A WOMAN called me wanting to know if I could do anything about her son, who wakes up the household frequently at night with the sound of his teeth grinding. She wanted to know about this abnormal/al habit called bruxism.
The grinding or clenching of the teeth usually occurs unconsciously and spontaneously and may be repetitive at varying levels. It is practised almost universally, usually during sleep.

Bruxism has been shown to be linked to psychological stress as a necessary component. While mental tension provides the spark for the initiation of this habit and the fuel for its continuation, the original energy source comes from the individual’s genetically determined drives and needs. Any unsatisfied need or interference with one’s satisfaction, which may be experienced as frustration, anger, anxiety, or fear, may result in tension and the possibility of teeth grinding.

Other causes, such as epilepsy and high fillings, have been implicated, but their relation to psychological tension should be obvious. So, while mental stress may manifest itself anywhere in the body, the structures in and around the mouth appear to be the focus of this tension. The reason the mouth is selected for this habit can best be appreciated if one reflects on the infant’s activities.
Since the mouth is the means of receiving food and the earliest method of exploring the environment, it is intimately tied to emotions such as satisfaction, frustration, anger and anxiety. These early associations are significant and seem to last a lifetime and are why the mature individual reverts to the oral cavity during periods of stress by smoking, eating, chewing gum and grinding teeth.

The chewing muscles must receive psychological tension for discharge for bruxism to occur. The first reaction to anxiety is increased tonicity (contraction) in preparation for either fight or flight. Other stress-inducers, such as pain or the physical exertion of lifting heavy objects, may also induce muscular tension. The net effect of this uptightness and movement is a vicious circle. Suppressing our emotions during the day for socio-cultural reasons may cause clenching or grinding of the teeth, increasing the tension.
The habit may be helpful to the extent that grinding movements during sleep reduces the tension. Unfortunately, this type of discharge is highly inefficient, and the tension may accumulate. Incidentally, bruxism may be practised even by persons without teeth.

What are the effects of teeth grinding? Most symptoms of the lower jaw joints are the result of the muscle spasm obtained through bruxism. The areas in front of the ears become painful and tender to the touch. In addition to localised discomfort, pain may be referred to neighbouring muscles in the scalp, neck, shoulder and back. The mouth may not be able to open fully due to the shortening of the muscles due to the persistent contraction of the fatigued muscles. This leads to tissue breakdown and, with it, an inflammatory response.
Grooves found on the area of the teeth next to the gum line are caused by the unconscious clenching of the teeth during episodes of anxiety and social stress. Blunting and wearing down (attrition) of the enamel and dentin result in short teeth, periodontal abscess and eventual extraction.