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“Oh, again? F*ckin’…”

If you’re one of the many, many people who’ve endured long, draining work days, excruciating conversations with people you can’t stand, or a landlord who refuses to fix the plumbing for the third week running, you’re likely familiar with the clenched jaw that accompanies high tension.

However, you may not realize that your body is also affected, and you may be grinding your teeth in your sleep. This can lead to complete lockjaw, pain, and additional stress that you didn’t ask for.

Teeth grinding, also called bruxism, is startlingly common. One 2019 study of a Dutch population found that 5 percent of the people in the study ground their teeth while awake and 16.5 percent did so while snoozing.Wetselaar P, et al. (2019). The prevalence of awake bruxism and sleep bruxism in the Dutch adult population. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849828/

Researchers from Poland put the amount of people with sleep bruxism closer to 13 percent in the same year.Smardz J, et al. (2019). Correlation between sleep bruxism, stress, and depression: A polysomnographic study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6781101/

Some people grind their teeth during the day, but many do so in their sleep, often without even realizing it’s happening. We know the dream with the sentient sausages can be alarming, but there’s no single reason sleep bruxism happens.

There are different medical explanations as to its causes. However, most experts trace the majority of their clients’ cases back to either a bite imbalance or stress.

“Grinding one’s teeth is a way your body is coping with stress,” says Dr. Kruti Patel, DMD. “It releases an endorphin in your brain, which makes your brain feel good, and you continue to grind.”

“The jaw muscles want to be in a comfortable orientation,” says Benjamin Lawlor, DDS, of Maine Cosmetic Dentistry. “When this doesn’t happen, the muscles will uneasily shift back and forth when trying to find that comfortable position.”

As you can imagine, this leads to grinding and pain — and no one’s about that. So, if your dentist can get to the root of the problem by helping you adjust your bite, it’s could be worthwhile.

There are other potential solutions, if you keep an open mind. When it comes to bruxism that’s a result of stress, there are all kinds of remedies that doctors suggest that meet with varying levels of success.

Solid research backs some of these methods, while others are just at the start of their exploratory journey, although there’s no logical reason to believe they can work. Still, stranger things have happened — but we go on science, here, and not pipe dreams (especially those about sentient sausages).

Here are a handful of promising solutions for teeth grinding and some research about what works and what doesn’t.

1. Botox

Yep, really! While Botox won’t “cure” grinding, it can drastically reduce the symptoms for some patients. The effects of each treatment last for several months.Jadhao VA, et al. (2017). Efficacy of botulinum toxin in treating myofascial pain and occlusal force characteristics of masticatory muscles in bruxism. https://pubmed.ncbi.nlm.nih.gov/29072209/

It’s not a fit for everyone and can be a little divisive among experts. However, some people who live with bruxism have described Botox as life-changing.

The solution can paralyze or slow the activity of some muscles around your jaw. This can mean you deal with way less pain from clenching or grinding.

“For nocturnal teeth grinding, I inject a small amount of Botox into the masseter muscle. This is the big, round muscle under the ears that sits at the angle of the jaw. You can feel it when you bite down with your mouth closed,” explains Charles Crutchfield, MD, clinical professor of dermatology and medical director at Crutchfield Dermatology.

“The injection does not work for everyone,” he says. “But in my experience, it can provide significant relief to about three-quarters of those who suffer from teeth grinding during sleep and wake up with sore jaws and headaches.”

Plenty of professionals are recommending Botox these days, but others aren’t convinced. One dentist even laughed when asked if he’d ever recommend the treatment.

Early research isn’t very substantial on either side of the debate just yet, but it’s worth noting that two small studies pointed to Botox as a useful option.Jadhao VA, et al. (2017). Efficacy of botulinum toxin in treating myofascial pain and occlusal force characteristics of masticatory muscles in bruxism. https://pubmed.ncbi.nlm.nih.gov/29072209/ One noting that Botox “effectively and safely improved sleep bruxism.”Ondo WG, et al. (2018). Onabotulinum toxin-A injections for sleep bruxism: A double-blind, placebo-controlled study. https://pubmed.ncbi.nlm.nih.gov/29343468/

On the other hand, another small study found that Botox led to bone density loss in rabbits.Navarette AL, et al. (2013). Botulinum neurotoxin type A in the masseter muscle: Effects on incisor eruption in rabbits. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562668/

(Reminder: You are not a rabbit, and non-human studies should be taken with a small bucket of salt) (unless you are a rabbit, in which case, be our friend and also don’t get botox in your face).

All in all, just make sure that you seek consultation with a dentist or medical professional before trying botox.

2. Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is a form of short-term talk therapy that explores the thoughts behind your behaviors and feelings. It’s a type of therapy that is less about digging up your childhood and more about learning how your brain works to help you hold back on destructive thought patterns.

The process helps you build healthier habits and thought associations. Through doing so, you empower yourself to ditch negative patterns and behaviors in your life.

Initial research has hinted that CBT could help people calm their bruxism down, but a conclusive and clear connection between CBT and improved symptoms is necessary before we can throw this out as a bona fide solution.Trindade M, et al. (2015). Interdisciplinary treatment of bruxism with an occlusal splint and cognitive behavioral therapy. https://pubmed.ncbi.nlm.nih.gov/26325649/

If you’re feeling anxious, either generally or around specific triggers, this might well be worth trying. It can’t hurt.

“CBT may help treat the underlying anxiety that can cause bruxism, but a night guard definitely helps protect against the consequences,” says psychiatrist Sandip Buch, MD, CBT, founder of Skypiatrist.

This form of therapy can be a powerful weapon in your one-person crusade against feeling like sh*t and all the unwanted habits that can accompany this. So as you can imagine, it has the potential to be a good fit for people with stress-fueled bruxism.

Mindfulness meditation can also help you counter stress in your life and often accompanies CBT — why not give it a try?

3. Hypnosis

Look into our eyes…

Case studies have shown that hypnotherapy can completely resolve bruxism.Dowd ET. (2013). Nocturnal bruxism and hypnotherapy: A case study. https://pubmed.ncbi.nlm.nih.gov/23427844/

Slightly wider studies (although much earlier and still only involving eight participants) found that suggestive hypnosis can help bring down the amount of grinding by a significant margin and reduce the pain, too.Clarke JH, et al. (1991). Suggestive hypnotherapy for nocturnal bruxism: a pilot study. https://pubmed.ncbi.nlm.nih.gov/2024617/

Like other treatments, hypnosis might not work for everyone. But if you’re down to get sleepy (very sleepy) it could warrant a shot.

You can undergo hypnosis in person. However, if you’re looking for something a bit more low-key, you can download or buy hypnosis recordings created especially for bruxism.

We took a look at the science behind hypnosis and other alternative treatments.

4. Tapping

Tapping, also known as the Emotional Freedom Technique (EFT), is a therapeutic method of “psychological acupressure” that takes its cue from certain elements of acupuncture.

Instead of acupuncture needles, however, the treatment involves tapping with your fingers on designated pressure points on your body. Many people with bruxism have said it works wonders, but there’s not much research on the topic.

Research has found, however, that EFT can provide benefits for helping people manage PTSD.Sebastian B, et al. The effectiveness of emotional freedom techniques in the treatment of posttraumatic stress disorder: A meta-analysis. https://www.sciencedirect.com/science/article/abs/pii/S1550830716301604

There’s a possibility that it could also help with stress-related habits.

5. General de-stressing

We recommend this anyway, however much you grind your teeth.

As stress can be a key driver of teeth grinding, both physicians and more holistic practitioners agree that relaxing at night can help a great deal.Demjaha G, et al. (2019). Bruxism unconscious oral habit in everyday life. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447347/

“Find ways to relax and de-stress before bed, such as getting a massage, using a warm compress, and avoiding alcohol and caffeine,” says certified personal trainer Caleb Backe of Maple Holistics.

Yoga, stretching, meditation, or any kind of self-care routine you’d usually use to de-stress is a good bet.

Since teeth grinding is so common, it’s easy to assume that it’s nothing more than a minor annoyance.

Sure, there are those wild cases of people forced into dentures at 50, you might tell yourself, but for most people, it doesn’t really matter, right?

Well, kind of. The extreme cases are rare, but according to the experts, grinding on a regular basis is definitely not ideal. Whenever you notice wear and tear on your teeth, get them checked out by your dentist. They can monitor the amount of wear and advise when it needs to be addressed.

Extreme cases are called “extreme” for a reason, in that they don’t happen to everyone. If you only grind your teeth occasionally, you may never develop any dental issues from it (although it can make your face feel a little uncomfortable and tense, which is never ideal).

Even regular grinders aren’t necessarily doomed to early dentures, but consistent grinding over time can lead to pretty intense dental wear and tear.

You could experience tooth cracking, bone loss around the roots of your teeth, and sometimes even loss of the teeth themselves. “Excessive force on your teeth can cause cracks in your teeth,” Patel says. “Depending on the crack, you may need anywhere from a filling to an extraction.”

You may also experience enamel loss. “Once enamel is lost, it is lost forever,” says Robert C. Rawdin, DDS, co-owner of Gallery 57 Dental in Manhattan. “It can only be restored through the restoration of the teeth.”

Restoration involves the use of methods like bonding, porcelain crowns, or veneers. It’s a lot of expense and effort to go to, so address bruxism through less intensive measures before it gets too bad.

Tooth grinding can also lead to pain in the joints around your jaw, as well as migraines that occur as a result of overexerting your jaw muscles. Ron Rosenthal, DDS, a retired dentist and dental educator, explains the migraine-bruxism connection by comparing the experience to a leg cramp — only way worse.

“The chewing muscles are the strongest in the body,” Rosenthal says. “They are far more powerful than the calf muscle in your leg. If you’re like most of us, you’ve had a leg cramp at some time or other. It felt kind of like someone stabbed you in the calf muscle with an ice pick, right?”

Right.

“Well, remember, the calf muscle is nowhere near as powerful as the chewing muscles,” Rosenthal continues. “Now, imagine that same kind of spasm in the chewing muscles on the side of your head.”

Oof. Is your jaw hurting yet?

When it comes to treatment, lots of dentists recommend custom-made night guards to wear when you sleep. These can buffer your teeth from the damage of the grinding.

You can also buy night guards off the rack at a store or online. but they haven’t been fitted to your individual bite, so you might not see the same results.

That said, there are some dentists who feel that the results of night guards aren’t worth the trouble. Also, if a bite problem triggers your bruxism rather than stress, they might instead recommend dental interventions that can correct an unbalanced bite.

Sometimes, it’s our bite. Sometimes, it’s our brains. Either way, bruxism can be a nuisance that takes away from your enjoyment of daily life. And who needs that?

Find ways to de-stress. If that doesn’t help, seek consultation with a dentist who can give you some advice as to whether your bite is to blame. Everyone’s bruxism is different and happens for different reasons, so you might have to try a few different solutions to see what fits.

If your jaws keep talking instead of grinding at night, we’ve got the solutions right here.