If you suffer from anxiety, you’ll know the many ways it can affect your life, from interfering with social occasions to disturbing your sleep. But anxiety could be taking away your smile in more ways than one. Teeth grinding is a common stress symptom that can cause permanent damage.

Around one in 10 people regularly grind their teeth in their sleep; many more do it at some point in their lives, with 25-44 year olds the age group most affected. Studies suggest that 20-50 percent of sufferers have a family history of tooth grinding during sleep, also known as bruxism. Stress is a contributing factor in around 70 percent of cases. Many people are not even aware of their grinding habit until symptoms develop. Patients may suffer from headaches, jaw pain and earaches in addition to tooth wear.

Grinding and clenching will eventually wear down the protective tooth enamel and affect the bones and nerves in and around teeth. Normal chewing typically exerts 20-40 pounds of pressure on teeth, while the pressure from grinding can be 250 pounds or more. It’s easy to see how that will cause damage over time.

Grinding your jaws together each night can chip teeth, loosen fillings or damage bridges. Jaw pain can lead to limited mouth opening and difficulty chewing. Over time, the teeth can be so worn that the bite “collapses” and the teeth appear stump-like.

Once bruxism has started to wear away, the enamel teeth will look discolored. They are also more vulnerable to staining, which is likely to increase any anxiety you feel about your appearance and further restrict social interaction. They’ll also become more sensitive, making ice cream and cold drinks a source of pain and misery rather than pleasure.

Unless you have a partner who tells you you’re grinding your teeth in your sleep, you may not even be aware you’re suffering from bruxism. Many sufferers find out when a dental check-up reveals that damage has already been done. If you tend to clench your teeth during the day, it’s more likely that you’re grinding them at night. If you often wake up with a headache, particularly with pain radiating down into your jaw, you should ask a dentist if they can spot any early signs of bruxism.

Teeth grinding is also related to disturbed sleep. Studies show bruxism can be a sign of a sleep disorder such as sleep apnea. Further, grinding typically occurs before REM sleep begins, thereby disrupting your deep sleep cycle. The jaw pain caused by bruxism can interrupt sleep, leading to a vicious circle. In addition, anxiety often causes restless sleep anyway, exacerbating the problem.

To make things worse, some common antidepressants such as Prozac (fluoxetine), Zoloft (sertraline), and Paxil (paroxetine) can all cause teeth grinding as a side effect. Self-medicating your anxiety can lead to problems too: alcohol, nicotine, high caffeine levels and illegal drugs can all cause bruxism rather than relieve it. These substances (alcohol, nicotine, caffeine) should be avoided three hours before bed. Meditation and exercise has been shown to decrease stress and aid in better-quality sleep.

If you’re concerned about your teeth getting damaged, talk to your dentist about a night mouth guard. These are less bulky than the mouth guards worn by sports players. Over-the-counter sports mouth guards should be avoided at night because these actually exacerbate the problem; the soft nature of these guards increases muscle activity as the natural tendency is to chew on them. Night guards are custom made to your teeth, offer a better, more streamlined fit and are thinner due to the nature of the slightly harder and more stabilizing material. They are designed to protect your teeth during the night. Doctors recommend relaxation and good sleep hygiene to help reduce bruxism, both of which can help relieve your anxiety too.

If you suffer from anxiety, then it’s more likely you’ll also suffer from teeth grinding. The problems that this causes—such as discolored, stained or broken or chipped teeth, tiredness and headaches—can then contribute to further anxiety. Simply being aware of the symptoms and effects of bruxism can help you address the problem and prevent further damage.

By Diane Jonas, DMD By Diane Jonas, DMD

Dr. Diane Jonas, a general dentist, practices restorative and cosmetic dentistry with Daniel Feit, DMD, at 19 Franklin Street, Tenafly, New Jersey. She can be reached at 201-569-4535.