February 2019 
Your patients symptoms might be indicating work stress for adults or exam stress for young people  
Stress appears to be an increasing feature in todays hectic lifestyles for both adults and children. There is a wealth of evidence suggesting how dangerous stress can be for our health, particularly when cortisol levels remain raised. 
 
Studies such as, https://www.proteethguard.com/relationship-between-stress-insomnia-and-sleep-bruxism/ have found that teeth grinding and jaw clenching can be the body’s way of relieving stress. Almost 70% of the grinding cases have been traced to a stress related cause. 
 
As well as adults stressed at work, the NSPCC identified that exam stress can often be overwhelming for teenagers, https://www.nspcc.org.uk/what-we-do/news-opinion/exam-stress-overwhelming-for-thousands-of-children/ With exam season on its way now would be a good time to check how your teenage patients are sleeping. 
 
So, do dentists have a role to play in helping patients cope with their stress? 
 
Naturally the ideal solution is for people to recognise their key stressors and either reduce these, or increase their physical activity levels, or adopt practices such as mindfulness; all of which will reduce cortisol levels. 
 
However, as dentists we can also help in the following ways: 
 
• Be vigilant in noticing the early signs of bruxism. It is often overlooked and underdiagnosed. Remember most people grind their teeth or clench their jaw at some point in their life 
• Talking to our patient we can explore if they are experiencing any of the common symptoms of bruxism, i.e. headaches, earaches, jaw ache, migraines, stiff shoulders, neck pain, sleep disruption 
• Displaying leaflets about bite guards in our surgeries will help patients recognise how their symptoms could be linked to bruxism. This can encourage them to have a conversation with you. Please contact us if you would like some literature for display. 
 
My personal favourite bite guard is hard/soft as for a reasonable cost it provides the comfort of a malleable appliance on the patients dentician but the hard outer to protect the occlusal surface of the teeth. However, soft bite guards are a great entry product and can work successfully as a deprogrammer for up to a year. 
 
The vast majority of patients who have used a bite guard will notice improvements, such as in their neck, jaw, shoulders, or their energy levels when they wake up. 
 
So, whilst dentists are unlikely to be able to remove stressors from their patients’ lives they can protect their teeth and help them have a good night’s sleep, which in turn will be a significant health benefit for the patient. 
 
Giles Bradley 
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