Managing the Side Effects of SSRI Teeth Grinding

The rate of global SSRI antidepressant use was already on the rise before the pandemic, but since COVID, statistics show a 64% rise over previous prescription levels. Many of these patients are between the ages of 12 and 25.

Side effects can come with the use of antidepressants, but one of the conditions unexpectedly linked to SSRIs is teeth grinding.

What is SSRI teeth grinding, and what can you do to stop it before it causes too much damage to your body?

What Are SSRIs?

Selective serotonin reuptake inhibitors (SSRIs) refer to a specific class of drugs that block the neurotransmitter serotonin from being reabsorbed into the brain’s neurons.

By inhibiting this reabsorption, the serotonin levels increase and are freed up to continue sending messages from one nerve cell to another. These meds are a first-line treatment for those with Parkinson’s disease and can be effectively used to manage symptoms of anxiety and obsessive-compulsive disorder (OCD).

This regulation is crucial since serotonin affects a person’s mood, emotions, and even sleep cycle. Low serotonin levels lead to depression and anxiety, while high levels can aid in receptiveness of treatment for these mental health issues.

SSRIs, usually given in tablet form, come in various chemical structures. The design of each medication determines how strong or effective it is and how fast it’s metabolized in and eliminated from the body.

If one SSRI med doesn’t work, switching to another can help. However, they all have similar side effects, like bruxism.

The Link Between SSRIs and Bruxism

When you’re prescribed an SSRI, it’s usually after you’ve tried other treatments and they haven’t worked. However, like many medications, these drugs often come with side effects like teeth grinding.

Since these studies show that bruxing resolves within three to four weeks of stopping the drug use, the teeth grinding and jaw clenching are clearly linked to the medication. Not all SSRIs are the primary offenders, though — sertraline, venlafaxine, and fluoxetine tend to be most often connected to bruxing symptoms.

Throughout their research, scholars have seen SSRI-related bruxism in pediatric and adult cases, although this side effect is most common in females. Symptoms appear with short and long-term use of the medication.

What Are the Symptoms of SSRI Bruxism?

Sleep and awake bruxism can happen to anyone, regardless of age or gender. Sleep bruxism is more predominant and is most common in children.

This condition is characterized by the behaviors of chronic, repetitive teeth grinding and clenched jaws. But when the bruxer is taking SSRI medications and didn’t have the grinding issues before they started the meds, the diagnosis is SSRI-related teeth grinding.

Many people with bruxism also have co-conditions such as TMD (temporomandibular joint disorders) or OSA (obstructive sleep apnea). Both of these health issues can add extra strain on the jaw muscles, causing dysfunction in the facial area and worsening the symptoms of bruxism.

Signs You’re Bruxing in Your Sleep

So, how do you know if your prescription medication is causing you to grind your teeth?

Regardless of the reason for bruxing, there are some typical signs that your jaw is working overtime without your permission while sleeping. The increased muscle activity isn’t confined to your mouth, though. The results become widespread throughout your muscular system.

First, let’s look at what happens to your body when you brux. Your brain sends a signal to your jaw muscles to tighten and move. This clenched position connects your upper and lower teeth until they touch.

The jaw movement rubs the enamel laterally (side to side) across the surfaces of the teeth, wearing away at the hard substance that protects the delicate tissues inside each tooth.

This behavior has a two-fold consequence:

• You begin to develop tooth and gum damage.
• The tissues connected to the jaw muscles start to tighten from overwork, causing neck and shoulder pain, headaches, and other complications.

Warning Signs of SSRI-Bruxism

If you think your SSRI prescription could be causing the unexpected side effect of bruxism, take a few days and monitor your physical and mental condition. If you’re bruxing in your sleep, you’ll likely notice at least a few of the following warning signs:

• Morning headaches, possibly turning into migraines
• Facial pain
• Jaw pain
• Teeth sensitivity
• Chipped, cracked, or broken enamel
• Ongoing fatigue, as though you can’t get enough sleep
• Trismus (Read: Is Anxiety Causing Your Teeth to Chatter? Bruxism Could Be the Cause)

Pay attention to the symptoms you didn’t have before you started taking your new SSRI medication. Keep a list of these signs, and look for patterns. This record will be helpful when you talk to your doctor about whether the medication works for you.

How Can You Manage the Effects of SSRI Bruxism At Home?

The main reason people brux is stress. Since your medication was likely prescribed for a mental health condition that could have stress linked to it, this connection could increase your risk of bruxing.

The dilemma becomes a question of how to manage the effects of SSRI-associated bruxism without stopping the medication you need.

Minimizing the Damage from Bruxism 

While your bruxism behaviors won’t stop until you address the cause (likely the medication), there are various steps you can take at home to minimize the harm to your body:

• Wear a custom night guard to keep your upper and lower teeth from touching. This will prevent the grinding that forces your jaw muscles to work overtime and give them a chance to relax. (Read This Before You Buy a Night Guard Online)
• Practice stress-relieving techniques throughout the day, such as yoga, meditation, walking in nature, and gentle exercise. These activities not only lower your blood pressure and heart rate, but they release the extra hormones that can cause bruxing and increase happy hormones like dopamine.
• Create a soothing bedtime environment and routine that teaches your body it’s time to relax. Avoid screen time at least an hour before you want to sleep. Install soft lighting in the bedroom and play restful sounds in the background.
• Try natural supplements, such as melatonin and chamomile tea. However, since you’re on medication, talk to your doctor before adding any supplements to your routine.

These small changes to your daily habits can make impactful, effective differences in your bruxing behaviors. Please note that if you have TMJ or OSA, your doctor may recommend different oral stabilization splints appropriate for your specific motor activity, like a TMJ or OSA splint or a CPAP machine.

What Kind of Professional Care is There for SSRI Bruxing?

When a medication is prescribed that helps you manage a very crucial condition, it’s often disheartening to have side effects that make other parts of your life worse.

But SSRI bruxing doesn’t have to mean choosing between a helpful medication and constant pain and tiredness.

Working with your medical doctor and other specialists, it’s possible to develop a treatment plan that maximizes the results of your medication while minimizing the effects of bruxism.

Reducing Bruxism Behaviors 

Your physician may suggest prescription muscle relaxants, which prohibit the brain from sending signals to the jaw muscle receptors. These inhibitors keep the muscles from clenching, stopping bruxism at its root.

Some experts claim that adding buspirone to your bedtime routine can reduce bruxing behaviors and the damage from other sleep movement disorders in as little as one or two days.

Other, non-medicinal options are available, as well. Because bruxism is often caused by stress, cognitive behavioral therapy and other similar psychiatry assistance are frequently effective. Through therapy, you learn how to manage your internal and external irritants better, reducing the stress hormones like cortisol and adrenaline that lead to sleep disorders like bruxism.

Fixing the Damage from Bruxism

Sometimes, it’s too late to prevent the damage of grinding. When that happens, it’s time to visit the dentist.

Professional dental care for your bruxism-induced enamel problems depends on the severity of the damage. Cracks, chips, and breaks may need composite binding, a veneer, or a dental crown. More serious issues could require a root canal or a dental implant.

When your grinding has caused the TMJ (the sensitive joint that connects your mandible to your skull) to become inflamed or displaced, a TMJ specialist is necessary. Over 30 different varieties of TMJ disorders exist, and the specialist can determine which kind is causing your pain and provide a treatment plan to care for your needs.

Changing Medication

Maybe you don’t want to deal with bruxing at all, and you’re not 100% sold on the SSRI meds. Or perhaps none of the tweaks you’ve implemented are working, and you’re ready for a change. The good news is that we have many kinds of antidepressant medications available today, and plenty that are not known to trigger nocturnal bruxism.

Note that SSRIs (selective serotonin reuptake inhibitors) are not the same as SNRIs (serotonin and norepinephrine reuptake inhibitors). These categories refer to antidepressants that treat depression and anxiety disorders by targeting neurotransmitters (serotonergic).

However, SSRIs increase serotonin levels, and SNRIs increase serotonin and norepinephrine levels. This difference is crucial if you need to adjust your medication to prevent bruxism.

Changing medications, especially when they’re vital to your health, should always be done under the care of a trained, licensed specialist in a clinical practice. Never stop meds or change your dosage without the advice of your doctor, as side effects may occur. Discontinuation of antipsychotics or mood stabilizers like Prozac, Effexor, or Escitalopram can be dangerous.

Conclusion

Managing the side effects of SSRI-induced bruxism doesn’t have to be complicated. Your behaviors could be helped with something as simple as a custom mouth guard, or, if your grinding is more serious and doesn’t go away with at-home care, you may need an overhaul of your medication.

No matter how mild or severe your bruxing is, talk to your healthcare provider and let them know that you’ve developed a case of teeth grinding since you started your SSRI meds. They must know of any adverse effects to monitor and adjust your treatment plan correctly.

If part of your care involves using a custom-made night guard to prevent enamel and muscle damage from grinding, JS Dental Lab has you covered. Our professional-grade, high-quality oral appliances are designed to fit comfortably in your mouth so you can get the rest you deserve while your medication does its job without the bruxing side effects!