Question: I have been clenching my teeth at night for years and they are sore when I wake up, as are my gums, jaw and head. I also suffer from ringing in my ears which is driving me crazy. Are these connected?
Name and address supplied.
Answer: Bruxism — nocturnal tooth grinding and jaw clenching — affects up to 10 per cent of adults and often can lead to discomfort around the jaw, facial pain and headache, as well as excessive tooth wear.
Risk factors include anxiety, heavy alcohol intake, smoking, caffeine and stress. There is also an association with a number of medications, including the antidepressant fluoxetine.
This week a reader asks if the ringing in their ears is connected to them clenching their teeth
It is difficult to disentangle the relationship between your bruxism, jaw pain and tinnitus, the ringing in your ears.
Tinnitus certainly can be related to the muscles that act on the jaw — the trigeminal nerve in the head supplies part of the muscle system for jaw movement and the muscles in the middle ear, so it may be that this nerve is irritated by the repetitive jaw clenching and so affects the middle ear.
Treating your jaw clenching is very likely to resolve your jaw and head pain, and may end the tinnitus, too.
As a first line of attack, I recommend avoiding alcohol, taking no caffeine after 2pm and (if you are a smoker) quitting smoking.
You can also buy mouth guards to protect your teeth. These may not reduce the bruxism, but patients often find they lead to less morning discomfort.
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If none of this helps, you can ask your GP to be referred for cognitive behavioural therapy with biofeedback. This talking therapy aims to identify and relieve any stress that is leading to this inadvertent behaviour.
My view is that, given your long history of symptoms, your best option may be Botox-style jabs into the muscles used in chewing. This partially paralyses them so the grinding is not so strong.
The effect fades, so jabs have to be repeated every six months. Your GP can refer you for this.
In my view…Regular gym visits can stave off dementia
As we age, we all lose muscle — but refusing to tackle this process, known medically as sarcopenia, is bad news for our health.
Not only does it result in frailty, causing falls, injuries and difficulty with all aspects of mobility, but it has been revealed it can also lead to insulin resistance (though we do not know how), a precursor to type 2 diabetes and possibly its sinister complications of heart disease and stroke.
Taking up an activity such as walking, table tennis, dancing or gardening can help stave off dementia says Dr Scurr. (Stock image)
Recent research has also shown that sarcopenia is independently associated with an increased risk of cognitive impairment, in other words, setting us on the pathway towards dementia.
Knowing that such outcomes are on the horizon for all of us is depressing — but the good news is that you can apply the brakes.
The large, high-powered muscle fibres that waste away in sarcopenia are exactly the tissues that can be rescued and improved by strength training.
If you have relapsed from earlier resolutions to hit the gym, now is the time to go back to them — or keep up with other activities that place stress on your muscles to help build and maintain them.
Try walking, table tennis, dancing, gardening, or whatever weight-bearing activity floats your boat.
Source: Martin Scurr
