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What Teeth Grinding Reveals About Your Psyche

The underlying causes behind this nighttime menace

Credit: Jamie Carroll/Getty Images

AAccording to the American Sleep Association, about 10% of people suffer from teeth grinding, also known as bruxism, and researchers believe the number of patients suffering from it has increased in recent years. While there are a number of medical and lifestyle causes for bruxism, teeth grinding can also be a window into your psyche — and a sign that you may need to reduce stress.

There are several risk factors for unwanted jaw movement: Medications (like some antidepressants, antipsychotics, and amphetamines), along with tobacco, caffeine, alcohol, or recreational drug use can cause people to grind their teeth at night. Age also plays a role; grinding teeth is fairly common among young children and, in most cases, it dissipates by adulthood.

But stress is another important culprit behind many cases of teeth grinding. For adults, scientific literature shows a significant relationship between stress levels and bruxism. For example, people who grind their teeth generally report more anxiety and depression symptoms than those who don’t grind, and teeth grinders (or “bruxers”), also tend to be more stressed and suffer from clinical depression and anxiety disorders. One 2019 study showed people who suffer from bruxism have higher levels of stress hormones in their bodies, and recent research has found that before a person enters a grinding episode, their brain activity and heart rate may rise, implying that the nervous system plays a role in bruxism.

That the nervous system has a role in teeth grinding means that teeth grinding isn’t always purely a physical issue, but can also be a psychological one. The body and mind are deeply intertwined. “A lot of people manifest mental health symptoms in a physical way and don’t connect the two,” says Vaile Wright, PhD, Director, Research and Special Projects at the American Psychological Association. “Often, people will have headaches or stomach problems, and sometimes these things have a mental health cause instead of a physical cause.”

Why is it that stress so profoundly impacts the body? Matthew Cooper, PhD, professor of psychology at the University of Tennessee-Knoxville, says that when a person perceives a threat in their environment, the body can respond defensively.

“One thing that stress will do is increase adrenaline, which mobilizes energy in the body and can manifest in teeth grinding when you’re not moving your body.”

“All stressors set off a chain of reactions that lead to an increase of stress hormones like cortisol, which affects the brain by changing neural activity to mobilize responses to the stressor,” he says. In some cases, stress-related chemicals might trigger the fight-or-flight response in the body, which causes physical responses like sweaty palms, fast heartbeat, and even a clenched jaw at night.

When the stress hormones released in the brain cause anxious thoughts, the stress hormones snowball further, leading to even more physical manifestations. “Stress can also turn into anxiety and worry, which continues to release cortisol along with activating other neurotransmitters like serotonin and dopamine, which can affect behavior.”

WWhen it comes to the physiological mechanism at work behind nighttime teeth grinding, Cooper says excess energy in the body due to chronic stress could be one culprit. “One thing that stress will do is increase adrenaline, which mobilizes energy in the body and can manifest in teeth grinding when you’re not moving your body,” he says.

Stress can also disrupt the chemicals that regulate sleep, which Cooper says can lead to sleep-related disorders like insomnia and bruxism. “Oftentimes, you can have sleep abnormalities with chronic stress, and some of those same neurochemicals like serotonin and dopamine that disrupt sleep can also increase teeth grinding.”

While stressful life events are a major contributor to teeth-grinding, some personalities might be more prone to it than others. People who are more susceptible to stressful emotions like anxiety, anger, and frustration — and even highly determined people — may unconsciously clench, gnash, or grind their teeth at night.

People who consider themselves “neurotic” also report grinding more, according to research. For example, in one 2010 study, participants who self-reported neurotic tendencies (being more prone to feeling negative emotions and vulnerable to stress, but not necessarily with a clinical diagnosis) were more likely to report grinding. But, interestingly, their dental exams didn’t always reveal that was true.

Angelina Sutin, PhD, associate professor of psychology at the Florida State University College of Medicine and author of that 2010 study, says one possible explanation is that neurotic people, who tend to be more negative, might have a reporting bias in that they see bruxism as a behavior of stressed-out or anxious people. “People who are more neurotic think lots of bad things always happen to them, to the extent they perceive bruxism is a bad thing to do, they might think, ‘Oh yes, I do that.’”

Whether or not the more neurotic individuals were actually persistent grinders, Sutin says her finding is consistent with the broader literature that people who are experiencing acute stress are more likely to grind their teeth at night. “My research shows this greater tendency to experience anxiety, stress, and negative emotions is associated with grinding teeth,” she says.

WWhile stress and grinding seem to go hand in hand, it’s not exactly a healthy or sustainable stress response; in fact, bruxism can lead to a number of uncomfortable symptoms, says Mariela Padilla, DDS, MEd, associate professor of clinical dentistry at the University of Southern California Herman Ostrow School of Dentistry.

Since grinding teeth increases the force in the muscles we use to chew, Padilla says it can produce facial pain, tension-type headaches, earaches, and even neck pain. Grinding one’s teeth can also increase loading on the temporomandibular joint of the jaw (TMJ), producing problems with mouth opening and pain while chewing.

There’s also the issue of tooth damage, according to Padilla. The movement and friction on teeth’s surfaces can damage tooth enamel, which protects the teeth. Grinding can also cause teeth to break or sustain other, more minor damage. “The damage the teeth experience is mainly on the edges or the borders, so they look smaller with an irregular shape,” she says. For addressing dental-related issues like misalignment of the jaw or broken teeth, a dentist can help repair the teeth or provide a dental guard to redistribute the forces produced by grinding. “The best guards are custom made with a resistant material that allows posterior adjustments,” Padilla says.

Another surprising consequence: When you grind your teeth, the body can interpret it as chewing and begin a series of events for digestion, such as releasing gastric acids. Since there’s no food involved in tooth grinding, Padilla says triggering acid can potentially lead to ulcers, which could be one reason why individuals experiencing chronic stress also have digestive concerns.

TThere are a number of interventions for bruxism. Scientific literature confirms that a holistic approach that deals with both physical and psychological causes is often necessary. “Teeth grinding is a multifactorial condition, and there is not a magic wand to get rid of it,” Padilla says. “First, it’s imperative to discover the cause, or at least, the contributing factors.”

The simplest course of action for preventing nighttime teeth grinding? Reduce potentially aggravating factors like alcohol, caffeine, and nicotine intake, especially in the few hours before bedtime, and instead try stress-relieving activities. Cooper recommends trying activities that engage the frontal cortex like mindfulness, meditation, positive mental imagery, yoga, and even talk therapy, which have been shown to turn off the stress response in the body. Cooper also recommends physical exercise. Not only does moving the body off-load adrenaline that may be associated with nighttime grinding, but he says exercise can also change neurotransmitters in the brain that help us cope with stress.

General body awareness is a good place to start, Wright says. “The more aware we can become with our bodies and notice when something doesn’t feel right, the more we can ask ourselves, ‘What’s happening in my life right now? Am I taking good enough care of myself?’”

Writer-mom hybrid. Health & psychology stories in NYT, WaPo, Allure, Real Simple, & more.

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