Are you sometimes self-conscious and embarrassed around others? It’s quite normal to feel anxious before a giving a speech or an interview or any stressful social situation. According to the National Institute of Mental Health, 15 million people in the United States suffer from social anxiety disorder. Sometimes referred to as social phobia, people with this condition may stay away from social events that cause them stress. They may even worry about a certain social event for days or weeks before it occurs. Now, a recent study from the Tel Aviv University in Israel reveals that social anxiety, even brief bouts of anxiety may be a precursor to bruxism or teeth grinding.
Bruxism or teeth grinding causes tooth enamel to wear down, and if not corrected, can lead to headaches, tooth fractures and jaw muscle and joint pain. People with bruxism can experience pain when eating, yawning or even talking. Clenching, like bruxism, is associated with stress and anxiety; both occur most often at night. People who suffer from bruxism or clenching can wear a custom made protective bite “splint” to prevent headaches, tooth fracture/wear and gum recession, just some of the consequences of these conditions if these habits are not addressed.
Study Symptoms Revealed
Published in the Journal of Oral Rehabilitation, the study indicates that social interactions trigger teeth grinding and clenching in those who are already socially anxious. It is the hope of the researchers that their studies can help mental health professionals identify patients predisposed to bruxism and help them receive the treatment they need.
Using questionnaires, researchers assessed the answers of 75 subjects, both men and women in their early 30s. One group of 40 people had social phobia which is characterized by excessive fear about social situations. Half of the 75 participants were taking antidepressants or SSRIs (selective serotonin reuptake inhibitors). The control group consisted of individuals who were not classified as suffering from social anxiety disorder or social phobia, and were not on any anti depressant medications. As part of the study, all 75 subjects had dental exams and psychiatric evaluations. The bruxism symptoms and oral habits were assessed for all the participants, which included questions about gum chewing, nail biting and jaw movements with no contact with teeth, often referred to as ‘jaw play.’
The results of the study found that 42% of the 40 subjects in the social phobia group suffered moderate to severe dental erosion, while only 28 percent of the subjects in the control group showed the same erosion. The rate of jaw play, those jaw movements with no teeth contact, was found in 32% of the phobia group and 12% of people in the control group. Forty-two percent of the social phobia subjects showed symptoms of awake bruxism, and only 2 percent of the control group reported these symptoms.
Bruxism is categorized into awake bruxism and sleep bruxism. Awake bruxism or clenching is an involuntary clenching of the teeth and jaw bracing that obviously occurs while awake. Sleep or nighttime bruxism is when people grind their teeth in their sleep in a rhythmic way while they simultaneously contract their jaw muscles. According to the Bruxism Association of the UK, it is estimated that at least 70% of sleep bruxers indicate that psychological disorders like stress and anxiety increased their nocturnal teeth grinding. It is also common for individuals who use alcohol, tobacco and caffeine regularly as well as those with sleep breathing disorders such as snoring and obstructive sleep apnea (OSA) and can even occur in children.
Children and Bruxism
While the underlying causes of bruxism can be extremely complex, researchers have narrowed the reasons why it may be happening in children:
- Nasal problems, allergies and OSA – It could be poor breathing. If a child has difficulty obtaining air due to environmental allergies or other respiratory problems they may brux during sleep as the body attempts to open a constricted airway by moving the jaw forward (this is what oral appliances do for treatment of OSA) to drag the tongue forward from its position back in the throat which blocks airflow.
- Stress and anxiety (from school, sports, social situations and, of course, adult expectations) are a part of growing up. If children lack or have not learned healthy outlets to cope with or relieve stress, they may take these emotions and anxiety to bed with them, internalizing the stress only to release it unconsciously as sleep bruxism.
- Teething – During teething, babies often clench as a way to relieve their pain. Sometimes this reaction just continues on as they get older, even though the child is well be past their teething years.
- Malocclusions – Malocclusions is a term for a misaligned or unstable bite. If a child’s teeth are erupting crowded or crooked, it can be uncomfortable so many time the child will unconsciously grind their teeth in an effort to relieve the “unevenness” of their bite and relieve the pain.
At Dr. Mark W Langberg, DDS, MAGD, PC we believe preventative care starts early. Caught in time, these habits can be addressed in children before they evolve into adult sleep bruxism causing pain and dental destruction. Once the habit occurs habitually and not only just when stressed, it becomes very damaging. At a certain point, it no longer requires life stressors or inadequate coping skills to perpetuate these clenching and bruxing habits. By then, bruxing and clenching have a life of their own and usually will require orthopedic or dental restorative procedures in addition to stress management and complementary treatment to control. If you think you may need help with any of these problems call us today at 248-356-8790 and schedule an appointment as soon as possible. We have advanced training in this field and can recommend a technique that can many time stop or at least avoid the negative consequences of bruxing or clenching in children and adults. Discover the difference a great dentist can make!
Until Next Time,
Mark W Langberg, DDS, MAGD
Your Southfield Family Dentist
Tel: (248) 356-8790