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Bruxism: Why We Clench and Grind Our Teeth
Can you imagine for a moment a desert tortoise, gorging on its favorite succulent plant? The sun is approaching its zenith and it is now crawling around on the hot sand, looking for some shade to nap and rest from the blistering heat of a summer’s day. Suddenly from behind a very large rock, a wily coyote vaults towards the tortoise. Its mouth is wide open, displaying its pearly white fangs. This wily coyote is hungry and wants to snap off a tail, a leg or even the tortoise’s head. What does this tortoise do?
Being a tortoise or any other creature on planet Earth, understand Nature has equipped us all with an arsenal of natural reflexes. These natural reflexes are the mental and physical “startle withdrawal reflexes.” As soon as the tortoise saw the wily coyote coming, these reflexes instantly recoiled the tortoise’s body. Without thinking, the tortoise contracted its exposed extremities back into the safe impenetrable space of its tortoise shell. After struggling with the shell for a while, this baffled wily coyote leaves the tortoise alone to seek easier prey. Seeing the coast is clear or really the desert is clear, the tortoise resume its daily tortoise activities. After surviving this stressful encounter with a predator, the tortoise goes on with the daily business of living.
Nature’s pleasuring experiences are the beautiful sights, sounds, smells, tastes and feelings of life, which the Earth offers any natural thinking intelligent wild being. For a tortoise in the desert, living wild is pretty fantastic, until the next brief encounter with stress, a hostile predator, which will again trigger the autonomic sympathetic nervous system of fright reflexes for freeze, fight or flight responses. Living with Nature’s protective reflexes, it is truly amazing these experiences we all have, existing on this garden planet of Eden.
Every animal on Earth is biologically genetically unique in appearance, including us Homo sapiens. We all have our own look and set of fingerprints, yet we are all very similar in that our minds think and our bodies function. We all have similarities in living and surviving experiences. A human smile is universal all over this planet and everybody’s blood is red. These are only two resemblances among the many other facts, depicting Nature’s similarities among plant and animal beings. So in my sixty plus years of being alive in this modern world, I have come to the conclusion that we are all distressed turtles. We are all walking around under the tension umbrella of constant threat. We are all turtles being burdened and weighted down, affected by the strains of this modern way of existing. Living is with foul air, unclean water, unsatisfying non-nourishing food, inactive, not being rested and afraid of the sun with one negative emotion arising after another. We are all contracted, mentally and physically, surviving in shells with iron barred windows, even afraid to look out. Wily coyote doesn’t ever leave us alone. The coast is never clear because stress is always there. The mental and physical strains are inside and outside our existence. They are here 24 hours a day, when awake or while sleeping.
For most of us, stress has evolved from a chance encounter with a predator to a life of constant surviving in ignorance. This ignorance is a bliss mentality for some, falling into the limbo existence of another day and another dollar. For a few others though, living is like a window that gets dirty. It just needs to be cleaned up regularly in order to experience the warming rays of the sun that will shine through the clean window. This article is for those turtles that are basking in the sun, as well as for those turtles that are constantly dueling with wily coyote. It is about the reflexes of living and how they can affect parts of our body, like our tooth functions. It is about the reactions and the responses to everyday life with its many different kinds of emotional states and how our choices in dealing with them can affect our mind/body health and well-being.
Here is a typical story from one of my patients. The theme of this article is stress and stress is the same for all of us. Her name is not Nadia, but let’s call her that. She calls me on the phone and tells me she has pain in her teeth. It’s a non-specific pain, generalized in one area of her mouth. Cold and crunchy foods cause her discomfort. Swallowing is not a problem. There is no swelling anywhere in the area. Sweet and warm foods are OK and the pain came up suddenly overnight. After hearing her symptoms, I asked her, “How has your stress levels been lately?” The answers I usually get in these situations from persons vary, usually unexplainable, or they will say, their stress is like everyone else. Nadia’s answer was in the neighborhood of overwhelming. On the phone I suggested that grinding and clenching of the teeth while sleeping, which are reactions to our daily stresses have probably caused the pain. We made an appointment for a consultation.
At that appointment I informed Nadia that our teeth are not supposed to touch, except lightly during swallowing. When speaking, the teeth might come close together, and may even slightly touch, but that would not cause any pain. Teeth would also not touch when chewing Nature’s juicy and fibrous foods, so that could not be the cause of the pain. Even eating cooked and over processed soft foods would not cause any discomfort because the muscles of chewing are designed to bring the jaws with their teeth close together, but not bang together with any traumatizing results. And when we are relaxed, the muscles naturally cause the lower jaw to hang loose and down. The tongue relaxes behind our lower teeth. The tongue’s tip lightly touches the roof of our mouth with our upper and lower lips kissing softly together. All this relaxation of our tissues will not cause any physical pain. By the process of eliminating possibilities, including an x-ray showing nothing obvious in the area to cause pain, I suggested to Nadia that her mind was the cause of her pain and her body, specifically the pain in her teeth and related head and neck tissues were the effects. These physical effects generally include excessive tooth wear, cracked teeth, broken teeth, bone loss around teeth, gum recession, loose teeth, muscle pains, head aches, neck aches, TMJ joint pain and a general oral cavity weakness to microorganisms. Having a chronically stressed out mind will cause an acidic pH for the salivary fluid and that will not support bodily oral health.
I explained to Nadia that she was not crazy and asked to her to listen and to not take this the wrong way. I have seen this behavior in myself and in so many, if not most of my patients over the years. I explained to Nadia that the pain was caused by her mind reacting to a stress. This stress was unique to her and her alone. The body when mentally stressed automatically contracts muscles, just like a turtle will to protect itself from a wily coyote. This contraction reaction can affect the speaking/chewing system as well as the entire body. With severe stress to process in a life threatening moment, the body can contract so hard that it will retake the fetal position. With the hands closed fist and the head and neck muscles all contracted, we will clamp down on our jaws and teeth, clenching and grinding with severe force. The result is physical trauma to our tissues with pain that we discover when we awake. This reactive and destructive behavioral habit can last for long periods of time while sleeping. Upon waking, many parts of the body may ache. Our tissues do not get their rest and instead of feeling recharged for another day of activities, we feel ignoble with pain and not rested.
Clenching and grinding habits occur to children and to adults. They may go on for years and even a lifetime. The damage done by a severe grinding habit is easy to spot in anyone because all the teeth will appear flat in one plane. See photo of human skull. When a person grinds the flat edges of their upper teeth against the flat edges of their lower teeth, they will appear to mesh together just like the two cut halves of an orange. Moving the cut halves of the orange side-to-side and then back to the original position, the orange halves fit perfectly together. The upper and lower teeth in a severe grinder will mimic this same precision of fitting together when moving them side-to-side. Our teeth were meant to last a lifetime and this nonfunctional destructive clenching and grinding habit from an out of control stressed out mind does not support our teeth and their preservation. When any animal looses its teeth in the wild, it will die. Loosing our teeth is not a design of Nature. You can see in museums 65 million year old dinosaurs and other animal skeletons, past and present, with all their teeth. They had stress too but probably they did not have the kind and the amount of stress we all experience today.
I recommended to Nadia a protective mouth guard to wear over her teeth. It can be worn on upper or lower teeth, while sleeping during the night or during the day. The mouth guard is designed to turn off the closing muscles, contracting when the teeth grind together, during the times we sleep with mental, emotional and physical stress. Dentists who know technically call this kind of therapeutic mouth guard design an “anterior discluding splint.” For persons who just clench, the mouth guard will distribute the physical forces of the contracting muscles evenly throughout the mouth, head, neck and shoulders. Some of my patients have to or choose to wear their mouth guards even when awake. With time the mouth guard will communicate to me, as well as the patient, the levels of stress a person is experiencing while sleeping by making teeth marks onto the surfaces of the guard. The mouth guard can only help by protecting Nadia’s tissues. The mouth guard will not stop Nadia from clenching and grinding. That she will have to do herself.
I suggested to Nadia that she keep a daily written journal of when her teeth touch. Not from talking, swallowing or from eating, only when she notices her upper and lower teeth together at any other time. The journal will help her keep track of those thoughts that occur during and just prior to noticing her upper and lower teeth touching together. It is important to write down the name of anyone she is with as well as any noticeable objects in the environment in those same moments. With time, patterns of stress reactions and there surrounding circumstances will appear. Once these patterns are recognized, she will be equipped to protect herself in the future by controlling the reactive mental nature of the habit and consciously keeping her teeth apart, thereby protecting them and the surrounding tissues. Instead of “reacting” to an unknown stress, she will now “respond” to a known stress appropriately. The appropriate response at the moment of experiencing the stress is a disciplined command to your mind from your heart to stop that behavior, whatever it is and relax. Being responsible is a life sentence while we live here on Earth. New constructive habits are just as hard to create as it is in the elimination of old destructive ones. We now have the intention to become more aware, to stop a destructive behavior and practice, observing our teeth when they touch. If you don’t practice, you cannot change any unhealthy mind/body habit and improve your well-being. It is a new practice for preserving your tissues and their health.
Because good psychotherapy is about behavioral changes, I recommend it. Another avenue I have used with my patients are the Bach Flower Remedies. Found in most health food stores, Bach Flower Remedies help us deal with the negative emotional states of life. They can help bring up old thought patterns or thought programs that are stressful to us so that they can be reexamined. These thought programs are buried deep down in the hard drives of our minds. These programs were learned and these programs cause us to react to present situations in a similar way that we acted to them the first time they happened. We need to know what was put there in our minds, through our experiences when we were infants, children, teenagers and adults up till this present moment. Lust, envy, greed, gluttony, sloth, pride, anger and vanity are all sinister activities that were all learned. We can delete these unbalancing stresses through our awareness of them because we now recognize them and their unhealthy effects. They do not serve us anymore, if they ever did. Changing our behavior is the goal and it will be an unlearning process. The first step is the awareness of the mind/body condition and the direction will be looking inward to change.
This is nothing new to our history and the process of Self-inquiry. It is in all the classical spiritual literature. Buddha said, “Be a lamp to yourself. Be your own confidence. Hold the truth within yourself as the only truth.” Muhammad said, “Whoever knows himself knows God.” In the Old Testament, Psalms 46:10, God said, “Be still and know that I am God.” In the New Testament, Jesus in Luke 17:21 said, “The kingdom of God is within you.” The Hindu prayer to their God “Ganesa” is, “I bow down to the God within, which is Who I Am.” My favorite line from spiritual literature comes from Stephen Mitchell and his version of Lao Tsu and his book the “Tao Te Ching” which says, “Stop thinking and end your problems.” When one stops thinking, only one’s heart remains to communicate to us by listening through the software of the mind. You can stop thinking by practicing keeping the source of your mind in its home, which is your heart. When the mind is home it is surrounded by love and there isn’t much stress in that environment. When the mind is out of its home, its thoughts are from our reactive ego, thinking of the past or imagining the future. When your mind is home you experience your heart moment to moment through your senses. It just takes a lot of committed practice to keep your mind at home. Once you realize that you are not your past and future mind thoughts and its physical conditioning. Life becomes very different, experiencing the present moments with your heart through your senses. You and everyone around you will benefit from this enlightening change.
Unfortunately, Nadia could not afford my services for a mouth guard at that moment and I didn’t hear from her for some time. She again called and told me that another dentist had recommended a root canal. I heard her story again and gave her the same opinion. I thought her clenching and grinding of her teeth while sleeping caused her pain. Several weeks went by and she called again. She told me she had a root canal, the pain didn’t go away and last night the tooth broke in half. I asked Nadia if there was anything else she could tell me about the tooth. She said that some time ago, she had a dream about breaking a tooth. When I saw her, I explained to her that in order to save the tooth, she would need to see a gum specialist, a periodontist. The fractured root canal tooth had broken below the gum line and the root, bone and gum relationships would need to be corrected.
We made an appointment with the periodontist. The next day the periodontist called me to change the appointment. I called Nadia and during the conversation she told me that last night she had a dream of losing the tooth. I asked for more details about the dream and my only question to her was, “How is your relationship with your father?” To shorten a long story, Nadia told me that several weeks ago she mailed a letter to her father in Germany. The theme of this letter was for him to find a high bridge and to do her a big favor, jump off it. It was after this letter that she saw the dentist who did the root canal and now the tooth was broken. I shared with Nadia some of my own stuff with my parents and suggested that she treat her father like a new acquaintance, with no past history. Hard to do but it would be better than bringing up her life story with him all the time.
For many of us, our parents were never friends. Also, they will never be able to live up to our expectations of what we think they should have been like. I suggested to Nadia that the broken tooth and the related symptoms were the result of breaking off the relationship with her father. And last night’s dream was about complete loss. This mental and emotional stress caused the body to contract just like the coyote stressed tortoise in the desert, and since Nadia’s stress didn’t go away, it resulted in chronic trauma with pain to her tissues. The body’s experience with clenching and grinding of her teeth was the direct result of the decision her mind made about her father. This decision goes against what her heart knows and the love that it expresses if we listen. In a short time working with Nadia, my opinion of her is that she has been and is a sweet heart. She composed another letter and sent it to her father in Germany. This letter’s origin and theme was more of that sweet heart. She informed her father that she loved her performing artist lifestyle in San Francisco with her struggling jazz guitarist husband and all his money and threats of being disowned could not change that. It would be healthier for him to surrender to these facts and accept that his 30-year-old daughter was all grown up now and not his little girl anymore. The bottom line was that she still and will always respect and hopefully love him.
I remember when I was twelve years of age and my mother started allowing me to drive the car. I got very good at driving all around town. I was doing errands for her like shopping and other things. Driving was something I enjoyed very much at the time. At seventeen, after a fantastic test-drive in the Hollywood hills, I found and bought a four-year-old Porsche. But before I could drive the car home, I had to get insurance. What a shock? Disappointed about the cost of the insurance for me as a teenager in Los Angeles. I asked myself, “Why the hell did I want to buy this damn car in the first place?” At that moment, I recalled what a close friend once said to me a few years earlier. He said, “A Porsche is the best car on the road!” It was that thought given to me by a friend that turned into a mental program, which made me think to buy this sports car years later.
Thoughts are very powerful and we need to protect ourselves from those unwanted stressful past ones that are buried deep down in the hard drives of our minds. We also need to be more selective of the many thoughts that are always coming at us in every moment from everyplace we turn. For Nadia, I can’t change her or her habits from thoughts and programs learned from childhood until now. I can only point in the direction from experience what one can do to decrease mental reactivity and increase awareness of the mental and physical stresses of our life. The investigative awareness will expose the subconscious doings of our minds so that change can take place from within.
Observing animals in the wild, one will see that life is about satisfying one’s needs to live. There are predators around but it is not a constant threat. In fact predators miss their prey most of the time. Predators and their prey, like us, have their freeze, fight or flight mind/body reflexes to respond to life. When we react with our minds to a stress, the autonomic sympathetic nervous system turns on and our blood pressure and related physiology goes up. When we respond with our hearts, which is what happens after any kind of treat is over, the autonomic parasympathetic nervous system turns on and our blood pressure and related physiology goes down. We come back to life again, living to satisfy our basic needs until the next treat happens. We may not have any predator after us but everything we do was learned and it can be unlearned if we find out it is stressful to us. So, if you want to have a healthy mind and a healthy body, do what the words are saying, heal-thy mind and heal-thy body. It is your choice to be healthy.
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