If you regularly wake up with a headache, neck ache or back ache you might blame an uncomfortable bed - but perhaps your teeth are the real problem.
Sarah Jessica Parker says she found the experience of making the Sex and the City film so stressful that she had to wear a mouth guard at night to prevent her from grinding her teeth. Indeed, clenching and grinding is a very common problem that can have a variety of symptoms, most of which you would never associate with your mouth.
“I estimate that around 50 percent of people clench their jaws at some time during the day or night, and a quarter of women grind their teeth while they sleep,” says Dr. Justin Glaister, a leading specialist in neuromuscular and cosmetic dentistry.
Crunch time
Left untreated, nocturnal teeth grinding (technically known as sleep bruxism) can damage your pearly whites and surrounding tissue, and trigger headaches and jaw pain. The trouble is, because they are asleep when it happens, sufferers often have no idea that they are doing it.
“Most people are unaware of the problem until they are diagnosed by their dentist, but there are some common 
symptoms to look out for,” says Justin. These usual warning signs include:
• Headaches, typically in the temples.
• Neck and shoulder pain.
• A clicking and aching jaw.
• Ringing in your ears or reduced hearing levels.
• Tingling in your fingers.
• Dental pain, including pressure pain on eating and sensitivity to hot and cold food and drink.
• Shortened or damaged teeth.
• Over time, the problem can also cause raised veins in the temples and enlarged jaw muscles.
Sarah Jessica Parker blamed work worries for her bruxism, but stress isn’t always solely the cause. Research has shown that alcohol, caffeine and smoking can all exacerbate the problem, and one school of thought is that malocclusion - a misalignment of the upper and lower teeth - is another culprit.
“A healthy, well-balanced set of teeth can endure great pressure, but it’s shared equally among 28 teeth,” explains Los Angeles-based cosmetic surgeon Alexander Rivkin, who specializes in treating bruxism with injections of Botox. “Now just imagine if one tooth is slightly higher that the others, then all of that load hits just one tooth. Your jaw or temporomandibular joint muscles try to compensate by shifting to avoid that pressure. This, in turn, sets up a cycle of clenching and grinding at night as the muscles never stop working to 
prevent pain and damage.”
Just relax
His preferred treatment method – Botox - involves a series of injections that require topping up every four to six months. “The Botox weakens the muscles that clench in the jaw. The effect is incredible, easing pain and grinding within a few days,” the American doctor claims. “For the first time people wake refreshed and pain free in the morning. And in the long term you save your teeth from literally being eaten away.”
While Botox is rarely offered for the management of bruxism, some persistent sufferers have found relief through acupuncture, but wearing a custom-made guard for your teeth at night - as Sarah Jessica Parker does - is the approach usually recommended by dentists.
“If you have any of the symptoms of bruxism, book an appointment with your dentist, who will be able to look at your teeth and see if you are literally grinding them away,” advises Justin. “They can then try to correct the bite by very lightly taking down the surface of a tooth or teeth, and perhaps building up others.
“They can also make a simple mouth guard that stops the teeth meeting and can be worn at night. This will prevent you from grinding or clenching your teeth, and could end the symptoms once and for all.”
