When we think of the effect stress has on our looks, we imagine furrowed brows or lines running down from the sides of our mouths to make us appear even more miserable. We talk about our shoulders getting higher and higher with every new demand and deadline, and we bemoan our nails and cuticles that we nibble on when the going gets tough. However, we often overlook another part of our body that bears the brunt of our stress – our teeth.
As stress levels rise, many of us grind our teeth and clench our jaws, often without realising what we’re doing, and by the time we are aware of it, the damage is done. There’s even a name for this grinding and clenching – it is called bruxism, and it can have disastrous effects on our teeth, as well as our general health.
With stress levels reaching epidemic proportions, if we’re not clenching our jaw by day, we’re literally chewing over our problems as we slumber, and grinding our upper and lower teeth against each other. By morning, instead of feeling refreshed after a night’s sleep, we wake with a collection of aches in our heads, jaws and teeth. In more serious cases, patients report feeling as if their teeth are moving around or coming loose. And unless our partners hear us grinding and recognise what we’re doing, we don’t realise the damage until we see a dentist.
Bruxism occurs in both children and adults, says Dr Giovanni Molina Rojas, from the Apa Aesthetic Dental and Cosmetic Centre in Dubai. ‘It can start when a baby grows her first teeth at one year old, but it’s most common among 25- to 44-year-olds. Men and women are equally guilty of this grinding and clenching,’ he says.
Although there are no specific figures for the UAE, international studies have revealed that awake bruxism, which is daytime grinding and clenching, affects about a fifth of the population, while up to 16 per cent of people suffer from bruxism in their sleep.
‘Bruxism has consequences in different areas of the mouth,’ explains Dr Rojas. ‘Teeth show wear, fracture and mobility, and you can get gum recession – all of which can lead to the premature loss of teeth.
‘Muscles become hyperactive, leading to muscle pain and limitation of mouth opening. Due to the excessive bite forces, the joints can also become inflamed and uncomfortable. Headaches seem to be the most commonly reported pain. Patients also report pain in the jaw, along with teeth sensitivity.
‘Although bruxism isn’t life-threatening, it can influence our quality of life. Pain, sleep disruption and frequent dental treatments are all factors that have an impact on our daily routine.’
As well as the misery of a poor night’s sleep, bruxism can damage the enamel on our teeth. In more severe cases, our teeth can wear down, resulting in shortened teeth, receding gums and sensitivity. If untreated, grinding can cause us to lose our teeth.
So if the end result is so startling, why do we do it?
Tricia Woolfrey, a stress resilience coach and therapist, says stress is the number one cause of bruxism.
‘I know of no other reason than stress,’ says Tricia, author of The Energy Solution – How to Overcome Fatigue and Lethargy.
‘People have been known to grind their teeth down to stumps, and they wake up with terrible headaches. But while many dentists treat the symptoms and supply their patients with mouth guards to wear in bed at night to protect their teeth, in my opinion it would be better to treat the cause.
‘I think people who grind their teeth in their sleep are disassociated from their stress. They may be in denial about suffering from stress and they may just not want to recognise it. But it has to come out somehow, and that’s why it’s happening in their sleep. I had a client who told me he wasn’t stressed and his life was normal, yet he was grinding his teeth at night. [Then] I found out a bit more about him.
‘He had a variety of problems – I discovered his children were annoying him, he wasn’t achieving his targets at work, his neighbour had nearly knocked him over in his car several times and he thought his partner at work was not doing his share of work. Yet he felt he should be able to cope with those things and he didn’t consider them as stress,’ says Tricia. ‘But little things that go unexpressed accumulate and there’s often one small thing that pushes us over the edge, and then our problems become overwhelming. But because we feel as if we should be able to cope, we pretend the stress isn’t happening and we don’t face up to it.
‘Ninety per cent of people who suffer from bruxism will say they have no stress when they’re first asked,’ she says.
Tricia has separate interpretations for the two types of bruxism. ‘If someone clenches their jaw or their teeth, it’s as if they’re fortifying themselves and bracing themselves for what lies ahead, whereas people who grind are literally chewing over their problems.’
So once we know we grind or clench, what can we do to stop, so we can save our teeth?
‘Understand the cause of your stress,’ suggests Tricia. ‘When you ask someone why they’re stressed, often they’ll give a glib answer and say they don’t know what’s making them anxious. To overcome the conscious or ego, I ask them what the answer would be if they did know, and by engaging the wisdom of the unconscious mind, they usually come up with a reason quite quickly.
‘Once they know what’s causing their stress, they can decide if it’s something they have to accept or something they can deal with differently. For the things they have to accept, it helps to sit quietly and imagine those worries floating away. Some people like to write out their worries, then burn them. It’s the letting go that’s important.
‘For other situations, their behaviour might need to change. If, for example, their father is terminally ill, they can’t change their dad’s illness or prognosis, but they can change the way they are with their father.
‘They can turn their time with their dad into quality time and make it an enriching and rewarding experience, whether that means holding his hand, really listening to him or even giving him a pedicure. Those moments of connection will make them feel proud of themselves once their father is no longer around,’ says Tricia.
‘If someone is afraid they may lose their job, they too could take action. They could get together an impressive CV, make sure they have really good relationships with their colleagues and bosses so they get a great reference, and build up a strong network. Or they could ask themselves if there is any evidence that they are going to lose their job. Sometimes we worry about things that are unlikely to happen.
‘Someone who has financial problems might look at areas where they could cut back or they could add up what they have in the bank and in investments. We’re often better off than we think.’
Psychologist Rachael Alexander, who helps people to fight their fears, explains that stress is ‘the perceived demands that are being placed upon us versus our perceived ability to handle those demands’. In other words, we create our own stress because of the things we think we have to do, and our doubts about whether we can do them.
‘List everything you have going on in your life at the moment,’ suggests Rachael. ‘Look through and decide which things give you joy and which of them you really want to do.
‘Then look at the flip side. What are the burdens? Look at the list to see what you could delegate or give away. Are there chores you could get your teenagers to do? If you love children but despise ironing, could you swap childminding for ironing with a friend?
‘Saying no to demands or requests that you don’t fancy will ease your stress considerably, but if you find it difficult to say no, have a good look at the reasons why. It might be you don’t want an argument with your spouse or your teenager, but by keeping the calm at home and avoiding rocking the boat, you’re actually creating stress for yourself.
‘Try to have some honest conversations and explain how you’re feeling. You’ll feel much better for getting it off your chest.’
BRUXISM: WHAT ARE THE STRESS TRIGGERS?
One way to suss out the stress behind our bruxism is to look at what we’re avoiding. ‘It may be you’re avoiding going in to school to talk to a teacher about a child who’s bullying your son,’ says psychologist Rachael Alexander. ‘In that case, ask a friend or your partner to go with you and have that conversation. Or you might be avoiding seeing the doctor about a suspicious new mole or that cough you’ve had for weeks.
‘If you just need your partner to be more affectionate and give you hugs, tell them. Sometimes we just need to be clear about our needs.
‘Once you’ve tackled a difficult issue, you’ll feel much happier and you may well find that your grinding and clenching will stop.’
Experts suggest that hypnotherapy can also be quite good if the patient is amenable to this treatment.
In a small number of patients, bruxism is caused by substances such as caffeine and tobacco, and ironically by medication for anxiety and depression. It seems, whatever the cause of our daily and nightly grind, rethinking our lifestyle is the way forward if we want to save our teeth and protect our smile long into old age.