Dr David Stephenson of Albany Creek Brisbane says
“The truth is that everyone swallows during their sleep, and when they do, their teeth go together for a short period of time. Everyone clenches to some degree ( even people without teeth who have dentures and wear them when asleep ). Most people just have static clenching. Bruxing is clenching in motion. The force of the clenching and the extent and duration of the muscle activity is what varies. Bruxers are often completely unaware of the unnerving tooth gritting noise which is enough to set a bedpartner on edge.
Some people clench/brux excessively and it can cause health problems, not just dental problems.
It is a little more complex than that. It relies on your brain’s capacity to process and deal with stress adequately enough that it can get to sleep and rest fully, heal and recover from the day. The upper brain needs to shut down and go to sleep and let the autonomic nervous system (lower brain ) also go into autopilot mode. Stress will prevent lower brain going into autopilot mode. Instead it remains in sympathetic mode. In other words, it is primed or charged and isnt as quiet during sleep.
Stress might be from life events, emotional issues, worry , anxiety, chronic pain, hunger, cold, illness, or behaviours like too much food, alcohol and stimulants. or neural irritation from dietary proteins like gluten.
But stress doesnt have to be negative. If you have a lot of physical or mental stimulation like cardiovascular exercise or thinking, study, audiovisual stimulation just before bed, the lower brain is not as quiet during sleep.
The lower brain gives input to the upper brain in such a way that you are aroused from deep sleep more often. Aroused doesnt mean awake but rather a lighter level of sleep. If someone is talking to you, you wont register that they are doing so.You stay asleep but your body isnt in deep restful sleep.
When your body is stressed, you will be in repetitive periods of arousal. Your heart rate increases, your brain activity increases and muscle activity is stimulated. Bruxism occurs during these periods of arousal, including during REM or dreaming sleep. If the bruxing causes damage to the jawjoint or overworks the muscles, the body registers this as stress.
But if you have been pushed too much out of autopilot mode by stress, maybe drinking too much caffeine, smoking, drinking too much wine, or you suffer chronic pain, or by too much physical stimulation from exercise, or intense audiovisual stimulation, you will be in the aroused state for longer periods of time.
You will brux and clench much more than normal, and this can damage your jaw joints pinching the cartilages, tearing the little ligaments and causing clicking popping and locking. Compression in the jaw joint also damages the acoustic properties of the inner ear, affects balance and hearing.
Some people say they cannot be bruxing or clenching because they go to sleep with their teeth apart and mouth open. This is all very well but once you fall asleep, your higher brain shuts down and your autonomic nervous system takes over and your muscle activity is out of your control. Similarly, people say they can’t be bruxing and clenching because their partner says they snore. Every time you swallow, your jaw muscles contract and your teeth go together for anything from a second to a couple of minutes before relaxing again.
Dr David Stephenson is a member of the American Academy of Craniofacial Pain and has a special interets in TMJ ( jaw joint ) dysfunction and sleep disordered breathing. Dr Stephenson has studied under Dr Steven Olmos DDS and attended AACP further education in the USA.
To see how we can help, please call Albany Dental and Sleep Health Centre on 07 32645698
for further information about sleep studies visit www.homesleep.com.au
for further information about craniofacial pain visit www.aacfp.com
for further information about TMJ dysfunction visit www.tmjtherapycentre.com
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