Can anxiety disorder cause bruxism (Bruxism is a condition characterized by grinding or clenching of the teeth)?

From the Guidelines

Anxiety can indeed cause bruxism, as it triggers the body's stress response, leading to increased muscle tension in the jaw muscles and resulting in teeth grinding or clenching. This connection is supported by the understanding that anxiety activates the sympathetic nervous system, releasing stress hormones that heighten muscle activity, including in the jaw muscles 1. The management of bruxism, especially when associated with anxiety, involves a multifaceted approach that includes:

• Addressing the underlying anxiety through relaxation techniques, such as deep breathing or progressive muscle relaxation
• Using a custom-fitted night guard to protect teeth from grinding
• Considering anti-anxiety medications if recommended by a healthcare provider
• Engaging in physical therapy and stress management strategies
• Avoiding substances like caffeine and alcohol before bedtime, which can exacerbate bruxism symptoms It's crucial for individuals experiencing anxiety-induced bruxism to consult both a dentist and a mental health professional for a comprehensive treatment plan, as highlighted in recent guidelines for managing temporomandibular disorders 1. Key recommendations from these guidelines include pursuing conservative approaches first, such as reassurance, education, avoidance of aggravating activities, and the use of oral appliances in the presence of bruxism, before considering more invasive treatments. Given the complexity of bruxism and its association with anxiety, a tailored approach that considers the individual's specific needs and circumstances is essential for effective management and improvement of quality of life.

From the Research

Anxiety and Bruxism

• Anxiety is considered a risk factor for bruxism, as shown in studies 2, 3, 4, 5
• Bruxism is defined as the grinding or clenching of teeth, and can be classified into two circadian manifestations: sleep and wake bruxism 3
• The prevalence of awake bruxism is reported to be 20% among the adult population, and is mainly associated with nervous tic and reactions to stress, including anxiety 5

Association between Anxiety and Bruxism

• Studies have found a significant difference in state anxiety between bruxers and non-bruxers, suggesting an association between emotional factors such as anxiety and bruxism 4
• The severity of social phobia has been shown to predict the presence of oral parafunctional activity, including bruxism 2
• Anxiety syndromes, along with stress and genetic disposition, are considered dominant factors that lead to increased muscle tension and bruxism 3

Consequences of Bruxism

• Bruxism is a major risk factor for tooth structure and dentures, and can result in alterations to orofacial structures, functional modifications, and social repercussions 3, 4
• The main complaints of bruxers during mastication include facial pain and headache while chewing, as well as the presence of clicking sounds in the jaw joint 4
• Bruxism can also exacerbate temporomandibular joint disorder (TMD), a broad pain disorder that refers to several conditions affecting the temporomandibular joint of the jaw and the muscles of mastication 6