Teeth Grinding and Bruxism (Podcast)

John Maher: Hi, I’m John Maher and I’m here today with Dr. Nammy Patel, founder of Green Dentistry in San Francisco, California, helping patients recognize the vital connection between dental health and whole body health. And the author of the best-selling books, “Age with Style: Your Guide to a Youthful Smile” and “Healthy Living and Total Wellness: Understanding the Link Between Your Teeth and Your Health”. Today, our topic is teeth grinding and bruxism. Welcome, Dr. Nammy.

Dr. Nammy Patel: Hi, John. Thank you for having me.

What Is Bruxism?

John: Sure. So Dr. Nammy, what is bruxism?

Dr. Nammy: Bruxism means grinding. So bruxism is basically when we grind our teeth, and that could be from a number of reasons. The most common reason for people who tend to clench and grind their teeth at night is actually if they’re not able to breathe really well. So if somebody has sleep apnea or doesn’t have enough suction for their tongue, it actually causes the body to actually grind the teeth in order to get the tongue out of the way. So that’s a main reason that we find majority of our patients to clench and grind their teeth.

A lot of times, we also say that stress is one of the reasons why patients clench and grind their teeth, as well as medications. Sometimes even anti-anxiety medications can cause grinding, and also a lot of times we see patients who are taking ecstasy, that will cause a lot of grinding. Sometimes women going through hormonal changes like through menopause, that’ll cause some grinding and some tension. So there are several reasons for grinding, but the most common one is actually related to sleep.

How Does Grinding Your Teeth Affect Your Mouth?

John: Okay. What happens when you grind your teeth? Why is that bad for your teeth and your mouth?

Dr. Nammy: So what happens when we grind our teeth is our teeth are stronger than bone. So they’re designed to take a lot of force. But when we’re grinding uncontrollably and unconsciously, over time, what happens is we start getting cracks on the teeth. And as these cracks propagate, they tend to chip a tooth. And if they end up chipping a tooth, we end up eating a filling or sometimes a crown or sometimes a root canal. Sometimes the cracks are so bad that we have to extract the tooth. So we want to help prevent grinding as much as we can.

The Connection Between Bruxism and Sleep Apnea

John: And can bruxism be related to sleep apnea?

Dr. Nammy: Absolutely. It is one of the most common reasons we find our patients crunching and grinding is that when we are sleeping, that’s when sleep apnea occurs, we stop breathing unconsciously, and if we start breathing, our bodies are going to do whatever it can to try to keep us alive. And it’s going to grind our teeth because we’re asleep. And grinding teeth is under unconscious control, kind of like our heartbeat or our breathing.

We don’t control our breathing, we just breathe no matter what, because we have an autonomic system that says if there’s too much carbon dioxide, I got to start breathing right away. And so our bodies naturally react to a drop in oxygen, an increase in carbon dioxide, and it automatically starts grinding those teeth in order to get that tongue out of the way.

Signs You’re Grinding Your Teeth in Your Sleep

John: So obviously you’re doing this generally at night when you’re sleeping and you’re not conscious for it. How do you know if you are grinding your teeth? Are there ways that you could tell?

Dr. Nammy: Absolutely. The most common thing that will happen is when you come see the dentist, you will see that there’s potholes on the teeth so that you can see the inner layer of the tooth. There’s also small crack lines on the teeth, and then also you’ll get receding gums. So receding gums will happen because there’s so much pressure on the tops of the teeth that it actually starts decaying or removing the bone. The bone starts deteriorating at the roots of the teeth.

Treatments for Bruxism

John: And what are some of the treatments for bruxism or grinding?

Dr. Nammy: The easiest and best solution really is sometimes we prescribe a night guard for patients, but many times we’re actually doing more research to figure out what’s the root cause of the grinding. So in my office, I tend to figure out what do I recommend for the patient. I like to recommend how to prevent grinding based on their root causes. So if it’s sleep apnea, we like to do a sleep study and a CT scan and we like to look at their sinus cavities.

Sometimes it could be upper airway resistance. Also a thorough check of their medical history and looking at which medications that they’re on. How can we help them get off the medication that they’re on? Like I was sharing with you earlier, anti-anxiety medications, we’re finding that a lot of patients are on anti-anxiety medications because they’re not actually getting good sleep.

And it doesn’t mean that they have sleep apnea, but it means that sometimes they have something called upper airway resistance, which leads to sleep apnea, which means that they just don’t sleep really well. And the reason for that is because they’re not able to breathe through their sinuses really well, because their sinuses are so clogged. And so it wakes them up in the middle of the night or doesn’t allow them to sleep as well as we like to. So the brain doesn’t get good rest.

When the brain doesn’t get good rest, the patients tend to feel more anxious. When they go to medical doctors and say, “Hey, I feel anxious.” The medical doctors just prescribe medication versus really looking at what’s the root cause of that anxiety. Is it really something physiologic or is it just that the patient is stressed? Majority of the time we’re finding that form follows function, so that means that our bodies have clues, we have to get to the root cause of the problem.

Cycle of Anxiety and Teeth Grinding

John: Kind of sounds like a vicious cycle where you have this sleep apnea or something like that and this waking you up in the middle of the night that’s causing you anxiety, and then you’re taking anxiety medications and then that’s making your grinding worse. And so it seems like you have to do something there in order to stop that cycle.

Dr. Nammy: Absolutely. And that is my next mission for the next year, 10 years. I’m committing myself to educating doctors, medical doctors, ENTs and naturopaths to really help them understand the link between their mouth and the rest of their body. And really grinding, it is easily preventable. We can figure out the root cause and help with the root cause instead of just giving them a pill.

Treatments for Sleep Apnea

John: If you do find that sleep apnea is what’s causing your grinding, what are some of the treatments available for sleep apnea?

Dr. Nammy: For sleep apnea, we are actually one of the few practices that provide holistic healthcare, and we can actually help activate stem cells in the roof of the mouth to actually expand the sinus cavities as well as make space for the tongue, which helps prevent sleep apnea, which allows your body to be in harmony.

And the most beautiful thing about this is that we actually work with the natural body’s rhythm, a cyclical rhythm, kind of like inhale and exhale. We actually allow the body to fix itself. So we give it a little push to say, hey body, find your homeostasis, find your balance. And the body’s actually able to do that, and we’re really proud to be able to offer services that do.

Contact Green Dentistry to Learn More About Bruxism

John: All right. Well, that’s really great information, Dr. Nammy. Thanks again for speaking with me today.

Dr. Nammy: You’re welcome.

John: And for more information about green dentistry, visit the website at sfgreendentist.com or call (415)-433-0119.