What’s the root cause of teeth grinding?
Experts say it’s a behavior, not a disorder, and a night guard may not be the right fix
Everyday stressors like a report due at work, the refrigerator breaking and the dog throwing up can sometimes make you want to grit your teeth. But layer on top of that a pandemic and economic uncertainty, and you might start to give your jaw a serious workout — gritting and grinding with as much as 250 pounds of force.
Dentists have reported an increase in patients with tooth fractures since the start of the pandemic, which they attribute to bruxism, the technical term for gritting, grinding or clenching your teeth. Thought to be precipitated or exacerbated by stress and anxiety, bruxism is largely subconscious and often occurs during sleep. Most people don’t know they grind their teeth unless a dentist tells them so, based on tooth wear. Less obvious indicators include itchy or plugged ears, neck pain and even premature aging of the face.
Acrylic or rubber mouth or bite guards — often called night guards — are typically prescribed as a prophylactic.
While night guards may help to prevent some dental wear and tear, some studies suggest they can be ineffective or even make the problem worse. This has led some experts in the fields of dentistry, neuroscience, psychology and orthopedics to say there needs to be a paradigm shift in our understanding of the causes and treatment of bruxism. They say it is a behavior, like yawning, belching or sneezing, rather than a disorder.
“It’s not abnormal to brux,” said Frank Lobbezoo, a bruxism researcher and professor and chair of the Academic Center for Dentistry Amsterdam in the Netherlands. “In fact, it can be good for you.”
Sleep studies indicate that the majority of people have three or more bursts of activity in the jaw’s masseter muscle (your major chewing muscle) during the night. It also happens during non-REM sleep. So, contrary to popular belief, you’re not doing it while you are dreaming.
Moreover, the evidence suggests that this muscular activity can have the salubrious effect of opening up your airway to allow in more oxygen. Clenching and grinding also stimulates salivary glands to lubricate a dry mouth and neutralize gastric acid. As a result, experts say it can be dangerous to wear a night guard or splint if you have sleep apnea or severe gastrointestinal reflux disorder, or GERD.
“There’s tremendous overtreatment for a nonproblem,” said Karen Raphael, psychologist and professor at New
York University College of Dentistry, referring to the widespread use of bite guards, tranquilizers and even Botox injections to prevent bruxism. “There is no evidence that tooth wear patterns reflect current grinding.” Indeed, she said, tooth wear is more often associated with an acidic diet, which erodes enamel and triggers bruxism to increase the pH in the mouth.
Of course, an overproduction of stomach acid and reflux often occur during times of stress, which might in part explain why dentists and patients are reporting more cracked teeth and jaw pain. Also, people tend to drink more alcohol when they are anxious. Even mild intoxication leads to more flaccid neck muscles, which can cause an increase in both the duration and force of bruxism to restore airflow.
Other factors that may increase bruxism are poor sleep hygiene and bad posture. If you are a light or poor sleeper, you spend more time in non-REM sleep, which is when people naturally brux.
This might be caused by stress, but also consuming caffeine or sleeping with your phone.
And we tend to take our postural habits to bed with us. If you’re tight and clenched when you are awake, you’re likely also tight and clenched when you are asleep, or at least it takes you longer to unwind.
So the question is not so much whether you brux, but why you might be bruxing more than is normal and possibly causing jaw or dental problems. “Bruxism is not a disease,” said Giles Lavigne, a neuroscientist, dentist and professor at the University of Montreal. “It’s just a behavior, and like any behavior, when it reaches a level that it’s bothersome you may need to consult someone.”
Perhaps a physical therapist who can teach you how to relax your jaw and do abdominal breathing. And maybe a psychologist can help you modify behaviors that lead to an increase in bruxism.
But simple awareness of the position of your mouth, tongue and teeth throughout the day may go a long way toward preventing tooth-grinding. “Nobody knows where their tongue is when they are at rest,” said Cheryl Cocca, a physical therapist at Good Shepherd Penn Partners in Pennsylvania, who treats patients with bruxism.
She recommends continually checking to make sure you are breathing through your nose with your mouth closed, your tongue resting on the roof of your mouth, and your teeth apart.
Part of the problem could be our modern diet. A growing body of evidence supports the once-fringe notion that, following the agricultural and industrial revolutions, as humans began eating foods that are more processed and easier to chew, we came to have smaller jaws than our ancestors and underdeveloped orofacial muscles. A result, researchers say, is that we tend to breathe through our mouths, with our tongues resting on the bottom of our mouths.
At night, our modern penchant for soft pillows and mattresses, rather than lying on the ground as our ancestors did, makes our mouths more likely to fall open and for us to drool, leading to a drier, more acidic mouth microbiome, not to mention sagging neck muscles, which further obstruct the airway.
A firm pillow, or a folded blanket under the head, can help, as can committing to an orofacial, neck and airway stretching and strengthening routine.
Research also indicates diaphragmatic breathing and singing can strengthen and expand your airway muscles to reduce both snoring and bruxism.
While bite guards worn during the day or night won’t stop you from grinding, they can act as a bumper to protect teeth, said Dr. Tammy Chen, a prosthodontist in New York City. But only if they are carefully designed according to the size and shape of your mouth, and of materials specific to whether you are a grinder, clencher or chomper.
“Bruxism often comes down to a breathing or airway issue,” Chen said. “Night guards are a band aid, but if you want to stop grinding, you have to get to the root cause of the issue.”
PHILADELPHIA — In America, the college dorm room has a special place in business lore.
Facebook, Google, Reddit, Dell and Snapchat were all invented by students in cramped quarters, their big dreams sharing precious space with bags of Doritos and overflowing laundry baskets.
Anthony Scarpone-Lambert, a 21-year-old University of Pennsylvania School of Nursing senior, hopes to follow iconic tradition and become a dormitorylaunched capitalist.
He and his co-founder have created what Jeffrey Babin, associate director of Penn Engineering Entrepreneurship, lauded as a “simple but elegant” solution to the problem of hospital personnel disturbing patients during nighttime interactions: a nurse’s wearable night light. Scarpone-Lambert’s company is called Lumify Care.
While Penn scholarentrepreneurs have hatched some notable ventures within the last decade alone (Warby Parker eyeglasses, Harry’s shaving and grooming products, Harper Wilde bras), “it’s pretty rare that a nursing student is doing what Anthony is doing,” said Marion Leary, director of innovation at Penn Nursing. “He’s been out front of where we are in nursing education right now.
“And he will be as successful as he wants to be.”
Scarpone-Lambert, who’s from a workingclass family in Chalfont, Pennsylvania, is also rare among the 2,457 undergraduates who entered Penn in 2017: He’s
one of just 300 who were the first in their families to attend college in the group.
“It wasn’t easy at first, being first-generation at Penn,” said Scarpone-Lambert, who’s also executive vice president of the senior class of 2021. “Everyone at school seemed so successful, like they all had it together. And I had impostor syndrome, like I didn’t belong.
“But incredible Penn people supported me, and I made it my personal mission to prove that no matter if I am a first-gen student, I can overcome challenges and reach goals for myself.”
The goal is to start selling the $20 uNight Light, billed as “the first-ever wearable LED light designed for nurses, by nurses.”
As part of his academic
schedule, ScarponeLambert has to participate in clinical work. In the emergency department of the Hospital of the University of Pennsylvania, he’s seen the crush of patients during the pandemic, and he knows firsthand how nurses do their jobs under great stress.
That wisdom is augmented by ScarponeLambert’s co-founder, Jennifferre Mancillas, 36, a registered nurse at Valley Children’s Hospital in Madera, California. The two met at a collaborative entrepreneurial conference and competition co-sponsored by Johnson & Johnson in New Jersey in 2019.
Together, they researched the difficulty of patients getting enough sleep in hospitals when nurses are turning on
lights, especially at night, to administer care.
After interviewing 250 nurses, Scarpone-Lambert and Mancillas discovered that 87% struggled to see while providing patient care at night. “When nurses can’t see, we put our patient and ourselves at risk,” Mancillas said. “This leads us to turn on intrusive overhead room lights that disrupt our patients.”
The Lumify pair’s data found that during a single night shift, nurses may turn on their patient’s room light an average of nine times, leading to disrupted sleep and potentially worsened health outcomes.
Scarpone-Lambert and Mancillas came up with the 2-by-1-inch LED light that they believe is a game changer.
“Nurses are wonderful
innovators,” often unappreciated, said Bobbi Martin, president and CEO of the Global Nurse Foundation, a nonprofit in Florida’s Tampa Bay area that supports nurses in places like Uganda. She met Scarpone-Lambert at the Johnson & Johnson event. “Nurses will do 25 workarounds in a shift,” finding innovative ways to care for patients.
Scarpone-Lambert is taking that outside-thebox thinking to a new level, Martin said.
“He just doesn’t quit, and never stops at ‘no,’ ” she said. “He gets people excited.”
Martin added that Scarpone-Lambert has a well-developed social conscience and will donate lights to health care facilities in Uganda, where the electricity is unreliable. “This light will impact how I will practice nursing,” she said.
Aside from its practical uses, the light is a symbol of sorts to nurses, said Rebecca Love, president of the Society of Nurse Scientists, Innovators, Entrepreneurs and Leaders, a Boston nonprofit working to elevate nurses into the forefront of health care innovation.
“In hospitals, nurses are meant to sit at the bedside and are not acknowledged for the expertise they have with improving patient lives,” Love said. “We are disempowered as a profession. But stories like Anthony’s focus on entrepreneurship and creating something that makes a difference.
“It has everything to do with his drive, character and passion. And Anthony operates at a different speed, thinking six steps ahead. He is one of the individuals with the potential to be a moonshot in the nursing profession, and I don’t say that lightly.”
What also helps Scarpone-Lambert, his admirers say, is his background in big-time theater. As a child, he was in two Broadway plays: The Miracle Worker and Mary Poppins. “That helps him tell the story of his business,” said Penn Nursing’s Leary. “He’s just so comfortable pitching ideas, more than a lot of nursing students are.”
As he looks toward graduation in May, Scarpone-Lambert credits his first-generation student status as a help in getting through the grind of creating a start-up, not to mention the heavy load of Penn studies.
“Being first-generation provides you with a kind of grittiness,” he said. “It’s knowing how to work hard, and it’ll help be a better entrepreneur.
“First-gen students are very resourceful.”
Here are some things Alan Kim likes: Harry Potter. The song “Blinding Lights” by the Weeknd. Legos. Vanilla ice cream with chocolate syrup and rainbow sprinkles.
Acting? Yeah, he likes it. But he’s just as into playing video games or watching TV and going outside with his dog, an American Eskimo named Cream.
Alan is 9, so you can forgive him for not knowing if this whole Hollywood thing is for him yet. At the moment, however, he’s getting a lot of attention because he is one of the stars of the new movie “Minari,” an award-winning drama about a family of South Korean immigrants trying to build a life for themselves on a farm in rural Arkansas in the 1980s.
The movie, playing in theaters where open and on a special digital platform from distributor A24, features actors who are far more recognizable than Alan: The family’s patriarch is played by “The Walking Dead’s” Steven Yeun, and Yuh-Jung Youn — who is kind of like Korea’s Meryl Streep — co-stars as the grandmother.
But it is Alan who has emerged as “Minari’s” breakout star. When the movie debuted at the Sundance Film Festival in early 2020, he turned up at every screening or interview dressed like a cowboy: Western hat, bandanna, boots and a sheriff ’s badge pinned on his suede vest.
“I had the cowboy boots from the movie,” Alan said, “and my mom was like, ‘Come on, wear this!’ ”
In his promotional appearances for “Minari,” Alan has continued to show off his panache even over
Zoom, rotating through a collection of dapper miniature blazers and starched shirts. For this interview from his family’s home in Irvine, California, he is wearing a pastel bow tie and collared shirt embroidered with seagulls and boats. While he may not be used to speaking about himself yet, he is comfortable on video chat. He’s in the third grade but has been doing virtual school since March 2020.
On Instagram, he has “like, maybe 2,000 followers?” — but his parents run his account because “I don’t think I’m responsible enough with it.”
Perhaps it was the adoration he was greeted with in Park City last year, but Alan seemed to have an idea that those numbers might be going up soon. Asked if he expects he’ll be famous post-“Minari,” he answered enthusiastically and without haste: “Yes.”
And how will his life change?
“I will have to stay inside all the time,” he said. Or, if outside: “I would have to wear a hoodie and full disguise!”
In “Minari,” Alan plays Daniel, a boy whose desire to run free through the Arkansas wilderness surrounding his family’s new trailer is restrained due to a heart murmur. He is forced to share his bedroom with his grandmother, newly arrived from Korea, who makes him try traditional herbal remedies he thinks taste revolting. Director Lee Isaac Chung needed a boy for the part who could pull off being both adorable and a hellion — “a kid who pees in his grandma’s tea and still somehow doesn’t come across terribly,” he said.
So with just six weeks, casting director Julia Kim set out to find the perfect kid. She needed a child
who was fluent in both English and Korean, and, of course, one who physically resembled the actors who’d already been hired to play his parents (Steven Yeun and Yeri Han).
“As you can imagine, that’s not a long database,” said Kim. Knowing she’d be unable to rely solely on young actors with talent representation, she drew upon her connections within LA’s Korean American community. In Koreatown, Kim visited churches and after-school programs, asking administrators for permission to quietly observe from a distance.
To broaden the scope of her search, Kim decided to visit the office of a local Korean newspaper. The next day, the daily publication ran a notice about the “Minari” casting call that included a photograph of Youn, 73, an actor who is revered in South Korea.
A couple of weeks later, emails started trickling in — one from Alan’s representative at a boutique agency. He’d never acted before, something his audition tape made obvious. In it, Alan’s actions were exaggerated; when he pretended to take a bad-tasting medicine, he scowled and yelled in an over-the-top fashion.
“But I still kept watching his tape because I found him so funny,” said Chung, the director. “I was kind of worried about whether or not he could take direction, and needed to see if he could do things in a more natural way instead of a stage way. And he does. There’s such an honesty to what he’s doing.”
Alan’s mother, Vicky, was on set for the entire 25-day shoot, fanning her son when temperatures soared above 90 degrees and keeping his juice box collection well stocked.
Vicky used hand motions to help Alan remember his lines and reminded him not to rush, “because if the words came too fast, the scene would have to be done again,” he said she told him.
But because Alan’s mother was more comfortable speaking Korean, the film’s second assistant director, Steve Hannan, became another vital on-set Alan-whisperer. Hannan — who has a son around Alan’s age — noticed early on that the young actor was becoming “a little kinetic” between takes during his six-hour days.
“So I took it upon myself to keep him positive about the whole experience,” Hannan said. “I’m a big guy, so I would put him up on my shoulder or let him crawl on my back. But I tried to talk to him like a professional, pointing out things about set etiquette.”
Which isn’t to say that the then-7-year-old got special treatment. Because of his experience working in print advertisements, he knew that being on a set meant “he had to be serious,” Chung said.
“And we had to keep that atmosphere going for him to respect him as a professional,” the director said. “After a couple of days, we set the rule that no one baby talks to him or overly celebrates when he does a great take or something. Treat him like a pro, and he’s going to act like a pro.”
In June, Alan will start filming his second movie, a dark comedy called “Latchkey Kids.”
“The choices he makes now are really important,” said Kim, the casting director. “… If you have a kid like Macaulay Culkin, you keep sending them in for the same thing, and it gets stale after a while. It’s about surprising the audience and letting him stretch his wings as an actor. Alan was the perfect fit for this film, but he also has the chops to have longevity.”
Aries (March 21-April 19):
Good news may come to you on the professional front today, rewarding all that you’ve been working toward. Perhaps your boss has finally filled a position that will lighten your load, or you might take the next step in growing your own business.
Taurus (April 20-May 20):
A new sense of lightheartedness is beginning to wash over you as an old fear that was holding you back is being left behind. You’ll hardly even notice that it’s gone. If an opportunity to conquer your fear of failure or embarrassment arises, allow yourself to simply have fun.
Gemini (May 21-June 20):
Emotional energy is charged throughout the day, asking you to be honest about how others make you feel. Acknowledge your feelings, and feel them out without trying to rationalize them. Your emotions are there to guide you, and when you’re in tune with yourself, you make better choices.
Cancer (June 21-July 22):
The biggest tasks of the day seem daunting, but your loved ones are charging you up with enough confidence to take on the world. With everyone around you letting you know you can handle it, you have what you need to conquer your day with gusto.
Leo (July 23-Aug. 22): By showing initiative, you will open doors for yourself that were formerly closed, bringing you to your spot at the table with the people you admire. Your actions now can change the minds of people who may have dismissed you before and impress them.
Virgo (Aug. 23-Sept. 22):
Everything is moving quickly, and you’ll need to keep up if you’re going to succeed. Luckily, you now have the speed and focus to finish your to-do list in half the time and the mental prowess to absorb information that was difficult to process before. Be careful not to rush through things just because you can.
Libra (Sept. 23-Oct. 22):
The past is seeping into the present, and your feelings are coming to the surface, but someone or something may be hindering your opportunity for vulnerability. It’s OK to keep your feelings to yourself, but remember that this is a day to power through fearfulness with authenticity.
Scorpio (Oct. 23-Nov. 21):
Compromise will be needed in order to keep your relationships running smoothly today. You’re communicating with a sense of urgency and fixation, and there’s the danger that you will drive people away with your impulsiveness. Obsessing over your relationships will cause you to waste the day.
Sagittarius (Nov. 22-Dec. 21):
Your recent accomplishments are in the spotlight within your social circle today. The people that you know and love will be happy for you. If you haven’t put in much effort, then you might see a spark in growth, but if you’ve been committed, you’ll see a huge boost in support.
Capricorn (Dec. 22-Jan. 19):
People want to connect with you, and the wisdom that they have to share will be invaluable. A new way of thinking will help you to separate your self-image from difficult experiences in your past, breaking down the walls you have put up around your heart.
Aquarius (Jan. 20-Feb. 18): You’ve been consumed lately with the present moment and your career, but now it’s time to take a break from this intense productivity. Reaching out to a family member or a friend who you haven’t seen in a while will have you reminiscing about places you used to know.
Pisces (Feb. 19-March 20): The speed is picking up in your life. You’re in a phase of connecting with new friends and talking about everything, which opens doors of opportunity and creates new interests. You are communicating with intensity now, so avoid being cruel. Life will go smoothly if you’re willing to follow its natural flow.