Bruxism is considered to be associated with severe teeth clenching, nail biting and grinding habits resulting in the loss of hard irreparable outer enamel surface of teeth. Occlusal surfaces are most commonly affected. Bruxism is not a dental disorder in the true sense. It is s stress induced psychological disease having serious dental consequences. Bruxism and nail biting results in tooth surface wear and loss reducing the height of teeth and causing severe sensitivity, pain and discomfort. Patients of bruxism clench their teeth during sleep at night. These people encounter difficulty in eating, drinking and swallowing food stuff especially too hot or too cold beverages and spicy dishes.
Bruxism and nail biting occurs mainly due to stress, anxiety, tension and depression in daily life. Anxiety reduction exercises remain the mainstay of treatment in patients along with the provision of especially designed appliances to prevent further destruction of natural tooth structures. Mouth guards and night guards are provided for continuous or night time wear during sleep. Dietary modifications are carried out to prevent the occurrence of tooth erosion due to acidic drinks and beverages. Pharmacologic interventions for anxiety reduction are also useful.
Anxiety disorders affect approximately one in six adult Americans, according to the National Institute of Mental Health. The most well-known of these include panic disorder, post-traumatic stress disorder, obsessive-compulsive disorder, and social anxiety disorder. But what of brief bouts of anxiety caused by stressful social situations?
A new study by Tel Aviv University researchers, published recently in the Journal of Oral Rehabilitation, finds that anxiety experienced in social circumstances elevates the risk of bruxism – teeth grinding which causes tooth wear and fractures as well as jaw pain. According to the research, led by Dr. Ephraim Winocur of the Department of Oral Rehabilitation at TAU’s School of Dental Medicine and conducted by TAU doctoral student Roi Skopski in collaboration with researchers at Geha Mental Health Center in Petah Tikva, Israel, interaction with people is likely to trigger bruxism in the socially anxious.
“This is not a dental problem, but one with clear dental consequences,” said Dr. Winocur. “If we are aware, then we can bring it into consciousness. Psychiatrists can identify patients predisposed to bruxism and can try to help prevent it, and dental experts will immediately know what to treat.”
Although antidepressant drugs have previously been linked to bruxism, this study found no association. However, moderate-to-severe dental wear was found in 42.1% of the social phobia subjects and 28.6% of controls. The rate of jaw play was 32.5% in the phobia group and 12.1% in controls. Symptoms of awake bruxism were reported by 42.5% of social phobia patients and by 3% of controls.
“Interaction with people seems to be necessary to trigger bruxism in socially anxious people,” said Dr. Winocur. “By treating social anxiety, we will be able to treat bruxism as well.” Dr. Winocur is currently researching the effect of post-traumatic stress disorders on sleep and awake bruxism.