint puts pressure on the nerves, muscles and blood vessels that pass near the head,” says Dr. Nigel Carter of the British Dental Health Foundation, “it can often result in headaches and migraines.”

Even so, adds Dr. Carter,

The cause of your headaches could actually be the way your teeth meet when your jaws bite together, otherwise known as dental occlusion. If you do suffer from continual headaches or migraines, especially first thing in the morning, pain behind your eyes, sinus pains and pains in the neck or shoulders, you should consider visiting your dentist, as well as a doctor, as soon as possible.

To check my patients’ occlusion, I use an imaging system called Tek-Scan, which shows how the teeth come together. It lets us see places where your bite may be “off” or where there’s an imbalance of force when you close your jaw. Once we’ve found these imbalances, we can determine the best solutions for correcting them.

For TMJ issues, we have another diagnostic tool: BioJVA (joint vibrational analysis). BioJVA lets us take fast, non-invasive and repeatable measurements of your TMJ function by determining the amount and kind of vibration at the joints. With it, we can diagnose dysfunction more specifically, and, because it’s repeatable, we can easily measure your progress through treatment.

Splint therapy is one of the most common and conservative measures taken to bring relief and readjust the jaw and related musculature. You may have seen or heard of over-the-counter “night guards” meant to cushion the forces of clenching and grinding, the main virtue of which is their low cost. Unfortunately, they’re often of little help to serious bruxers, who pretty quickly grind right through them. Their fit can often be poor, as well, causing problems such as discomfort, damaged gums or increased clenching.

A custom splint, on the other hand, will fit your mouth precisely and will normally last much, much longer than an over-the-counter device. Here’s what one of my patients had to say after just the first week of wearing a night guard we provided him:

But wait, you say. If I’m sleeping, how can I know if I’m grinding my teeth? Here are a few questions to ask yourself:

  • Are your jaw muscles or neck achy when you wake up?
  • Is it hard to open your mouth first thing in the morning?
  • Do the biting surfaces of your teeth look worn down?
  • Do you have frequent headaches?
  • Has your bed partner ever complained about you making grinding noises while you sleep or told you about any mouth movements he or she has seen you make while sleeping?

As is the way with such questionnaires, the more “yesses,” the more likely it is that bruxing is an issue for you, in which case you should consult your dentist for help with remedies and relief…and a better night’s sleep.

Image by justin, via Flickr

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Natural Ways to Deal with Stress-Induced Teeth Grinding

TrevinC/Flickr

Ever since the economic meltdown, the news has been peppered with stories about dentists seeing more patients who clench their teeth, grind and brux. According to a Chicago Dental Society poll, “Nearly 75 percent of dentists surveyed said their patients reported increased stress in their lives. And 65 percent of dentists said they have seen an increase in jaw clenching and teeth grinding amongst their patients.” As recovery from the recession appears to be slow-going, it’s no great leap to presume that these habits may become chronic.

There are several reasons for concern, not the least of which is the pain that can result – headaches and pain throughout the jaw, face and neck, even into the shoulders and upper back. Chronic clenching and grinding also damage the teeth over time, wearing down the biting surfaces or even chipping the teeth. Occulsion – how the teeth come together in a bite – also may be thrown out of alignment, which can further contribute to pain.

Moreover, the psychological stress itself may contribute to other dental problems. Research published last year in the International Journal of Dental Hygiene demonstrated that elevated stress increases the levels of inflammatory markers in the gingival crevicular fluid and of cortisol in saliva. Study subjects also had inflamed gums and more dental biofilm (plaque) on their teeth – conditions that pave the way for increased caries (cavities) and gum disease. Compounding these problems are the fact that, as research published in the Journal of Periodontology has shown, more than half of us neglect regular brushing and flossing when stressed.

Times like now, when national and global problems can contribute so much to our stress load – problems that we can’t do much about individually – it becomes more important than ever to do what we can to manage our stress and not let it get the best of us.

Some ways of managing stress can also help you reduce grinding and the damage it can do:

  • Eat well.
    Eating a nutritionally dense diet based on whole foods, including plenty of fruits and vegetables, can minimize inflammation while giving your body the nutrients it needs for good health. Avoid processed foods that are high in sugars and refined carbohydrates, as well as caffeine, which just adds to muscle tension when you’re under stress.
  • Get a massage.
    Therapeutic massage or other body work can help by both soothing the pain and loosening the muscles, working the tension out of the body. You can even massage your neck and jaw yourself to do this. If you choose to use a therapist, consider finding one who’s qualified to provide craniosacral manipulation, as it can be particularly helpful for releasing tension and easing pain in the face, neck and upper body.
  • Get some acupuncture done.
    Acupuncture can be used for general relaxation or for dealing with pain. In fact, more and more studies are showing the real benefits of acupuncture for reducing pain, including that associated with clenching and grinding, as well as TM joint disorders (TMD). Though many of us flinch at the thought of needles, when performed by a well-trained and qualified acupuncturist, the procedure is not at all painful or uncomfortable.
  • Take supplements before sleep.
    Most people who grind do so at night, so taking supplements to help relax both body and mind can help reduce the amount of nighttime grinding. Magnesium and calcium supplements taken together are wonderful for relaxing the muscles. Valerian root and chamomile are excellent calming herbs. Most bedtime teas include one or the other in addition to other calming herbs such as passionflower, lemon balm, mugwort, St. John’s wort and lavender.
  • Exercise.
    Exercise is well-known to reduce stress and anxiety, thanks in part to the release of endorphins: opiate-like neurochemicals that reduce pain and give the sense commonly known as a “runner’s high.” Also, moderate exercise keeps your body – including your immune system – strong and healthy, more resilient to stress. Activities such as yoga and tai chi may be especially helpful in that they combine both mental and physical processes, releasing stress.
  • Meditate.
    Taking a mental and physical time-out to slow down, breathe deep and focus beyond immediate problems and stressors can also provide for greater calmness and mindfulness – states that make us better able to deal with stress and problems in our daily lives. Some people choose prayer, while others choose zen-style meditation, and yet others may do guided visualization or any other sort of meditative activity. The key is to find the meditative style that works best for you.

Your dentist, of course, can also help. Typically, the first step is to provide you with a molded plastic mouthguard fitted to your teeth to help cushion and absorb the pressure from grinding. Using such a “night guard” – so called because it’s worn during sleep, when most grinding tends to occur – can often reduce the strength and frequency of headaches and other pain resulting from these behaviors.

To learn more about this topic and other treatment options, see “Why Your Jaw, Face, Head and Neck Might Hurt – and What We Can Do to Help” at drerwin.com.

 

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