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Sophie, 38 years old, was biting during the night...

Updated: Dec 8, 2020

You must have heard at least one time a friend complaining about biting during the night.

This is a very common problem touching both young, but also older people and that can be helped by the right osteopathic treatment.

First, a bit of anatomy to understand the concept:

There are 2 muscles to close the jaw articulation: the masseter and the temporal.

The natural position of the mouth is "closed" but important detail: teeth should not contact each other. The jaw is then called a "suspended" articulation (like the shoulders). You do need to tight up your shoulder to hold them, and if you do so, you will of course have tensions in your neck. This is exactly the same with the jaw. So in a way, "bruxism" or "biting" is like holding the shoulders up during several hours!

I let you imagine their state after that...

When biting there are 3 types of consequences:

- Muscular pain/tension: the masseter and temporal muscles are made to be used only when we eat. They are "short action" muscles compared to the "spine muscles" which are made for long action: holding the spine vertically during the day.

- Articular tension: when there is increased muscles tensions, the result is a compression in the joint (less mobility). A compressed articulation will need more power (from the muscles) to be able to move. This is the infernal spiral of pain: the muscles tense up, the articulation gets compressed, which leads to more tensions in the muscles.

- Referred pain: headaches, neck pain, sleeping issues.

We cannot have a good mobility of the jaw if there is not a good mobility of the first cervical vertebras. Mechanically, the jaw and the upper neck are intimately liked. Tensions in the upper neck can give headaches, pain or sleeping problems.

So how to treat a patient who is biting?

A few aspect has to be considered:

- Releasing of the different "closing action" muscles

- Stretching and decompressing the jaw environment

- Relaxation exercises before sleeping

- Movement learning

- Sensation learning (biofeedback)

- Holistic osteopathic treatment (cervical, cranial, jaw, visceral)

It is important to know: there is no miracle technique to treat bruxism! It is case by case.

Sophie's case:

It happened as I was working in Switzerland. I remember her because she did not mention bruxism at first.

Her reason for consultation were chronicled headaches and sleeping problems.

I first tried to understand how this patient was functioning. Are there any repeated micro trauma in here every day life or is there a major trauma that happened once in Sophie's life.

Sophie could not remember a precise moment when the headaches/sleeping problem came... It was more of a progressive issue that had settles over a few months. Most probably because she started a new job and was sitting a lot in front of the computer (bad postures, repeated micro traumas, stress)

Then, I started my examination first globally (entire body check up) and then more specifically to the neck, jaw and crane.

It didn't take long to figure out that here first cervical (C1) could not move so well (hypo mobility) and that her jaw was also not moving correctly. I then placed my finger on a specific fiber of the masseter muscle and she said: "wow, I have never felt it was so tense over there!"

At that moment, we figured out that her job was playing an important role in her problems.

Side story: it is only I few months later, when I treated her boyfriend that he told me remembering her biting during the night! The suspicion was confirmed: the tension is the jaw was affecting the upper cervical spine causing tension in the sub-occipital muscles. This translated into headaches and sleeping problem.

I did my osteopathic treatment by releasing the upper cervical spine and its relation with the jaw. I also taught her how to condition herself to not bite during the night and I emphasize that it was a long process to re inform the brain to not activate the "closing" muscles during the night.

Very fast (3-4 treatments) the headaches got better and after a few weeks, she could feel she was sleeping deeper and was less tired in the morning.

I showed her a few exercises to self-release her jaw and also shown her some more global exercises to reduce the action of the stress on her body.

At last, we spoke ergonomic, and how to optimize her working posture so she doesn't accumulate so many neck tensions.

She now comes and sees me once in a while when I go back to Switzerland to help her release the accumulated tensions. Indeed, she is still working at the office and has some stress. Now she has some good tools to reduce the tension, but: working means using the body and some tensions might result.

Osteopathy is also here to follow up patients and release these accumulations once in a while.

Sleeping issues and headaches:

These kind of sleeping problem is well explained. When the upper neck is tight, it means that the muscles holding the skull are over activated. These muscles are made to hold the head straight while being awake and they should release when lying down.

This tension sends to the brain a retro feedback supposing the patient is awake. Therefore, the brain has a hard time to activate the sleeping process.

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