Bruxism - Jaw Clenching
Bruxism from a Brain Body Perspective
Bruxism, commonly referred to as teeth grinding or clenching, affects millions of people globally. It often occurs subconsciously during sleep (nocturnal bruxism) and sometimes even while awake. Left untreated, bruxism can lead to significant dental wear, jaw pain, tension-type headache or migraine, TMJ dysfunction, and even other wider effects. With this post, we’re going to dive into an East-West understanding of this disorder as a way to explore the complexities of something that seems simple.
The So What
Bruxism is my personal favorite example of the brain-body interaction. It's common. It’s part of the stress response but one that people can get without having mental health disorders. It’s subconscious and involuntary, typically with sleep, and so it can seem impossible to change. We (Westerners) don’t know why people clench their jaw. Why the jaw? Why don’t people clench their fingers, toes, or even their eyes while they sleep? Traditional Chinese Medicine has a potential explanation and that can be fun to explore.
Western Perspective
Modern medicine identifies several potential causes of bruxism:
Stress and Anxiety: Stress is a significant trigger for teeth grinding. Individuals under chronic stress are more likely to develop bruxism due to increased muscle tension.
Sleep Disorders: Obstructive sleep apnea (OSA) is associated with nocturnal bruxism, as disrupted sleep cycles influence jaw muscle activity.
Malocclusion: Misalignment of the teeth can contribute to improper jaw functioning, leading to grinding and clenching.
Neurological Disorders: Parkinson’s disease and certain medications (e.g., antidepressants) can provoke bruxism as a side effect. The most common SSRI/SNRIs to provoke bruxism are Fluoxetine, Sertraline, and Venlafaxine.
Lifestyle Factors: Excessive consumption of caffeine, alcohol, or recreational drugs (particularly MDMA) can exacerbate bruxism.
An Eastern Perspective
Traditional Chinese Medicine (TCM) provides a unique framework for understanding bruxism, emphasizing the interconnection of organ systems and energy (Qi) pathways. TCM is fascinating from a Brain Body perspective because it views emotional or stress difficulties the same as a physical problem— both are manifestations of the same energy imbalance. According to TCM:
Meridian and Organ Relationships
Spleen Disharmony: Excessive worry or overthinking weakens the Spleen, disrupting the energy needed for muscle relaxation. The Spleen meridian pairs with the Stomach, and the Stomach meridian has acupuncture points in the masseter. Other signs of “Spleen” (which modern scholars think was a mistranslation of “Pancreas”) disharmony include gastrointestinal problems (primarily stomach upset, bloating, and loose bowel movements) menstrual or fertility difficulties, and anemia.
Liver Qi Stagnation: The Liver governs the smooth flow of Qi in the body. Emotional stress, anger, or frustration can cause Liver Qi stagnation, leading to tension in the jaw muscles and grinding. The Gallbladder meridian (which pairs with the Liver) flows over the Temporomandibular Joint (TMJ).
Kidney Deficiency: The Kidneys are considered the source of vitality in TCM. A deficiency in Kidney Yin or Jing (essence) may lead to overactivity of Yang energy, manifesting as nighttime grinding. Put another way, the body is overactive because it isn’t balanced well with restorative energy.
2. Meridian Patterns
Bruxism is often associated with the Stomach meridian, as the jaw is anatomically along its pathway. Overactivity in this meridian, often due to improper diet or stress, can lead to teeth grinding. The specific pattern of stress with the Stomach meridian is Rumination (as in continually gnawing on an idea and continuing to come back to it). This is a common stress pattern in people who struggle with bruxism.
An Integrative Approach to Managing Bruxism
Modern Medicine Strategies
Stress Management: Mindfulness techniques, cognitive-behavioral therapy (CBT), or relaxation exercises can reduce stress-related bruxism.
Dental Interventions: Custom-fitted mouthguards protect the teeth from damage during grinding episodes.
Sleep Studies: Identifying and treating underlying sleep disorders is crucial.
Medications: In severe cases, muscle relaxants or Botox may be prescribed. Botox also has the benefit of slimming masseter hypertrophy that can cause a widened jawline.
TCM Interventions
Acupuncture: Stimulating specific points along the Liver, Stomach, and Kidney meridians can alleviate tension and balance Qi flow.
Dietary Adjustments: Avoid spicy, greasy, and caffeinated foods that can exacerbate heat or phlegm conditions. Replace coffee and soda with Green or Herbal teas or supplement with L-theanine (from Green Tea). Eat warming and nutritious brothy foods (like bone broth soup) regularly. Increase your fiber intake and don’t overeat.
Qigong or Tai Chi: These practices promote relaxation and improve overall energy balance.
Bringing It Together
Bruxism reflects the complex interplay of physical, emotional, and energetic factors. By understanding its causes through both modern and traditional lenses, we can adopt a tailored and effective management strategy. Thinking about the brain's manifestations on the body, the holistic insights of traditional Chinese medicine coupled with modern techniques provide relief and address the root causes of bruxism.