Millions of people bite their way through their problems at night and suffer from headaches, neck problems or tinnitus as a result. BRIGITTE author Markus Brügge is also one of them – and has started looking for solutions.
At least one thing I can say: I not only share my suffering with 20 percent of adults in Germany – my problem also goes far, far back. Already in the Gospel of Matthew it says: “Then you will howl and grind your teeth.” And with Goethe, the lovesick Werther secretly grinds to himself. Presumably a stressed mammoth hunting Neanderthal was already lying on his fur and rubbing his teeth together.
Incidentally, the disease also has a name and it sounds quite martial: bruxism, derived from the Greek word for crunch. We “bruxers” (that’s what dentists actually call us) almost all have one thing in common – we are stressed. Alcohol, coffee, cigarettes, drugs and even psychotropic drugs can also promote the grinding, but the worn down nerves remain the main factor. A Finnish study found that people with negative stress have five times the chance of biting their way through their problems.
The consequences of the crunch
So far, so stupid. The only stupid thing is that you don’t just press or rub your pearly whites together a little at night (80 percent brux while sleeping), and you’re good. Before the enamel suffers, those affected usually already have symptoms. “This ranges from a shortened deep sleep phase to an increased release of adrenaline to a significantly higher muscle tone in the jaw,” explains physiotherapist Beate Kurz-Weiß from the Celenus Klinik Kinzigtal. The specialist clinic for psychosomatics in the Black Forest offers special courses for bruxism patients.
Often those affected feel themselves utterly bruised after a crunchy night. In addition, there are often numerous other problems: neck tension, headaches, tinnitus, facial pain or chewing problems. For those who value academic accuracy: When bruxism causes symptoms, it is called craniomandibular dysfunction (CMD), which means that there are functional or structural disorders in the temporomandibular joint or muscles.
The “masseter” – stronger than you think
What otherwise proves to be quite practical is a major disadvantage here. The so-called masseter is the strongest muscle in the body with a bite force of up to 80 kilos. Accordingly, it can also do a lot of damage if you overexert it at night. “Many of those affected do not initially know that pressing or grinding is responsible for their problems,” says Tobias Klur from the Cologne Polyclinic for Orthodontics in a preliminary talk on the phone. You grind in your sleep, and thus unconsciously.
So whether my herniated disc in the cervical spine comes from bruxing? The specialist dentist doesn’t want to go that far – but my permanently tense neck could very well be due to straining. “The jaw muscles are linked to the neck muscles,” says Klur.
For me, it was my dentist who first noticed that I belonged to the biter species. Because I press and don’t grind, my teeth showed no wear, but tiny cracks in the enamel. I got one of those bite or gnash splints that have been prescribed more and more frequently in recent years. And probably not a few feel like me: I put the soft splint on in the evening and found it somewhere in my bed every morning. After three weeks I gave up, annoyed.
What was the problem?
A few years and a thousand days later I am in a painful neck in Cologne in the orthodontic polyclinic. The dentist’s chairs in the high room are separated by white, airy curtains. Tobias Klur, early 30s, wears a white T-shirt with white trousers and white sneakers and initially surprised me: “The old rail was too soft.” But wasn’t that exactly my problem: that I found the bite guard so annoying that I took it out again and again at night while half asleep? “Bruxing is a kind of reflex. Your body has got used to dealing with stress and worries about pressing,” Klur explains to me. But the track should break through precisely this automatism. So the soft splint didn’t bother me enough, a hard one is supposed to drive the reflex out of me. But can I still sleep then?
Although people have been grating for generations, research into the causes and effects of bruxism is still fairly recent. Which is why Tobias Klur’s answers to some of my questions are a bit cautious. “We are only just learning what is going on and how we can help the patient.” In addition to stress and anxiety, there are other risk factors. It is believed that the crunch is triggered by a kind of reflex in the brain stem, similar to the “Restless Legs Syndrome”.
Treatment with the occlusal splint
It is considered most effective today an occlusal splint. Although there are now smaller studies with biofeedback (BFB), this treatment for bruxing has not yet been very well researched, says Klur. In biofeedback, devices are used that indicate increased muscle tone. This should make the person concerned aware of unwanted processes so that he or she can train them off in a targeted manner. Sounds logical. A study by LMU Munich shows significant improvements through BFB in terms of frequency and duration of bruxing – but only 41 people took part.
For Beate Kurz-Weiß, however, the biofeedback is an indication that there is more than just one approach to reducing nightly biting through. “This is an interdisciplinary problem in which specialists from orthodontics, physiotherapy, and possibly psychotherapy and relaxation training work together best.” The pain therapist has put together simple exercises for new bruxers.
So I practice the eye clock and the two-minute relaxation every day (okay, almost every day) and struggle with my splint at night. Unfortunately, disturbing still works a little too well. So Tobias Klur advises me to wear the splint more often during the day. “And if that really doesn’t work, Botox would be another option”. This would then specifically weaken my jaw muscle so that it can apply less pressure. And in principle, of course, applies to me and everyone who bruxen: If you deal constructively with your problems during the day, you don’t have to chew them through at night.
Three exercises that make you loose
EYE CLOCK
Sit up straight, close your eyes and point at 9 on an imaginary clock, then at 3. Then at 12 and 6, at 10 and 4 and so on. After one or two cycles, open your eyes and relax.
TWO MINUTE RELAXATION
Sit down straight. Now use your tongue to draw smaller and larger circles on the inside of the cheeks, use your tongue to trace the inside of the row of teeth, opening your jaw wide in between.
MAKE THE PINE SMOOTH
Carefully slide the lower jaw to the left and right several times a day. The goal is that it works “smoothly”.
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