Do you grind your teeth? Then you’ve come to the right place.

Teeth grinding is by no means a new or rare phenomenon. It was mentioned in the Bible. But while people clenched their teeth in anger or fear in the Book of Job and the Gospel of Matthew, today the world grinds to relieve stress. Recently even more people were doing so than before: «There is clear evidence in the literature that the prevalence of bruxism increased in all age groups during the COVID-19 pandemic,» says Prof. Dr Jens Christoph Türp from the Clinic for Oral Health & Medicine at the University Center for Dental Medicine Basel (UZB). Several studies prove this too. Türp is a designated bruxism expert and works at the UZB on diseases of the masticatory muscles and temporomandibular joints.

But it wasn’t just academics who looked at the correlation between bruxism and stress during the pandemic: «Lay people were also interested in the topic, as this study reveals the demand for the term bruxism in Google searches at the time of the pandemic.»

Tooth grinding: a central nervous phenomenon

Bruxism is a term used by specialists to describe two phenomena: teeth grinding and jaw clenching, i.e. when you bite down hard on your side teeth. This is often noticeable in the morning after waking up, but also throughout the day.

Today, researchers agree that bruxism is a phenomenon of the central nervous system – and not, as was long assumed, an anatomical-morphological one. Plus: teeth grinding or clenching also isn’t triggered by the fact that your upper and lower teeth are in a certain contact with each other.

Bruxism is now no longer considered a disorder or dysfunction. Rather, it’s an expression of physiological and behavioural processes: grinding is, on the one hand, a stress valve. On the other hand – and you will have certainly observed this yourself – people clench their teeth when they carry heavy loads. Grinding during sleep conveniently causes open airways too.

By the way, a lot of people do this: Jens Christoph Türp reports on population studies according to which about 60 out of 100 adults are affected by bruxism. «For 8 out of 100 it’s even severe enough that therapy is advised.»

However, the high number of unreported cases is unknown. After all, bruxism isn’t an issue people are conscious of. «Nobody says, 'I’m stressed, so I’m going to clench and grind,'» Türp says. Therefore, COVID-19 hasn’t triggered a teeth-grinding «trend» nor have people discovered bruxism as a stress-relieving measure. They just do it. Most without knowing.

Bruxism: grinding and clenching derives from body tension

But what actually happens during the repetitive, unconscious activity? People who grind their teeth discharge tension from the body. The result: «Increased stress on masticatory muscles, jaw joints and teeth.» This isn’t tragic at first, because our body basically has «a high adaptability to increased force. But in unpredictable cases, this ability may eventually be exhausted and the patient may feel symptoms such as tension in the jaw muscles, or even pain in masticatory muscles, jaw joints or teeth.»

Pronounced bruxism can also be recognised visually by the increased masseter muscles (masseter muscle between the cheekbone and lower jaw) – and that, says the expert, «doesn’t always look visually attractive». Likewise, the expert eye can detect the abrasion of enamel or even the underlying dentine.

But even if bruxism hasn’t already developed into severe symptoms, it’s visible to the average person: «Look in a mirror, pull your lips apart and let your lower jaw hang down loosely,» Türp says. «Are your canines still pointed like they used to be – or do they look like the adjacent incisors, with a wide edge? Then this is probably the result of many years of teeth grinding. Tooth-guided mandibular movements have abraded the canine tips as well as the incisal edges of the lateral and central incisors.»

The all-clear: why bruxism isn’t all that bad

If you’re now standing in front of the mirror and anxiously checking your teeth, don’t worry: «Despite this ominous-sounding list, bruxism isn’t as bad as its reputation may seem. You can relieve the tension and pain from bruxism-related stress. Plus, until a few centuries ago, the changes to teeth described above – predominantly the abrasion of enamel and dentine – were much more pronounced than what we see today. By your mid-20s, your teeth were all levelled, and that was normal. But today the type of food and the way we prepare it has changed and no longer leads to an extreme loss of dental hard tissue, which was once the norm.

If the bruxism is so severe that it needs treatment, and is revealed at the latest by a dentist, or you suffer with tense jaws and jaw pain then specialists recommend SMS therapy. The first «S» means self-observation. «M» stands for muscle relaxation and «S» for splints.

Step 1: Self-observation

Expert Türp explains the process of self-observation. «I give patients red, round stickers for this. They should stick these in places they look at from time to time, be it at home or at work and leave them there for three days. It’s enough for them to unexpectedly glance at one of these coloured stickers every hour. In that moment, they should ask themselves: are my teeth touching each other now, or is my lower jaw hanging down in a relaxed manner, with no contact between the lower and upper teeth? The jaw is relaxed when your teeth don’t bite together in everyday life, apart from when you’re chewing obviously.»

Since most people with bruxism grind and clench much more often than they realise, the goal of therapy is to reduce the frequency and severity of excessive muscle activity. «To do this, for example, take a cherry pit or a piece of chewing gum during the day. This allows the tongue to unconsciously play with the pit or chewing gum, which you can still chew, of course. However, this only works if the teeth of the upper and lower jaw aren’t in contact. The required space is created by unconsciously lowering the lower jaw and thus increasing the distance between the rows of teeth. Your teeth have no contact and thus cannot clench or grind.»

Step 2: Muscle relaxation

In muscle relaxation, patients learn relaxation techniques, for example progressive muscle relaxation by Jacobson. Usually, a one-time visit to a clinical psychologist or psychotherapist is enough for this.

Step 3: Splints

Splints (or braces, night guards) are made in the dental laboratory as advised by your dental practice and are exclusively worn in the upper jaw during sleep. According to the expert, Türp, the best one is the Michigan splint. «The splint is designed to prevent tooth wear and is intended to distribute the forces acting on the jaw and tooth more evenly. Once the first two steps take effect, the force should be less intense and occur less frequently anyway. If made professionally, the splint is very comfortable. Patients generally don’t want to sleep without theirs any more.»

But as long as your teeth grinding and/or jaw clenching doesn’t cause pain or put undue strain on your masticatory system, you can carry on with this unconscious coping strategy.