At the end of a long day most people can’t wait to get home, peel off their jeans and unwind, but some of us have one part of our body that we just can’t relax: our jaw. For the last couple of years I’ve found myself clenching my teeth constantly; most of the time I don’t even realise I’m doing it. I suffer from bruxism, a condition where the sufferer excessively grinds or clenches their teeth – and, unsurprisingly thanks to all 2020 has dealt us, it’s on the rise.
Many people will be familiar with teeth-grinding at night but for me the problem comes during the day as well. It starts with tightness around my jaw and by the evening my entire face aches as if I’ve just gone 10 rounds with Tyson Fury. My teeth tingle nonstop with sensitivity and my tongue often feels bruised from being constantly plastered to the roof of my mouth. After two years of clenching, my teeth are now visibly damaged and my jaw clicks whenever I move it.
Bruxism isn’t a rare condition. According to the Bruxism Association, up to 10% of the population suffer from it, the majority of whom are 25-44-year-olds. Even before COVID, it appeared to be on the rise, with dentists reporting an increase in cases. That’s not surprising. Teeth-grinding increased during the recession, so it isn’t hard to imagine what climate change, political unrest was doing to our mouths. Throw a global pandemic in the mix as well and it's a wonder you haven't clenched your jaw right off.
Unfortunately, despite the millions of sufferers, research in this area is lacking. "The topic of bruxism creates a lot of opinion and little good research," says Professor David Bartlett, head of the Centre for Oral, Clinical & Translational Sciences at King’s College London. This is especially true for awake bruxism, for which everything from alcohol and smoking to genetics has been blamed. However, the recurring thread in nearly all research is that anxiety and stress is a trigger. "Stress is acknowledged as a risk factor causing habits related to clenching and grinding teeth," says Professor Bartlett. Dentalcare.com cites stressful occurrences such as bereavement and overworking as triggers, while a 2001 study of the risk factors for sleep bruxism suggested that those who experience teeth-grinding are more likely to suffer from depression and anxiety disorders.
Jess Commons, lifestyle director at Refinery29, clenches her teeth during the day. "I don't know how to stop, I literally can't," she says. Jess thinks that her bruxism has been triggered by psychological causes. "I do have anxiety so I believe it's linked to that." I’m convinced that my bruxism is linked to anxiety, too, and I can always tell when I’ve had a particularly stressful day by how my teeth and face feel at night.
Anecdotally it seems that bruxism – particularly awake bruxism – affects women more than men. One study from 2010 claimed that awake bruxism is more common in females, while another, from 2006, suggested that teeth clenching is 22% more frequent in women. However Professor Bartlett said he didn’t know of any evidence to support this idea. It wouldn’t be difficult to draw the conclusion that women living in 2020 experience greater levels of stress than men and are therefore more susceptible to bruxism, but there just isn’t the scientific proof to support this. It’s also possible that women are simply more likely to report symptoms of bruxism to their dentist as we make dental appointments more regularly and even brush our teeth more than our male counterparts.
One thing is clear, though: Bruxism is wreaking havoc on our wellbeing. Bruxism can exert enormous pressure on the teeth, which in the long term may crack and become loose; sufferers may also experience a locked jaw and a misshapen face. The continued pressure of clenching might not be life-threatening but it does impact our quality of life. Damage to our teeth and jaw can make the simplest pleasures, like talking, eating and kissing, painful. That’s not to mention the mental impact of long-term pain, which has been shown to affect sleep, brain function and cardiovascular health. On a personal level, anxiety is a trigger for my bruxism but my bruxism is one more thing to be anxious about, creating a vicious cycle over which I have little control.
Amy has suffered with mouth and jaw tension for a couple of years. "It’s definitely contributed to headaches and neck pain," she says. Her dentist suggested a mouthguard for nighttime grinding but Amy also suffers from awake bruxism; and when it comes to treatment, dentists are as in the dark as we are. Six months into my bruxism I booked a dental appointment, hoping to get some practical advice. Instead the dentist declared that I had two options: "Buy a £200 mouthguard or just stop doing it." Since then I’ve tried yoga, cutting out caffeine and spraying everything within a 100-mile radius with lavender oil. I even tried a mouthguard at night but the thick plastic between my teeth just made me clench harder.
Google 'how to treat bruxism' and the results are a mixed bag. Plenty of websites suggest mindfulness and meditation – the solution to any and all problems in 2020 – but there’s no evidence to suggest either of these will help you overcome bruxism. Treating underlying stress with therapy or medication is a common suggestion but as the link between anxiety and bruxism remains unclear, this advice – however sensible – may not impact your teeth grinding.
Amy has had Botox injected into her masseter muscle, after researching the treatment online and finding an aesthetic practitioner to administer the injection. "You’re injected at four different points on each side, and the Botox takes about 4-5 weeks to kick in. From there, it lasts approximately 4-6 months," she says. Botox reduces the function of the muscle, making it harder to clench, but alongside the expense and the discomfort of regular injections, studies have shown that it can affect bone density. Just as astronauts lose bone density without the force of gravity, the jawbone could lose density without the force of the masseter muscle. Amy is happy to continue with the treatment, though. "Botox has proven a great longer term treatment for me with no ill effects."
Botox won’t be an option for a lot of sufferers so I asked Professor Damien Walmsley from the British Dental Association for advice. "If your teeth grinding is stress-related, it's important to try to relax and get a good night's sleep," he says. Unfortunately, as this bruxer knows, that's easier said than done.