The Year of Grinding Teeth | Hacker News Reader

The Year of Grinding Teeth

theparisreview.org

95 pointsbekind51 comments

I asked about bruxism last year and got extensive replies. This may be of use to someone reading: https://news.ycombinator.com/item?id=23665164

I did not solve mine, though it is signficiantly better managed. I got an improved night guard that isn’t causing jaw misalignment, did some physiotherapy of the jaw and exercises to improve masseter joint junction, and used the sleepguard bruxism monitor so I can see when I’m grinding.

The last one has become less useful as I’ve started knocking it off or turning it off in sleep, but it’s helpful to know bruxism is happening even if you think you have fixed it.

My new guard is a lower guard. I seem to grind more with it, but the upper guard was causing front tooth pain, so I think that may have interrupted grinding but been worse?

Anecdotally I grind more since no longer having a dog.

Do you know how the dog reduced your grinding?

Probably just helped keep stress levels down.

Precisely that!

FYI there may be an association between bruxism and sleep apnea: https://www.sleepfoundation.org/sleep-apnea/link-between-sle...

I have both. I wear a very tough nightguard whenever I sleep. I tried a few 'comfort' guards but just ground through them. Finally my dentist got me a very hard plastic guard and it has lasted over 5 years.

I'm naturally tense and I don't think I'll fix my bruxism until I can stop worrying about how I'm going to afford alimony and my retirement. Modern problems I guess.

I was coming in to post this. There is new evidence that bruxism is your body just trying to keep its airway open when you are asleep.

If you grind your teeth at night and have excessive daytime sleepiness even after getting 8+ hours of sleep, then you should get a sleep study done to check for sleep apnea. Sleep apnea is a very serious medical condition that increases blood pressure, damages your brain, wrecks havoc on your mental health, and increases risk for heart attack, stroke, diabetes, etc.

Absolutely, I learned about this from my dentist and I started to see it everywhere. Seems like half the people I know have one or both problems. In a lot of cases it's a chronic thing that unfolds over 10 or 20 years, somewhat below the threshold of doctor's visits.

But it can absolutely cause your life to be way harder than it needs to be.

Also, doctors don't talk to dentists. That is a big problem.

See the 2018 book "Jaws" and 2020 book "Breath" for more info. Here are three links to previous HN stories here, including the book recommendations:

https://news.ycombinator.com/item?id=24247066

Is there medication (maybe a mild sedative) you can take that prevents bruxism for a night?

I've heard people recommend magnesium but I don't think it will help unless you're deficient, and even then the effect will be small.

Not sure about that, but magnesium and ashwaganda were recommended to me for insomnia by a friend. They didn't do anything for me for my teeth grinding. Not sure about the insomnia, as I still had problems falling asleep, but -

They did give me unbelievably vivid, amazing, lucid dreams. I was in full control of my dreams, and aware of that fact that I was dreaming. I don't know if my sleep quality was better, or I was just happier that I had a fantastically creative output for my brain, but I really did feel better for the two months I took that mix.

Masseter muscle botox gets surprisingly little attention for this and derivative issues. Not too expensive. Very simple walk-in procedure, don't need consults. Zero effort. Not permanent (both a con and a pro), but some say their problem doesn't come back even after it wears off.

Pretty much all other interventions (besides self-awareness/lifestyle) are way more involved and don't have a great record either way. Nothing is proven about botox either, but seems like the best thing to try first.

I’ve had two injections (3 months apart) and it didn’t do anything for me. My grinding stopped when I started doing therapy. You’re treating the symptom, not the cause and digging at the root of this problem migh outwheigh the involvement, or at least it certainly did in my case.

To clarify, do you mean therapy in the psychiatrist sense or some specific physical thing for bruxism? I could imagine either helping with this issue

I was originally recommended kinesiotherapy by a dentist to aid back/neck pain and psychotherapy to work out what's causing this. Never went to any form of physical therapy, but I started going to a psychotherapist (psychoanalyst to be exact). Little by little, my bruxism, neck and back pain went away. Another thing that helped was learning proper tongue placement. I still grind my teeth while asleep sometimes, but only during more stressful periods of life and it can be avoided by tiring myself physically (going for a run, etc).

That's a great idea, a temporary solution to kick the habit.

Something I never paid attention to is that the natural/ideal resting position of your jaw is that you teeth never touch, and your tongue is touching your upper palate just behind front teeth. I had issues with grinding teeth when younger. But at some point I adopted that position unconsciously.

This is a bit like resting breathing rate, the lower the better, but that's controlled completely unconsciously. Your lifestyle will influence it a lot though (exercise, relaxation, diet)

I changed my resting tooth/jaw position recently, too, and it's made a big difference. I used to feel more stressed out in the mornings, and I was sure it was because of jaw clenching I would do at night which is now largely gone.

And this is going to sound weird, but I've taken it even further by buying some baby chew toys off Amazon and chewing on them for maybe an hour a day. The benefits I've seen since starting about six months ago are 1) less teeth stress/pain at night and in the morning, 2) less nasal pressure/stress (pretty sure I have more breathing capacity through my nose now), and 3) I feel my face has widened ever so slightly but that may be the jaw positioning alone.

Hehe, in my case, I have to chew a lot just for eating (raw food, mostly fruits and green/leafy vegs), since a few years.

Doctors have told me specifically to not eat chewy food, like chewing-gum, so what you say seems contradictory to me.

Was there any reason to use toys instead of just chewing-gum?

>Was there any reason to use toys instead of just chewing-gum?

Not really, except it lasts longer and I dislike the taste of chewing gum. Mastic gum works well, too.

I’m usually sleeping in a fetal position which immediately makes me grind my teeth. Straightening in bed (both breast out and head straight ) helps a lot.

Yup there's actually a kind of therapy called myofunctional therapy that fixes your "tongue posture"! Intro videos here:

https://www.youtube.com/user/sarahkh12

Tongue posture is a real thing, which was news to me! The therapy fixed my breathing, it was miraculous! An improper tongue position can inhibit nose breathing. If the tongue doesn't seal the airway, you will have a turbulent and inefficient breath --- 10,000 times a day.

Yes, the resting position is important (doctors have told me).

I think another possible issue is that some people lock up their jaw without necessarily putting the teeth together. At least I do this if I don't pay attention. By "lock up" I mean that the jaw is simultaneosly pulled down by muscles and pulled up by the masseter. Then at night, the downward pulling muscles relax, and the upward pulling muscles (masseter) wins, and the actual teeth grinding occurs.

Curious if that tongue-palate trick would also reduce bruxism during stimulant use.

IME, yes. I tend to tap my teeth. Focusing on my tongue--pushing against my palette, keeping my teeth separated--helps.

Seemingly coincidental remedy, too. I don't remember reading anything about the proper resting position of the jaw. I just found that the one the helped the other. In fact, I was worried doing this with my tongue was a no-no, but figured it was better than the alternative.

I was taught the tongue-palate trick years ago as a relaxation technique. It's basically impossible for your facial muscles to be contracted while doing it, helping an overall relaxation.

Yeah it helps. Magnesium taken beforehand helps too, at least in my experience.

We just started doing tests with couple dozen patients for my startup that provides multiple independent dental opinions. It turned out that 80% of people have bruxism.

Yes, we only had less than 20 people so far, so this statistic will likely change. But what was worrying is that they had no clue. Even despite having tooth wear in a very advanced stage.

Enjoyed my first-ever root canal a couple of months ago that was attributed to bruxism.

P.S. - nights guards through dentists are expensive; note that there are some cheaper D2C options becoming available.

I'm getting braces due to this weird habit I developed of thrusting out my lower jaw, putting my bottom teeth on top of the upper ones and pulling. After a few years of this I've pulled my lower teeth out of alignment and the ones I do this to pitch forward now.

Asking my dentist how to defeat the bruxism all he could suggest was having braces might do it. Mentally preparing for sleep by telling myself not to grind my teeth can help, but I think without reducing all the stress it'll never stop.

I look forward to reading all the advice in this thread on ways to make myself stop.

> I think without reducing all the stress it'll never stop.

Is there anything you can do to reduce excessive stress?

Why didn’t you get a night guard? Simple. Cheap. Easy.

I have both the soft malleable kind and the hard Sisu kind. Doesn't stop me from doing something in my sleep although it can mitigate the effects somewhat.

FWIW, I've used these [audio lessons](https://www.feldenkraisresources.com/Sensory-Motor-Education...) to cure my own bruxism. It also cleared up the problem for several friends.

Thanks. I have some questions. How long did it take you to complete the program? Do you still need to do exercises? Was the improvement gradual, or sudden? And did you suffer also from daytime bruxism (teeth clenching e.g. while working behind a computer)?

So sad to read her account...stress is a deadly condition. De-stressing during pandemic is harder than ever, but we must try. Exercise, diet, sleep, things like meditation or yoga, reduction of substance use, increase of time spent in the outdoors, I've been trying all of the above to varying degrees of success.

I can recommend surgical tape over the mouth. This forces nose breathing. For some reason it also means you don't grind teeth.

I highly recommend trying this, you sleep much better. Apart from surgical tape there is bespoke nose breathing tape, but this is more expensive.

https://archive.is/2hTAx

I'm interested in this topic... my list

- grinding teeth in sleep

- nightly/morningly sleep paralysis

- not being able to breath through nose

sleep is hard...

For the nose: try breathe right strips. I had chronic nasal congestion.

Not only did those help me breathe at night but they seemed to have helped my daytime breathing as I keep my nostrils open a bit wider. My average blood oxygen rose after starting.

Thank you for the recommendation. I've ordered a pack of 10 to try - I hope they help.

No prob. Be sure to use warm water when you take them off in the morning. Makes it substantially easier.

I forgot, the other thing that helps is a saline rinse. I like the neilmed solutions. If you don’t use the premade water solutions, be sure to boil water or use distilled.

An update! I purchased a pack and I've had it on for 5 hours now. I think it's working. It isn't perfect, but I can actually get some air in, thank you.

I tried the neilmed sinuflo readyrinse a while ago but I couldn't ever get it to work properly as my nose was almost sealed shut! Maybe it will help now.

The only trouble is I don't want to take it off now!

Awesome, very pleased to hear it! For neilmed, you might try one of the higher flow crevices temporarily to dislodge stuff: https://www.amazon.com/Multi-Purpose-Saline-Spray-ounces/dp/...

For the breathe right, I can tell you my early experience:

1. I actually got hypocapnia: pins and needles in arms from excess ventilation. This just showed how unused my body was to proper airflow. My pulse o2 went up a couple percentage points and the hypocapnia went away fairly quickly.

2. My nose clogged up a bit temporarily, almost like it wasn’t used to the airflow. This went away. After a couple days

3. My nostrils started staying further apart when I didn’t have the strips on. I basically just resisted them collapsing inwards.

So you may find after a few days use they lead to some improvements when not wearing them. I use them most when sleeping.

You might also consider a sleep study, in case thus blockage has led to apnea or anything similar.

Final thing: there is a device called a pulmonica, used to train the lungs. Believe I read reports from some people saying it improved congestion via vibration of the sinuses. I have not tried one extensively, but am currently evaluating. I’d consider my sinus congestion mostly managed now so can’t give feedback there. But as you seem to have a severe case it might be worth tracking down this lead.

For nose breathing, myofunctional therapy fixed it for me:

https://news.ycombinator.com/item?id=25911557

It wasn't cheap, but it only took a few weeks, after years of no results! I tried Breathe Right strips and many more things.

The problem is that everyone is a snowflake, so you have to try a bunch of different things.

It was a brand new feeling being able to exercise with my mouth closed, and now sleep with my mouth closed.

For others who aren't sure about it, try holding a popsicle stick between your sealed lips and do stuff around the nose. If you feel out of breath and want to drop the stick, then you're a mouth breather.

You experience sleep paralysis daily?!? I want to cry for you thinking of the terror you must be having to endure. I'm so sorry.

For as long as I can remember! My first real fear of "ghosts" as a child was from a sleep paralysis episode where I had the usual hallucinations that go with it.

Every morning when I "wake" into sleep paralysis, I'm lucky if I'm shaken awake because I can signal it with my breathing. Either way, I will wake up after some struggle... and it is so exhausting that I will sometimes fall back asleep, only have sleep paralysis again. It means I wake up stressed!

A bonus is that I also "fall" into sleep paralysis when going to bed. Having to make up to 4 attempts to fall asleep can be frustrating...

Here is the combo! I can barely breathe through my nose, so if I experience sleep paralysis whilst I'm on my side, front, or somehow under the covers, I will feel like I'm suffocating... when I pull out of it, my eyes will feel strained and on rare occasions bloodshot.

"you look terrible you should get some sleep"

I had TMJ issues my whole life. Jaw started clicking at 8 and 20 years later I developed chronic pain. For the past 3 years I have seen Dr. after Dr. and every doctor dismissed my pain and gave me generic stretching/exercise. I finally found a TMJ expert who create mouth inserts to extend your jaw forward for several months, followed by physical therapy and then a lip tie/tongue tie procedure. The first day I wore my mouth inserts I could literally breathe better.

I don’t have this problem but I know of someone who does and would probably like to hear about these inserts. Do they have some specific name?

They are probably referring to Mandibular Advancement Devices. I had the same kind of thing, but more of an acute event precipitated by stressful work, late night partying/drinking, and years of sleep apnea. The device was magic. The morning after the first night wearing it felt like heaven.

I _highly_ recommend calling around and finding a "sleep dentist" who will bill the device as a medical device (not a dental device). This is the only way to get American health insurance to pay for it (they are ~$5k). The down-side is you can only use the device for ~10 years before you get permanent forward lower jaw displacement. But those 10 years allowed me to get everything in order and gracefully switch to a nasal pillow CPAP (which is also heaven once you get the settings right).

If you live in the Boston area or LA area, I can recommend a fantastic sleep dentist that specializes in these devices. PM me.

The manufacturer for my nighttime inserts or "stilts" is Prosomnus Sleep Technologies. I'm not sure who manufactures the day insert. But the other commenter is correct, I am using a medical credit card and the balance is $13,000.

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