When stress makes teeth grind

“Teeth should only come into contact briefly during the day, primarily during chewing. Outside meals, at rest or while speaking, they should remain slightly apart," explains Benedikta Kamdem, a specialist in oral and maxillofacial surgery at CHUV.

Bruxism can occur in two ways: centric bruxism, where the teeth are strongly clenched without movement, and eccentric bruxism, which involves the grinding caused by repeated friction between the jaws. A dentist can easily detect it by examining the condition of the teeth.

In Switzerland, about a third of the population suffers from involuntary grinding or clenching of the teeth, a condition known as bruxism. According to the Federal Office of Public Health, 37% of women and 29% of men were concerned in 2022. The reason for this difference remains unknown. This unconscious reflex is common among stressed or anxious people, who tend to clench their jaws without realising it. “There are areas of the brain that deal with emotions, and others that control muscle contraction reflexes. These two systems can interact, which may explain the appearance of bruxism.”

This behaviour can have serious consequences for the teeth, the chewing muscles, and the temporomandibular joint (TMJ), which connects the skull to the jaw. “In both forms of bruxism, the muscles are overstretched,” says Benedikta Kamdem. “It is referred to as muscle hypertonicity, meaning an excessive and prolonged contraction of the muscles.”

This muscle overactivity often leads to morning pain in the jaw, temples, or even the neck. Symptoms such as stiffness, muscle fatigue, and headache may then appear. The specialist recommends seeking medical advice at the first signs of jaw tension or teeth grinding. “In some cases, this can lead to degeneration of the joint disc. When the muscles are too contracted, opening the mouth becomes difficult. And as soon as a joint stops working properly, the overall quality of life suffers. Talking, eating, or simply living on a daily basis can become a real challenge.”

Understanding the cause

Stress significantly influences the onset of bruxism. “During consultations, I systematically look for possible sources of stress, and sometimes patients identify them and express their discomfort. I offer them a psychological follow-up with a psychologist or a psychiatrist. The stress they experience can have a significant physical impact. It is therefore preferable to intervene as early as possible in a multidisciplinary way (dental, oral and maxillofacial surgery, psychotherapy/psychiatry, physiotherapy) to protect the joint.” 

Relieving the pain

Treating bruxism requires a gradual approach. Biofeedback is a simple way to identify moments when one unconsciously clenches their teeth. “For example, you can place stickers in various places around the house. Every time you see one, you can ask yourself whether you are clenching your teeth,” explains Benedikta Kamdem. This awareness is sometimes enough to significantly reduce episodes of bruxism.

If the problem persists, physiotherapy can provide effective relief. “We work with physiotherapists specialising in jaw disorders. They offer tailored exercises, including massage, stretching and mouth-opening and closing movements.” In the most persistent cases, a more targeted treatment may be considered, such as botulinum toxin injections. “The toxin is injected into the chewing muscles to reduce muscle contraction force and relieve pain.” The nocturnal occlusal splint also protects teeth from wear during sleep. However, the fact that it is not reimbursed by health insurance may be a barrier for some people.