Dear GoodTherapy.org,
For years now, I’ve had a problem with grinding my teeth, and it only seems to be getting worse. I think it might be hereditary because my mom says she grinds her teeth, too. It used to only happen at night, but lately it’s almost constant, and I have to consciously stop myself from clenching my jaw even during normal daily tasks (like writing this letter, for example).
I know things like biting cheeks and the skin on your lips can be linked to anxiety or other mental health issues. Is it the same with grinding teeth or jaw clenching? So far, amazingly, my dentist says my teeth haven’t been affected too much—but they always still try to sell me on expensive mouth guards. I’ve tried store-bought mouth guards and had a retainer for a while, but obviously they’re not really stopping the jaw tension even if they’re protecting my teeth. Sometimes I fall asleep biting my tongue and wake up with really pronounced indents from my molars. And I think sometimes the tension is related to how stressful my dreams are. But I don’t always remember my dreams, so I can’t say for sure.
Anyway, do you have any suggestions for things I can try? I wake up with a dull headache from this nearly every morning, and I’d really like to stop popping painkillers. I do think I have a more-stressful-than-average life, but honestly I prefer staying busy, and I don’t think my stress level is likely to change. Besides, I know people who lead lives with far more responsibilities and stress who don’t have this issue. Any ideas? —Ground Down
Dear Ground Down,
You’re not alone in this! Many people grind or clench their teeth, often in their sleep but also often in the daytime as well. Fortunately, there are many things you can try to help yourself overcome this issue and prevent more significant damage as a result of teeth grinding. I will provide some suggestions of things you can do, but first I’ll share a little more information about grinding teeth, how and why it happens and persists, and the role of anxiety in clenching or grinding teeth.
Clenching or grinding teeth without awareness, also known as bruxism, affects many (the incidence at any one time is around 10% of the population) and can range in severity from mild (no physical evidence of consequences) to severe. More notable effects of grinding or clenching include facial pain, tired jaw muscles or the development of jaw disorders, sensitive or damaged teeth, damage to tongue or inside of mouth walls, headaches, or earaches. It has been found to happen more frequently during periods of high stress, though it can become habitual and happen regardless of stress level. It also appears to have a hereditary link and happens more frequently in women than men.
Does this mean you have anxiety? It’s hard to accurately assess that without information that can only be gleaned by talking to you in person. I recommend making an appointment with a therapist near you to discuss the issues you may be experiencing.
Certainly, grinding or clenching teeth can be one manifestation of holding tension and responding to stress, and many individuals who experience anxiety (and depression) do also grind their teeth. Grinding teeth does not necessarily mean you are experiencing anxiety (or depression), however. That said, one way to treat this is by using many of the same behavioral techniques you might use to help manage anxiety.
The first step in overcoming grinding or clenching teeth is to become aware of the issue. How did you discover you were doing this? Have you experienced headaches or tightness in your facial muscles? Has your dentist remarked about damaged teeth or suspect you might be grinding or clenching? Are you hearing from your partner that you are grinding teeth in your sleep? Ask yourself questions about the frequency and nature of this behavior. When are you grinding or clenching your teeth? Are you doing other activities at the same time (e.g., sleeping or working)? Do you notice you are feeling stressed when you are clenching your teeth? You may want to keep a journal for a period of time to track this behavior and when it occurs. This information can inform your strategies to help overcome these behaviors.
Essentially, a pattern has developed over time. For example, you have trained yourself to engage in teeth clenching if you automatically start clenching your jaw when doing things like typing on your keyboard or stepping out into the winter cold. Now is the time to break this habit, before you notice more significant consequences.
Essentially, a pattern has developed over time. For example, you have trained yourself to engage in teeth clenching if you automatically start clenching your jaw when doing things like typing on your keyboard or stepping out into the winter cold. Now is the time to break this habit, before you notice more significant consequences.
Be aware of your mouth position. Believe it or not, there is a correct way to position your jaw. With your lips closed, you want to keep a gap between your top and bottom jaw, which can he assisted by placing the tip of your tongue just behind your front teeth on top. This may take some practice and regularly checking in to modify your habit of how you typically position your mouth. If, as you are reading this, you notice you are clenching your jaw, start to make a change. Begin by opening your mouth as if you are about scream, which is a great stretch for these muscles, followed by adopting the correct mouth position. This correct position will likely reduce tension in the jaw.
How do you know whether you are holding tension in your body? It is not always obvious. One thing to do is to scan your body for tension. Deliberately think about every muscle group in your body. Are muscles in your back or shoulders holding tension? Muscles in your jaw? Take a deep breath in and exhale. Let go of the tension where you notice you are holding it. Various relaxation techniques, centered on mindful breathing, can be especially effective. You may want to end every day by scanning your body for tension. You may want to do some yoga stretches. Additionally, try placing a warm washcloth on the muscles of your jaw to relax them before bedtime.
There are some suggested “don’ts” as well. Because this is a habit, be mindful of nonfood items you may “chew” on. Chewing pencils, straws, toothpicks, etc. may increase your tendency to engage in that behavior when you are not aware of it. Be aware of your chewing all around. Also, some experts would recommend reducing caffeine, nicotine, or alcohol before bed.
Other strategies to consider are what your dentist has been suggesting to you. If relaxation strategies and retraining your behavioral patterns are not the approach you would like to try, many individuals do utilize bite plates and find that custom plates are useful. If you are reluctant to try this approach, first try the behavioral strategies suggested above.
Knowing potential damages or consequences can be enough to motivate many to try to make a change. It sounds like you are quite motivated to overcome this on your own. Good luck!
Kind regards,
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