I'm sure I'm not the only CPPSer that has this? Apparently almost everyone does it at least a little, but for me it came on strong last month, concurrent w/ intensified depression, after half a year of pelvic pain. I have started antidepressants, which may soon dampen the grinding, I read. Anyway, symptoms (some of which you might not expect as relevant) are here:
http://www.austindental.com/more/bruxism.shtml
I think you're supposed to eventually get a real, custom acrylic bitepiece thing, but as a stopgap you can get a hot-formable sportsman's mouthguard and use that. Apparently you heat this thing up in water and impress your bite into it while its hot and soft (i havent gotten it yet, as you can tell). [edit: it appears that these pieces protect your teeth but do not stop the bruxing, which can mess up a lot more than your teeth. see below]
teeth grinding and/or clenching (bruxism)
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hodologica
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teeth grinding and/or clenching (bruxism)
Last edited by hodologica on Mon Jun 07, 2004 1:19 am, edited 1 time in total.
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Richard.N
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I had noticeable bruxism once from work stress (way before CPPS). A gum shield helped me.
Richard
Age: 39. | Onset Age: 30. Onset Date: January 2002. Symptoms (back then): Supra-pubic pain, back pain, urinary frequency, urgency and difficulty, weak stream, nocturia, (and variously) chronic fatigue, IBS. Current symptoms: more frequent than normal, but pretty much under control. Current amelioration: Xatral 10mg, Mirtazapine 30mg. | Worsened By: Stress, binge drinking, strained bowel movements, bloating, sitting on hard surfaces, jogging, and regularly - THE WINTER!
I'm not a medical expert. My comment is opinion. See your medical professional.
Age: 39. | Onset Age: 30. Onset Date: January 2002. Symptoms (back then): Supra-pubic pain, back pain, urinary frequency, urgency and difficulty, weak stream, nocturia, (and variously) chronic fatigue, IBS. Current symptoms: more frequent than normal, but pretty much under control. Current amelioration: Xatral 10mg, Mirtazapine 30mg. | Worsened By: Stress, binge drinking, strained bowel movements, bloating, sitting on hard surfaces, jogging, and regularly - THE WINTER!
I'm not a medical expert. My comment is opinion. See your medical professional.
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darwin
always done that
I think I've always grinded my teeth in my sleep. 13 years ago, when I was 17, I got a retainer when I got my braces off. I've been wearing it at night ever since. Not so my teeth don't move, but so I don't grind them. It seems to make me sleep better and I can't physically grind my teeth with it in, since it blocks those teeth from making contact.
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Richard.N
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Good point Ddream. What antidepressants are you on hodologica?Some antidepressants can cause bruxism
Richard
Age: 39. | Onset Age: 30. Onset Date: January 2002. Symptoms (back then): Supra-pubic pain, back pain, urinary frequency, urgency and difficulty, weak stream, nocturia, (and variously) chronic fatigue, IBS. Current symptoms: more frequent than normal, but pretty much under control. Current amelioration: Xatral 10mg, Mirtazapine 30mg. | Worsened By: Stress, binge drinking, strained bowel movements, bloating, sitting on hard surfaces, jogging, and regularly - THE WINTER!
I'm not a medical expert. My comment is opinion. See your medical professional.
Age: 39. | Onset Age: 30. Onset Date: January 2002. Symptoms (back then): Supra-pubic pain, back pain, urinary frequency, urgency and difficulty, weak stream, nocturia, (and variously) chronic fatigue, IBS. Current symptoms: more frequent than normal, but pretty much under control. Current amelioration: Xatral 10mg, Mirtazapine 30mg. | Worsened By: Stress, binge drinking, strained bowel movements, bloating, sitting on hard surfaces, jogging, and regularly - THE WINTER!
I'm not a medical expert. My comment is opinion. See your medical professional.
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hodologica
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My short-term bruxing symptoms (strong localised gum irritation, slightly sore jaw muslces) were worse before starting the hed meds.
The meds are non-prescription (in US): L-tyrosine, 5-HTP, DLPA, and SAMe. They're really great so far (~4 days) - and I have high hopes for their possible impact on my physical pain, since in combination they approximate the dual serotonergic/noradrenergic modulation of SNRIs like milnacipran, which has tested so well (relatively) for FMS sufferers. Also, DLPA takes out its frustrations on the enzymes that metabolize endorphins. And of course it is easier not to clench the PF when youre glad to be alive.
Anyway, I'll be posting about them extensively after a couple weeks' observation is complete.
The meds are non-prescription (in US): L-tyrosine, 5-HTP, DLPA, and SAMe. They're really great so far (~4 days) - and I have high hopes for their possible impact on my physical pain, since in combination they approximate the dual serotonergic/noradrenergic modulation of SNRIs like milnacipran, which has tested so well (relatively) for FMS sufferers. Also, DLPA takes out its frustrations on the enzymes that metabolize endorphins. And of course it is easier not to clench the PF when youre glad to be alive.
Anyway, I'll be posting about them extensively after a couple weeks' observation is complete.
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Richard.N
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And of course it is easier not to clench the PF when youre glad to be alive.
Good point!Richard
Age: 39. | Onset Age: 30. Onset Date: January 2002. Symptoms (back then): Supra-pubic pain, back pain, urinary frequency, urgency and difficulty, weak stream, nocturia, (and variously) chronic fatigue, IBS. Current symptoms: more frequent than normal, but pretty much under control. Current amelioration: Xatral 10mg, Mirtazapine 30mg. | Worsened By: Stress, binge drinking, strained bowel movements, bloating, sitting on hard surfaces, jogging, and regularly - THE WINTER!
I'm not a medical expert. My comment is opinion. See your medical professional.
Age: 39. | Onset Age: 30. Onset Date: January 2002. Symptoms (back then): Supra-pubic pain, back pain, urinary frequency, urgency and difficulty, weak stream, nocturia, (and variously) chronic fatigue, IBS. Current symptoms: more frequent than normal, but pretty much under control. Current amelioration: Xatral 10mg, Mirtazapine 30mg. | Worsened By: Stress, binge drinking, strained bowel movements, bloating, sitting on hard surfaces, jogging, and regularly - THE WINTER!
I'm not a medical expert. My comment is opinion. See your medical professional.
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hodologica
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I've had a bit of a huge breakthru... I have been on antidepressants (st johns wort now, for nearly a month) with good, but - atypically - very inconsistent results. Then I learned my fatigue, hypersomnia, "spaciness," and often extreme malaise (getting worse and worse depite the continual decrease of pelvic pain) could all be caused by bruxing in sleep, and that the mouthguard I was using was basically ONLY good for teeth protection, according to multiple sophisticated sources.
After hours of inconclusive research into the known methods of nocturnal bruxism control, I went home and went to sleep with my forefinger duct-taped into my mouth. Six hours later I woke up feeling better than I had felt in a couple months. It no longer takes me an hour to get out of bed after waking up from 9 hours' sleep. My remaining chronic prostatitis / chronic pelvic pain syndrome manifestations, consisting mainly of marked muscle and joint pain and stiffness from high thigh to low back, are minimized (~10% of what they were two days ago). Very minor TMJ symptoms I had lately developed (rumbliness and clickiness of the jaw joints) are declining sharply.
Overbruxing in sleep (apparently everyone bruxes a little at least once a month or so) is a "muscular parafunction" - just as most chronic prostatitis / chronic pelvic pain syndrome is, in the opinion of many leading minds. Apparently Wise has called chronic prostatitis / chronic pelvic pain syndrome a TMJ of the pelvis (TMJ refers to the terrible jaw pain/dysfunction that can be caused by bruxing or trauma). Tho negative evidence seems to suggest otherwise, it would not be too surprising if CPPSers had a relatively high rate of problematic bruxism.
This is something CPPSers should really think about in my opinion, especially if they suffer fatigue or headache (incl migrane). Other possible symptoms include jawache, face-ache, jaw-clicking, depression, dizziness, "spaciness," anxiety, dissociation, tooth pain, gum pain, gum recession, etc. Unfortunately I am no expert on it and I think there are other possible symptoms. The mental and systemic symptoms are not as common for bruxers and not as strongly indicative of bruxism. The jaw/head/mouth symptoms including frequent headache are strongly indicative. You would not necessarily know you were bruxing even if it were causing you health problems. Some bruxers clench without grinding, so they make no noise that can be noticed by bedmates. Many people can't believe they are sleep-bruxers even when their dentists can clearly see from their teeth that theyve been doing it heavily for years.
The only antidepressants known to cause/increase bruxism are the SSRIs, according to one internet poster who was quoting her doctor... I dont recall whether that doc was a regular GP or a bruxism specialist. Regular GPs are known for not knowing much about bruxism.
After hours of inconclusive research into the known methods of nocturnal bruxism control, I went home and went to sleep with my forefinger duct-taped into my mouth. Six hours later I woke up feeling better than I had felt in a couple months. It no longer takes me an hour to get out of bed after waking up from 9 hours' sleep. My remaining chronic prostatitis / chronic pelvic pain syndrome manifestations, consisting mainly of marked muscle and joint pain and stiffness from high thigh to low back, are minimized (~10% of what they were two days ago). Very minor TMJ symptoms I had lately developed (rumbliness and clickiness of the jaw joints) are declining sharply.
Overbruxing in sleep (apparently everyone bruxes a little at least once a month or so) is a "muscular parafunction" - just as most chronic prostatitis / chronic pelvic pain syndrome is, in the opinion of many leading minds. Apparently Wise has called chronic prostatitis / chronic pelvic pain syndrome a TMJ of the pelvis (TMJ refers to the terrible jaw pain/dysfunction that can be caused by bruxing or trauma). Tho negative evidence seems to suggest otherwise, it would not be too surprising if CPPSers had a relatively high rate of problematic bruxism.
This is something CPPSers should really think about in my opinion, especially if they suffer fatigue or headache (incl migrane). Other possible symptoms include jawache, face-ache, jaw-clicking, depression, dizziness, "spaciness," anxiety, dissociation, tooth pain, gum pain, gum recession, etc. Unfortunately I am no expert on it and I think there are other possible symptoms. The mental and systemic symptoms are not as common for bruxers and not as strongly indicative of bruxism. The jaw/head/mouth symptoms including frequent headache are strongly indicative. You would not necessarily know you were bruxing even if it were causing you health problems. Some bruxers clench without grinding, so they make no noise that can be noticed by bedmates. Many people can't believe they are sleep-bruxers even when their dentists can clearly see from their teeth that theyve been doing it heavily for years.
The only antidepressants known to cause/increase bruxism are the SSRIs, according to one internet poster who was quoting her doctor... I dont recall whether that doc was a regular GP or a bruxism specialist. Regular GPs are known for not knowing much about bruxism.
Last edited by hodologica on Mon Jun 07, 2004 12:40 am, edited 2 times in total.
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hodologica
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Whoops, forgot to add that I have no idea what may be the consequences of sleeping with your finger in your mouth. That is not medical advice. It is well known that perseveration of thumb-sucking in children older than ~5 (usually the result of overzealous attempts to correct that very behavior) can cause dental malformation.
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Richard.N
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That's a really interesting point. My fatigue/headache stopped when I started Elavil, and then switched to Mirtazipine - which would fit with the analogy, as both drugs can improve sleep. I would never have implicated bruxism. It's something to ponder, so thanks for pointing it outThis is something CPPSers should really think about in my opinion, especially if they suffer fatigue, headache, jawache, face-ache, jaw-clicking, depression, dizziness, "spaciness," anxiety, dissociation, tooth pain, gum pain, gum recession, etc. You would not necessarily know you were bruxing even if it were causing you health problems
Incidentally, isn't St. John's Wort a natural SSRI? It made me anxious when I tried it - similar, but not as bad as I felt on SSRIs.
Richard
Age: 39. | Onset Age: 30. Onset Date: January 2002. Symptoms (back then): Supra-pubic pain, back pain, urinary frequency, urgency and difficulty, weak stream, nocturia, (and variously) chronic fatigue, IBS. Current symptoms: more frequent than normal, but pretty much under control. Current amelioration: Xatral 10mg, Mirtazapine 30mg. | Worsened By: Stress, binge drinking, strained bowel movements, bloating, sitting on hard surfaces, jogging, and regularly - THE WINTER!
I'm not a medical expert. My comment is opinion. See your medical professional.
Age: 39. | Onset Age: 30. Onset Date: January 2002. Symptoms (back then): Supra-pubic pain, back pain, urinary frequency, urgency and difficulty, weak stream, nocturia, (and variously) chronic fatigue, IBS. Current symptoms: more frequent than normal, but pretty much under control. Current amelioration: Xatral 10mg, Mirtazapine 30mg. | Worsened By: Stress, binge drinking, strained bowel movements, bloating, sitting on hard surfaces, jogging, and regularly - THE WINTER!
I'm not a medical expert. My comment is opinion. See your medical professional.
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hodologica
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Latest research indicates that the wort modulates all three monoamine transmitters - dopamine and noradrenaline (=norepinepherine) as well as serotonin, tho it appears to have other activity as well.* In fact it modulates all three monoamines roughly equally. This fact tallies with its excellent side-effect profile vs SSRIs, which is well-established clinically (your report of anxiety is not unheard of, but rare). I think SSRIs may be a bit stronger though, though that is hard to demonstrate (empirical clinical measurement of antidepressant activity is rather difficult for a number of reasons, and not rarely a trial will fail to show the superiority of SJW or a leading SSRI to placebo).
* eg, and particularly relevant to CPP, "St. John's wort also had antinociceptive effects in mice similar to those seen with tricyclic antidepressants." (web page of the Tang Center for Herbal Medicine Research, University of Chicago, which, non-Americans might not know, is one of our best universities.) Actually, now that I think about it, that effect may or may not be totally seperate from the monoamine modulation, but there are other examples, see http://www.biopsychiatry.com/stjohnrev.html
* eg, and particularly relevant to CPP, "St. John's wort also had antinociceptive effects in mice similar to those seen with tricyclic antidepressants." (web page of the Tang Center for Herbal Medicine Research, University of Chicago, which, non-Americans might not know, is one of our best universities.) Actually, now that I think about it, that effect may or may not be totally seperate from the monoamine modulation, but there are other examples, see http://www.biopsychiatry.com/stjohnrev.html
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hodologica
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Yeah I didn't either, during looong weeks of suffering... I had this continual low-grade, non-throbbing, light-sensitive, concentration-disrupting headache which I did not identify as a headache. It just felt like total malaise. I thought it was my mild depression becoming really clinical... until I noticed it was substantially relieved by aspirin. That pointed to my bruxism, and then I hypothesized my fatigue and somnolence could come from sleep attenuation due to bruxism, and was able to verify that fatigue and spaciness were indeed reported symptoms.I would never have implicated bruxism. It's something to ponder
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Ddream
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hodologica
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No, I can't tolerate it anymore, it hurts my arm muscles after 2 hours. Looking into other control means is a pain... bruxism is possibly worse-understood than CPP and there are zero adequate clinical trials on any of the worthwhile therapies. Also there sure aint no cpp.us or cp.com of bruxing, not by a longshot, which reminds me of my gratitude to Mark and everyone here.
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hodologica
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It turns out my fatigue may not have been caused by bruxism (i have recently been treated for another sleep disturbance). My headaches, photophobia, etc, are another story, they are definitely from bruxing.
I have located one other case of TMJ amongst CPPS/PM sufferers: see
viewtopic.php?t=610 ...TMJ is usually (almost always?) a product of bruxing.
BRUXISM TREATMENTS are as follows:
Hard or soft full-bite-coverage splints/mouthpieces seem to be worthless in most cases, aside from protecting the teeth from wear.
the NTI-tss (or just NTI) is a custom-fit piece of plastic which snaps onto your incisors, preventing any teeth but the incisors from contancting directly or indirectly. The incisors are not able to gnash nearly as hard as the canines or molars. This device costs ~150-700 USD (average = 350) and was developed around '99 by one Dr James Boyd, a sufferer himself, who appears to be a very well-intentioned person (has painstakingly answered individual queries online). One dentist on a forum claimed ~80% success with the device, and it is very well regaurded by all the dentists on the usenet group sci.med.dentistry. Risks are low, include development of "open bite." I have been using this for ~12 days and am pretty pleased with the results so far. http://www.nti-tss.com/
Sleep biofeedback. Alarms that wake you when you brux, thus teaching you not to. Two units are for sale, both ~200 USD with 30-day money-back guaruntee, the OralSensor (mouthpiece) and the GrindAlert (headband EMG). Little info online besides testimonials from the maker of GrindAlert. However, I have gleaned that Dr Boyd vouches for the intentions of the maker of OralSensor, and I learned a few design details about it that I liked, so I'll be acquiring the latter if the NTI doesnt work out.
Magnesium. See http://www.is.wayne.edu/mnissani/bruxnet/ploctran.htm
A word on one very interesting website, http://www.is.wayne.edu/mnissani/bruxnet/advice.htm ...Essential but IMO very misleading reading. The author's pessimism about NTI and biofeedback is, to the best of my current discernment, a disservice. Frankly, the vigorous disclaimer found in the 4th paragraph of the page is warranted, but in poor harmony with the fact that the page basically reproduces the contents of a published journal article by same author (see http://www.oc-j.com/june00/Splint1.htm ). Finally, while the author's taste-based biofeedback approach to bruxism is ingenious, his/her degree of enthusiasm for it as a therapy, after testing on but a single patient, is quite excessive.
I have located one other case of TMJ amongst CPPS/PM sufferers: see
viewtopic.php?t=610 ...TMJ is usually (almost always?) a product of bruxing.
BRUXISM TREATMENTS are as follows:
Hard or soft full-bite-coverage splints/mouthpieces seem to be worthless in most cases, aside from protecting the teeth from wear.
the NTI-tss (or just NTI) is a custom-fit piece of plastic which snaps onto your incisors, preventing any teeth but the incisors from contancting directly or indirectly. The incisors are not able to gnash nearly as hard as the canines or molars. This device costs ~150-700 USD (average = 350) and was developed around '99 by one Dr James Boyd, a sufferer himself, who appears to be a very well-intentioned person (has painstakingly answered individual queries online). One dentist on a forum claimed ~80% success with the device, and it is very well regaurded by all the dentists on the usenet group sci.med.dentistry. Risks are low, include development of "open bite." I have been using this for ~12 days and am pretty pleased with the results so far. http://www.nti-tss.com/
Sleep biofeedback. Alarms that wake you when you brux, thus teaching you not to. Two units are for sale, both ~200 USD with 30-day money-back guaruntee, the OralSensor (mouthpiece) and the GrindAlert (headband EMG). Little info online besides testimonials from the maker of GrindAlert. However, I have gleaned that Dr Boyd vouches for the intentions of the maker of OralSensor, and I learned a few design details about it that I liked, so I'll be acquiring the latter if the NTI doesnt work out.
Magnesium. See http://www.is.wayne.edu/mnissani/bruxnet/ploctran.htm
A word on one very interesting website, http://www.is.wayne.edu/mnissani/bruxnet/advice.htm ...Essential but IMO very misleading reading. The author's pessimism about NTI and biofeedback is, to the best of my current discernment, a disservice. Frankly, the vigorous disclaimer found in the 4th paragraph of the page is warranted, but in poor harmony with the fact that the page basically reproduces the contents of a published journal article by same author (see http://www.oc-j.com/june00/Splint1.htm ). Finally, while the author's taste-based biofeedback approach to bruxism is ingenious, his/her degree of enthusiasm for it as a therapy, after testing on but a single patient, is quite excessive.
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