The grind never stops: Bruxism and its connection to stress

Do your patients seem more stressed these days? Or maybe even you, yourself, are experiencing higher levels of stress and anxiety. A 2021 survey by the American Dental Association's Health Policy Institute revealed more than 70% of dentists noticed signs of teeth grinding and clenching in their patients, which is a 10% increase compared to the previous year.¹

Is stress-induced bruxism on the rise?

This condition, commonly known as teeth grinding, can be caused by a myriad of factors. Bruxism can be a direct result of sleep apnea or bad habits such as smoking and consuming high amounts of alcohol or caffeine. However, stress can also be a major catalyst; people may grind their teeth in response to anxiety, depression, and even emotional changes—which can all be linked to an overarching feeling of stress.²

Bruxism can be difficult to detect because it commonly manifests subconsciously during sleep; some people could be regular teeth grinders and not even know it.² Not only that, but a sleeping person is not aware or in control of the strength of their own bite, so they may employ up to 250 pounds of force when clenching and grinding their teeth.³

This can be especially dangerous because the act of grinding one's teeth intensifies alongside increased stress levels in the individual.² Prolonged or excessive distress or anxiety can also permanently alter our internal stress responses, which means bruxism may become a person's default response to dealing with high levels of stress.²

Stress levels on the rise

As a country, we're collectively more stressed out than we were three decades ago. In fact, 49% of US adults reported frequent feelings of stress—and compared to the numbers in 2003 (33%), that's an alarming spike.⁴

These increased stress levels are, in part, due to a lack of adequate sleep. Having enough sleep and leisure time is attributed to higher life satisfaction rates, especially among young adults. For example, members of Gen Z who reported having enough time to sleep and relax are twice as likely to say they are happy compared to those who do not get enough sleep or relaxation.⁴

Young women appear to be the most stressed ... and only 27% reported getting adequate sleep in 2023. Overall, 53% of women reported frequently experiencing stress, compared with 45% of men.⁴

Tying this back to bruxism, results from a 2020 study found that people grind their teeth as a response to psychological and psychosocial stress, which can manifest in situations in and outside the workplace. Being faced with social exclusion, evaluation, or judgement from others—as well as situations centered around goal achievement and social performance—are stress-inducing triggers that may lead to teeth grinding.²

What's more, the same study found that stressed participants showed a 97% higher chance of presenting bruxism than their healthy, stress-free counterparts.²

Consequences of bruxism

Over time, bruxism may lead to painful, eroded, or loose teeth. Dental crowns, fillings, and implants can also be damaged. Not only that, but teeth grinding can increase the risk of temporomandibular joint (TMJ) issues, causing the jaw to lock, make popping or clicking noises, difficulty chewing, and general jaw pain.³

As dental practitioners, it is crucial to be vigilant in recognizing the signs of bruxism in patients, especially given the rising stress levels contributing to this condition. Early detection and intervention can prevent long-term damage and improve patients' overall oral health and well-being.

References

1. Teeth grinding and jaw pain. MouthHealthy. https://www.mouthhealthy.org/all-topics-a-z/teeth-grinding/

2. Chemelo VDS, Né YGS, Frazão DR, de Souza-Rodrigues RD, Fagundes NCF, Magno MB, da Silva CMT, et al. Is there association between stress and bruxism? A systematic review and meta-analysis. Front Neurol. 2020;12(11):590779. doi:10.3389/fneur.2020.590779

3. Suni E, Truong K. Bruxism: teeth grinding at night. Sleep Foundation. Updated April 22, 2024. https://www.sleepfoundation.org/bruxism

4. Fioroni S, Foy D. Americans sleeping less, more stressed. Gallup News. April 15, 2024. https://news.gallup.com/poll/642704/americans-sleeping-less-stressed.aspx