February 15, 2010
Although he didn't know it at the time, the Walnut Creek, Calif., comedian began grinding his teeth at night during the dot-com bust of 2000, when his Silicon Valley gigs disappeared and he was down $12,000. That's when the horrendous morning headaches started, he says.
A year later, the terrorist attacks of Sept. 11 cost him $6,000 more in jobs. At a routine appointment, his dentist took one look inside Barkley's mouth and knew the culprit of the headaches. "He said, 'You're grinding your teeth like crazy,' " recalls Barkley, 57.
But the ultimate "nail in the coffin" came three years ago, when Barkley lost a $65,000 contract gig. His bruxism, or teeth grinding, became so severe that he broke two molars, had one extracted, and, without health insurance, was out thousands of dollars in medical bills.
While some wear and tear is natural - children grind their teeth at night when they're losing baby teeth - prolonged grinding or clenching of the jaw can cause facial soreness, headaches, neck pain and serious damage to the gums, bones and teeth, says Steven Goldman, a Walnut Creek dentist of 42 years and a professor in University of California, San Francisco's department of restorative dentistry. In less than 10 percent of patients, the teeth are ground so low that all of them must be reconstructed, he adds.
It's no surprise. The masseter - the thick muscle in the cheek that aids in chewing - is arguably the strongest in the human body, and it is estimated that teeth grinders can exert as much as 600 pounds per square inch on their back molars while they're sleeping, he adds. But, because bruxism is controlled by the central nervous system, it is of utmost importance to receive a proper diagnosis before treating temporomandibular disorders, or TMD, Goldman says. Too many patients, he believes, are overtreated or misdiagnosed.
Fixing the Underlying Problem
"It's the Clint Eastwood muscle," says Curtis Barmby, a Walnut Creek, Calif., prosthodontist, or reconstructive dentist, who works with many patients who suffer from TMD. "When people are stressed, ... the shoulders go up, the teeth come together and the head comes forward."
Before long, he says, those muscles start screaming for relief. Less frequently, bruxism can be a reaction to certain medications or an abnormal bite.
Not everyone who suffers from bruxism needs a guard, or has damaged teeth. Charlotte Johnson's jaw clenching was a side effect of an anti-anxiety medication. Johnson, of Bethel Island, Calif., was put on muscle relaxants to reduce the tension in her jaw area. Ultimately, however, a few visits to a physical therapist eliminated the deep ache.
"He taught me how to stretch out the muscle gently and apply ice for pain relief," says Johnson, 69.
Barmby and dentist Steven Goldman are big proponents of physical therapy and biofeedback. "When people come in and say, 'My spouse lost his job, we don't have insurance, please tell me a temporary fix because I'm going nuts clenching on my teeth,' I tell them to spend $85 for one visit with a good physical therapist," Goldman says.
Also, he advises people to be aware of their sleep patterns. "Someone who is not sleeping well is more likely to have an active jaw because grinding is largely a nighttime phenomenon that occurs in the shallow stages of sleep," Goldman says.
For some people, listening to one's body can be the ultimate cure. Fifteen years ago, Denise Parla of Oakley, Calif., woke up most mornings with a sore face and jaw. Parla, now 45, was diagnosed with TMD and saw a chiropractor who taught her massaging techniques. Eventually, she was pain-free.
Still, after a divorce, foreclosure and job changes, the tension - and clenching - can creep back. At the end of a stressful day, Parla is still not immune to tightening her jaw.
"But I become aware of it now," she says. "I just loosen up and try to handle my stress better."
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