Leah Bucholz delves into the critical yet often overlooked connection between bruxism, or teeth grinding, and Post-Traumatic Stress Disorder (PTSD) in veterans. This blog sheds light on the implications of bruxism in the context of VA disability claims, emphasizing how stress and mental health issues like PTSD can exacerbate or even cause bruxism. Let’s explore the nuances of bruxism, its symptoms, risk factors, treatments, and its connection to stress and mental health conditions.

Understanding Bruxism
Leah distinguishes between two commonly confused conditions: temporomandibular joint disorder (TMJ) and bruxism. While TMJ is associated with the jaw joint, bruxism specifically involves teeth grinding. Leah emphasizes the need to differentiate them for effective diagnosis and treatment.
What is Bruxism?
According to the Mayo Clinic, bruxism is a condition characterized by unconscious teeth grinding or clenching. It can occur while awake (awake bruxism) or during sleep (sleep bruxism). Sleep bruxism is classified as a sleep-related movement disorder and is often associated with other sleep conditions, such as snoring or sleep apnea. While occasional grinding is common, chronic bruxism can lead to serious tooth damage, jaw pain, headaches, and other complications.
Signs and Symptoms
Bruxism, a condition marked by grinding or clenching of the teeth, can cause a variety of symptoms affecting both the teeth and jaw. Common signs of awake bruxism and nocturnal bruxism include:
- Frequent teeth grinding or clenching, often loud
- Flattened or worn teeth, damaged enamel
- Increased tooth sensitivity or fractured teeth
- Sore jaw muscles or difficulty moving the jaw
- Facial pain, earaches, headaches (especially around the temples)
- Sleep disturbances, snoring, or sleep apnea
- Damage to cheek tissue from chewing
- In severe cases, temporomandibular joint (TMJ) disorders.
Recognizing these signs and symptoms of bruxism is crucial for timely intervention and treatment.
Treatment Modalities
Treatment options for bruxism include consultation with a primary care doctor or dentist. The Mayo Clinic suggests mild cases may not require immediate treatment, but severe instances can lead to jaw disorders, headaches, and damaged teeth. Leah shares her own journey, currently in braces, as an attempt to correct bite issues related to bruxism.
Besides custom-made mouthguards or splints, stress management techniques, such as therapy, meditation, or physical exercises, are beneficial for veterans whose bruxism is related to anxiety. In some instances, medications like muscle relaxants or Botox injections are used to relieve muscle tension and prevent grinding, especially for patients suffering from sleep bruxism.
Risk Factors
There are various risk factors associated with bruxism, such as stress, anxiety, age, personality traits (hyperactivity, aggression, or competitiveness), certain medications like antidepressants, and family history. Stress, in particular, is a significant contributor to teeth grinding, as increased anxiety and frustration can exacerbate the condition. Lifestyle habits like smoking, excessive caffeine, and alcohol consumption, can elevate the risk. Bruxism is likely to occur in patients with other health conditions, for example, sleep apnea or Parkinson’s disease.
Prevention
Preventing bruxism requires lifestyle changes, including stress management through relaxation techniques and maintaining proper sleep hygiene. Regular dental checkups are essential for early detection. Avoiding caffeine, alcohol, and smoking can help lower the risk. For those at higher risk, wearing a protective mouth guard at night is an effective preventive measure.
Exploring PTSD in Veterans
Post-traumatic Stress Disorder (PTSD) is a mental health condition frequently affecting war veterans who have endured traumatic events such as combat, environmental distress, or sexual assault. Veterans suffering from PTSD often experience common symptoms such as intrusive memories, nightmares, fatigue, and heightened emotional distress.
These mental health issues not only impact their psychological well-being but also contribute to physical health problems like bruxism, where involuntary grinding or clenching of teeth can lead to tooth wear, jaw pain, headaches, and temporomandibular joint pain.
The stress, trauma, and anxiety associated with PTSD symptoms increase the severity of bruxism, resulting in chronic pain and further psychological distress. Scientific research indicates that patients with PTSD are more likely to suffer from bruxism compared to the general population. Addressing the root cause of PTSD through appropriate treatment can alleviate both mental and physical symptoms.
The Link Between PTSD and Bruxism
Research shows that individuals with PTSD are more than three times as likely to suffer from bruxism due to heightened emotional distress, anxiety, and chronic stress. This connection between PTSD and bruxism primarily stems from the body’s response to psychological tension, which manifests as muscle tension, particularly in the jaw.
Several factors contribute to this connection between PTSD and bruxism:
- Chronic Stress: PTSD keeps the body in a state of heightened alertness, causing continuous jaw clenching and teeth grinding, especially during sleep (sleep bruxism). This response is triggered by the body’s fight-or-flight mechanism, leading to persistent tension in the jaw muscles.
- Emotional Responses: PTSD-related emotions such as fear, anger, and anxiety can subconsciously trigger teeth grinding, both during day and night.
- Disrupted Sleep Patterns: Sleep disturbances, including nightmares and insomnia commonly associated with PTSD, further aggravate bruxism by inducing unconscious grinding during sleep.
- Neurological Impact: PTSD affects the autonomic nervous system, shifting the body toward the sympathetic (arousal) state and away from the parasympathetic (calming) state, causing more muscle tension.
- Hypertrophy and Endocrine Factors: Constant muscle tension can lead to hypertrophy (muscle growth), increasing jaw strength and wear on teeth. Elevated adrenaline levels from PTSD’s triggers also heighten tension, contributing to bruxism.
Addressing both PTSD and bruxism requires integrated care from mental health and dental professionals to treat both the psychological and physical aspects of the condition.
Bruxism and Mental Health
Leah delves into the research articles exploring the relationship between bruxism and mental health conditions. She emphasizes the potential value of these articles for veterans seeking to understand and discuss the connection between bruxism and their mental health with healthcare providers.
Literature Review
A literature review from 2011 characterizes bruxism as a movement disorder with various contributing factors. It introduces psychosocial, peripheral, and pathophysiological factors and outlines treatment modalities involving occlusal correction, behavioral changes, and pharmacological approaches.
Stress and Bruxism
A systematic review and meta-analysis from 2020 explore the association between stress and bruxism. The findings reveal a significant link between stress and bruxism, especially in patients experiencing emotional disorders. It is important to recognize and address stress as a potential factor in bruxism.
Psychosocial Predictors
Research from 2019 delves into psychosocial predictors of bruxism, providing insight into how anxiety, depression, and other mental health conditions may contribute to teeth grinding.
PTSD, Depression, and Anxiety
A study from 2009 evaluates the relationship between anxiety, depression, and bruxism. The findings suggest that mental health conditions, including PTSD, may be interconnected with bruxism, further underscoring the importance of a holistic approach to veterans’ health.
The study “Prevalence of painful temporomandibular disorders, awake bruxism and sleep bruxism among patients with severe post‐traumatic stress disorder” found that there are significantly higher rates of painful temporomandibular disorder (TMD), awake bruxism (AB), and sleep bruxism (SB) in severe PTSD patients as compared to the general population.
Dental Damage
Mental health conditions like post-traumatic stress disorder can lead to stress-related behaviors including teeth grinding and clenching, potentially causing poor oral health. A study at the Buffalo VA Medical Center found PTSD patients with 100% disability had significantly more tooth surface erosion, plaque, and gingivitis compared to controls. The tooth wear, caused by bruxism and clenching, was over 3 times greater vertically, 4 times greater horizontally, and 10 times greater in depth than controls.
Bruxism Secondary to PTSD: Veteran Disability Compensation
Bruxism, or teeth grinding, can be considered a secondary service-connected disability when linked to post-traumatic stress disorder. Veterans with PTSD may experience bruxism due to emotional distress and chronic stress caused by the trauma disorder. If a veteran has a primary service-connected disability such as PTSD, they may be eligible for additional compensation if bruxism develops as a secondary condition. The VA considers bruxism compensable when connected to an existing service-related condition, though it is not rated as a primary disability on its own.
VA Disability Rating for Bruxism
The VA does not provide a direct disability rating for bruxism. However, bruxism is often rated under related conditions, such as Temporomandibular Disorder (TMD) or tooth loss, using diagnostic codes 9905 and 9913. Bruxism that leads to TMD can be rated between 10% and 50%, depending on the severity of jaw dysfunction. For tooth loss, ratings range from 10% to 40%, depending on the number and location of missing teeth. Compensation depends on the extent of the condition’s impact on the veteran’s overall health and quality of life.
Establishing Service Connection for Bruxism
To qualify for VA compensation for bruxism as a secondary condition, veterans must prove a service connection. This involves demonstrating that bruxism developed as a result of a primary service-connected disability like PTSD. Veterans should provide medical records, service documentation, and evidence linking their bruxism to their PTSD symptoms. Lay statements from spouses or family members can also help establish sleep-related bruxism. A thorough medical nexus linking bruxism to PTSD is essential for successfully obtaining disability benefits.
Conclusion
In conclusion, Leah Bucholz offers a comprehensive exploration of bruxism in the context of veterans’ health, particularly its connection to mental health conditions such as PTSD. Veterans grappling with bruxism are encouraged to explore the wealth of research available and engage in open conversations with their healthcare providers. Recognizing the bidirectional relationship between bruxism and stress is crucial for effective diagnosis, treatment, and the pursuit of comprehensive VA disability claims.
Also read: Fibromyalgia And PTSD In Veterans Disability
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