Dentists are seeing a rise in teeth grinding and clenching, but do patients need a psychologist, dentist, or paleontologist to solve this common oral health issue?
By Genni Burkhart
Three years out from the onset of the pandemic, experts are discovering the reverberating effects of increased stress on our physical, mental, and emotional well-being.
Too much stress can manifest as increased tension in the muscles that control our mouths, jaws, and teeth. In fact, occlusal habits are historically seen as an outlet for human aggression and frustration. While there are a whole host of underlying causes – from lifestyle to medical – the psyche might be the key to effectively treating bruxism.
Now, sit up straight, unclench your jaw, and let your shoulders relax as we peer into the human psyche and ponder some of the more interesting culprits associated with bruxism.
A Gnawing Problem
According to the ADA Health Policy Institute data (HPI), dentists have seen an increased prevalence of stress-related oral health conditions since the onset of the COVID-19 pandemic. In 2021, the American Dental Association (ADA) polled dentists on this issue, and overall, the numbers are up with a
- 71% increase in teeth grinding and clenching.
- 63% rise in chipped and cracked teeth.
- 62% increase in TMD symptoms, including headaches and jaw pain.
Patients are presenting more often with symptoms of headaches, sore jaws, and cracked teeth due to grinding, clenching, and gnawing their teeth, usually while asleep. And while there isn't (yet) conclusive scientific data linking the COVID-19 pandemic directly to bruxism, dentists across the U.S. report increased oral health issues related to stress and depression.
Blame It on Evolution
Paleontologist Michael Archer spoke with Cosmos Magazine in October 2022 about the evolutionary connection between stress and bruxism. A Biological, Earth & Environmental Science professor at the University of South Wales, Archer explains that humans respond to stress as a threat. As a result, a lesser-known result, equally as instinctive as the fight-or-flight response, is called "thegosis" – aka tooth sharpening behavior.
While humans (thankfully) don't use their teeth as weapons anymore, society is responsible for teaching us to refrain from that behavior. Think of teeth as a predatory tool (bears, lions, dogs). Therefore, teeth are our "primary biological weapon," and according to this article, it makes sense that we'd grind (sharpen) them when faced with a perceived threat (stress). The more we stress, the more we "thegosis" our teeth. Perhaps even more fascinating, our brains can suppress this instinct while we're conscious, but the moment we fall into a deep sleep, all barriers are down, and the thegosis urge is free to wreak havoc on our face, head, neck, jaws, and teeth. Furthermore, if a situation is too intense, frightening, or confrontational, thegosis can occur while awake, kicking in much like the fight-or-flight response.
Psychological Factors
Stress has an undeniable effect on the body. More specifically, the hormones that stress releases cause anxious thoughts, cascading into increased physical manifestations, such as headaches, digestive issues, and bruxism.
Matthew Cooper, Ph.D., Professor of Psychology at the University of Tennessee-Knoxville, gave an interview at medium.com explaining that the fight-or-flight response is triggered by neural activity meant to mobilize a response to perceived harm. Much like the "thegosis" theory states, Dr. Cooper suggests this response can manifest in one form, as bruxism.
Dr. Cooper continues to explain that the physiological mechanism behind nighttime teeth gnashing is due to excess energy in the body. Chronic stress can lead to an increase in adrenaline, which readies the body for action. When the body is at rest, it can manifest as teeth grinding, clenching, and gnashing when asleep.
Stressors in life factor into teeth-grinding, but Dr. Cooper also suggests some personalities are possibly more prone to it than others. For example, those inclined to anger, anxiety, and frustration, and those highly determined, neurotic, and driven may be more susceptible to bruxism.
In Conclusion
Thousands of years of human evolution cannot hide that we are innately prone to stress, and our teeth are essentially tools, ready to fight or bite.
As dentists continue to treat various patients suffering the effects of bruxism, the treatment options range from splints, mouth guards, medication, physical therapy, dry needling, and even BOTOX®. However, the most effective treatment will deal with what's at the root of the problem – stress.
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Author: With over 13 years as a published journalist, editor, and writer Genni Burkhart's career has spanned politics, healthcare, law, business finance, technology, and news. She resides on the western shores of the idyllic Puget Sound where she works as the Editor in Chief for the Incisor at DOCS Education out of Seattle, WA.
