“Stress sheared off my front teeth,” Demi Moore recently told Jimmy Fallon. And she isn’t alone.

For months, my jaw and teeth have been in a constant state of clenching and grinding. Now, a molar had broken in half, pushed over the edge by one bite of a salted caramel cookie and a steady diet of political news-induced stress.

Indeed, as we’ve noted before, stress is a common cause habitual clenching or grinding, often during sleep – a habit known as “bruxing.”

teeth showing effects of bruxismBut it’s not the only cause.

Quite often, bruxism is a symptom of sleep apnea, a condition in which you periodically stop breathing during sleep. Each episode may last for several seconds to minutes, and there may be dozens of episodes each night. Each time, your brain is deprived of the oxygen it needs. Naturally, the body reacts as though it’s at risk of death, doing all it can to get you to start breathing again.

Bruxing is one of those things. Dentist Dr. Louis Malcmacher describes the process well:

The brain needs to open the airway and get the muscles of mastication [chewing] to start working hard and fast, a process we know as bruxism. The masticatory muscles move the jaw forward, the airway opens, and the patient takes in a deep rescue breath. The patient falls back asleep, the airway gets blocked, and the process repeats many times during the night.

So how does the airway get blocked?

One way is by your own tissues, for when you sleep, your tongue and the muscles around the top of your throat relax and can fall back, partly blocking the airway. (“Snoring” is the sound made when air forcefully pushes past the blockage, and it, too, can be a sign of apnea.) Or the whole mandible may be retruded – pulled backward – or fall back during sleep. Or the tongue may simply not have enough room to rest comfortably, due to an underdeveloped jaw and narrow dental arches.

In the short term, splint therapy can be helpful for cushioning the force of biting and protecting the teeth. But in the long-term, you want to address the cause of bruxing. If it’s stress-induced, then you want to pursue stress management or relaxation strategies. If it’s due to your bite, then you want to address the bite.

And if it’s apnea, then you address the apnea. (And it’s important you do: Obstructive sleep apnea has been linked with a wide range of health problems, from high blood pressure to dementia. It can even be deadly.) One oft-cited study found “a complete eradication of the tooth grinding events” after CPAP was used to ensure steady breathing through the night.

But not everyone can tolerate CPAP. Fortunately, there are other good options, at least in the case of mild to moderate apnea. Myofunctional therapy has been shown to be helpful, and an ever increasing array of sleep appliances are available to help keep the airway open and even to widen it.

The main thing is, there are options for saving your teeth from the ravages of bruxing.

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