Authors: Ana Cristina de Oliveira Solis; Felipe Corchs; Érica Panzani Duran; Cláudio Silva; Natalia Del Real; Álvaro Cabral Araújo; Yuan-Pang Wang; Francisco Lotufo-Neto · Research
How Does Post-Traumatic Stress Disorder Affect Teeth Grinding and Jaw Pain?
A study finds that PTSD is linked to daytime teeth clenching and jaw pain, highlighting oral health impacts of trauma.
Source: de Oliveira Solis, A. C., Corchs, F., Duran, E. P., Silva, C., Del Real, N., Araújo, A. C., Wang, Y. P., & Lotufo-Neto, F. (2023). Self-reported bruxism in patients with post-traumatic stress disorder. medRxiv. https://doi.org/10.1101/2023.09.03.23294937
What you need to know
- People with post-traumatic stress disorder (PTSD) are more likely to clench their teeth while awake compared to those without PTSD
- PTSD is associated with higher levels of jaw and facial pain
- The effects of trauma on oral health highlight the need for dental professionals to consider psychological factors
Understanding post-traumatic stress disorder and oral health
Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a traumatic event. While PTSD is known to affect mental wellbeing, less attention has been paid to how it impacts oral health. A new study sheds light on the connection between PTSD and issues like teeth grinding and jaw pain.
What is bruxism?
Bruxism is the medical term for grinding, gnashing or clenching your teeth. It can happen while you’re awake (awake bruxism) or asleep (sleep bruxism). Many people occasionally clench or grind their teeth without it causing problems. However, when bruxism occurs regularly, it can lead to tooth damage, jaw disorders, headaches and other issues.
Some signs of bruxism include:
- Flattened, chipped or loose teeth
- Worn tooth enamel
- Increased tooth sensitivity
- Jaw, neck or face pain
- Tired or tight jaw muscles
- Earache-like pain
- Dull headache starting in the temples
- Damage from chewing on the inside of your cheek
- Indentations on your tongue
How PTSD affects teeth grinding and jaw pain
The researchers in this study wanted to examine how PTSD impacts bruxism and orofacial pain (pain in the mouth, face and jaw). They compared 38 patients diagnosed with PTSD to 38 control participants without PTSD.
Key findings on bruxism:
- 81% of PTSD patients reported some form of bruxism, compared to 43% of the control group
- PTSD patients were over 3 times more likely to report awake bruxism specifically
- There was no significant difference in sleep bruxism between the groups
This suggests that people with PTSD are much more prone to clenching or grinding their teeth while awake and going about their daily activities. The lack of difference in sleep bruxism was somewhat surprising to the researchers.
Key findings on orofacial pain:
- PTSD patients reported significantly higher levels of current jaw/facial pain
- They also reported more pain over the past 6 months
- Having PTSD was associated with about 3 times higher rates of orofacial pain
Why might PTSD lead to more teeth clenching and jaw pain?
The researchers propose a few potential reasons for the link between PTSD and daytime teeth clenching:
Stress and anxiety: PTSD involves chronic stress and hyperarousal. Clenching the jaw is a common physical response to stress.
Hypervigilance: People with PTSD are often in a state of heightened alertness. This may cause increased muscle tension, including in the jaw.
Avoidance: Clenching teeth may be an unconscious way of suppressing emotions or trying to maintain control.
Sleep disturbances: While this study didn’t find a link with sleep bruxism, PTSD often disrupts sleep patterns which could potentially impact nighttime teeth grinding.
As for the increased pain, there are likely multiple factors at play:
Physical effects of clenching: More daytime teeth clenching can lead to muscle fatigue and pain in the jaw area.
Altered pain processing: PTSD appears to change how the brain processes pain signals, potentially making people more sensitive to pain.
Stress-induced inflammation: Chronic stress associated with PTSD may increase inflammation throughout the body, including in the jaw and facial muscles.
Implications for patients and healthcare providers
These findings highlight the wide-ranging effects that trauma can have on a person’s health, extending beyond just psychological symptoms. For patients with PTSD, being aware of the potential for increased teeth clenching and jaw pain can help them seek appropriate care.
For dental professionals, this research underscores the importance of considering psychological factors when treating patients. Someone presenting with signs of bruxism or chronic jaw pain may benefit from screening for PTSD or other mental health concerns.
Similarly, mental health providers treating PTSD patients should be aware of these potential oral health impacts. Collaborating with dentists may help provide more comprehensive care.
Limitations and future research
It’s important to note some limitations of this study:
- The sample size was relatively small (76 total participants)
- Bruxism was assessed by self-report rather than clinical examination or sleep studies
- The study didn’t control for use of medications, which could impact bruxism
Future research with larger sample sizes and more objective measures of bruxism could provide additional insights. Studies examining how PTSD treatment impacts oral health symptoms would also be valuable.
Conclusions
- PTSD is associated with higher rates of daytime teeth clenching
- People with PTSD report more jaw and facial pain
- The oral health impacts of PTSD highlight the need for integrated physical and mental healthcare
- Both dental and mental health providers should be aware of the potential link between PTSD and oral health issues
While more research is needed, this study sheds important light on how the effects of trauma can extend to oral health. For those struggling with PTSD, addressing both psychological symptoms and physical manifestations like teeth clenching may help improve overall wellbeing and quality of life.