Bruxism is the medical term for grinding of teeth (especially during sleep), which leads to pathological abrasion of the tooth enamel.

If a person does not get adequate relief from dental treatment of bruxism, it is worth considering additional treatment – psychologically as well as somatically.

With this, an efficient improvement of the condition can be achieved and at the same time further treatments of other medical specialties can be avoided.

The cognitive approach based on Rational Emotive & Cognitive Behavioral Therapy (RE&CBT) offers the most efficient, scientifically proven treatment method.

There are 3 main emotional reasons for the emergence of bruxism:

    • Depression or burnout

    • Chronic stress

    • Anxiety


In order to manage and get rid of (physical) stress-reactions, as well as to understand the other psychological causes of bruxism, it is important to recognize:

                          “It is not things themselves, but a person’s subjective view of these things that cause human suffering.”


Here an example:


The fear of lifts

It is not the elevator that causes fear, but the thought about the elevator. Usually an elevator is simply used without thinking about it. However, a patient with fear thinks about it before entering and fantasizes that he may get stuck, then starve and dehydrate or can’t go to the bathroom. Because of this thinking the patient reacts with a cramping of the chewing muscles. He gets used to it and every time an uncomfortable situation arises, he then reacts with bruxism.

The relationship between mental disorders and bruxism is mutual.
This means that both mental disorders can be the cause of bruxism and vice versa.



Stress leads to a state of mobilization of all forces in the human organism (sympathetic state aka flight-or-flight). Its goal is to defend, increase efficiency, complete tasks, prepare for a threat, but also in response to something unknown.

Physically the state of stress is expressed by:

  • digestion slows down

  • blood pressure as well as adrenaline and sugar levels rise,

  • the heartbeat accelerates,

  • increased sweating,

  • brain activity increases (BETA and GAMMA brain waves are produced),

  • the breath accelerates with emphasis on the inhalation,

  • the electrical skin resistance decreases and

  • the muscles get tense or cramped.


Stress is caused by excessive physical and mental exertion, pain, illnesses, emotions, inadequate or no satisfaction of certain material needs and inadequate satisfaction of social needs.

Today’s society creates more and more stressful situations. The comfort zone is threatened and inconvenience is no longer acceptable.

The 4 objective and innate causes of an immediate stress-response include:

  • Loss of permanent residence,

  • Fear of pain or loss of control over pain,

  • A sudden loud noise,

  • Fear of snakes (This primed stress-response occurs between the ages of 2 and 4 when there is contact with snakes. Contact at a later point in time does not lead to this fear development).


Often, people with chronic stress are blaming other people or the circumstances for their own problems and mistakes. They deny that they are chronically stressed, are unable to receive criticism and are increasingly contentious. Over time, these people get used to the chronic state of stress and it is then taken for granted.

The result is a distorted perception. Own complaints are often overlooked and tolerated, although their health obviously suffers from it.

Smokers are an example of this. It is best to let the facts speak and realize that even without cigarettes can live and survive.

Help with chronic stress syndrome can be found in recovery (sleep, eating, exercise), relaxation (autogenic training, progressive muscle relaxation), healthy and rational thinking to induce stress-reduction and -prevention.

Meditation is also a way to reduce stress. Even for people that don’t suffer from chronic stress meditation can lead to the 5 properties of physical health:

  • physical strength,

  • endurance,

  • physical flexibility,

  • fast and precise mobility,

  • balanced posture




The general symptoms of depression are listed in the World Health Organization (WHO) ICD-10 catalogue.

Among other symptoms, these patients feel empty and weak, appear tearful, have fluctuations in weight of at least 5 kg within 4-6 weeks, are disinterested or have trouble sleeping, and may have suicidal thoughts.

Possible causes of depression are an innate predisposition, it can be learned or caused by thinking. Most people think that they are predisposed to depression. However, this is more often a state that is learned and patterned, just like a rational and functional way of thinking can be learned and patterned.

There are various forms of therapy for depression. While the psychoanalytic approach, relaxation methods, positive thinking and other forms are less efficient therapy options, depression can be treated very well with cognitive therapy (CBT) and medication. A 5-year long-term study found that patients with medium or severe depression recovered best with a combination of medication and cognitive therapy (CBT).



Various criteria are known for diagnosing a GENERALIZED ANXIETY DISORDER. The patient’s fear comes to light in different situations – even without a connection to traumatic experiences.

SYMPTOMATIC is that the person cannot stop brooding, is restless, nervous, slightly tired and suffers from sleep disorders. The patient has poor concentration and muscle tension. People suffering from generalized anxiety disorder are cautious people who have a selective perception and are literally looking for the threat. The person is afraid of an assumed danger and then afraid of the fear. Generalized anxiety disorder can cause panic attacks and phobias.




The most common cause of bruxism is chronic stress.

Unfortunately, previously used methods for reducing stress have not always proven to be good. The cognitive approach of RE&CBT offers a scientifically proven method for stress treatment.

Basically, bruxism patients are best treated interdisciplinarily. Accordingly, in addition to medical clarification – whether incorrect chewing patterns are the cause and should be treated by a dentist – it is recommended that psychotherapeutic diagnostics and treatment be considered. The pure splint therapy at the dentist is unfortunately only a palliative, a symptom treatment – not a cause treatment.

This dissociates itself from the thesis that bruxism is a necessary way of reducing stress. Humans are not animals, the ability to change their mind can reverse this state of stress.