Bruxism or teeth grinding is one of the many examples that show that our mental health has physical manifestations as well. Bruxism is an excessive parafunctional habit of grinding teeth and clenching the jaw.
It is a common problem that usually occurs when a person is anxious, stressed or in deep concentration or sleep. In addition to excessive tooth wear, teeth grinding and clenching can also cause tooth fractures and mobility, hypersensitivity, muscle and joint pain and severe headaches.
Bruxism can occur during sleep or during wakefulness. While both types have been claimed to have different causes, the effects on the person’s teeth are the same. Since teeth grinding is a parafunctional habit or an excessive use of a part of the body beyond its normal use, it has been debated that it could be both a subconscious and involuntary habit.
The medical community completely recognises bruxism to have multiple causes influenced by a range of factors. Psychiatrists and dentists share different views but agree that management of the condition should begin by identifying the underlying cause. Genetic and psychosocial factors may also come into play. Certain medications also increase the risk of developing sleep or awake bruxism. Ironically, such drugs are used to treat mental disorders.
The Role of Behavioural Management
Although the evidence that supports the cause of bruxism is unclear and insufficient, the condition has been proven to have a strong relationship with stress and anxiety. While dental and mental health professionals and organisations have opposing views regarding bruxism, they agree that behaviour modification is the best way to manage the symptoms.
Behaviour therapy is especially apt for people with daytime bruxism, since the condition is somewhat semi-voluntary, just like fingernail biting and pen chewing. While wearing mouth guards or splints reduce muscle activity in the jaw to help manage sleep bruxism, managing daytime bruxism is a bit more complicated.
Behaviour therapy includes relaxation exercises and lifestyle modification to reduce stress and anxiety and other underlying causes of bruxism. While mouth guards prevent further tooth damage, psychosocial interventions will help reverse the habit. Biofeedback, a specific type of psychophysiological intervention, has also been said to be clinically effective to treat a variety of conditions, including bruxism.
The management of bruxism is a close collaboration between the dentist and the psychologist. The best way to manage the condition and prevent further damage to the teeth is to treat the underlying cause and help the patient become more aware and proactive about eliminating the habit.