Bruxism is a condition in which you grind your teeth and clench your jaw, either while awake or asleep. It is most commonly associated with stress, anxiety, and anger, but can also be caused by certain medications, other medical conditions (e.g. sleep apnea), an aggressive personality type, and young age. Since bruxism can occur at night, when you are not aware of it, it is important to know the symptoms and get routine dental check-ups to prevent complications.
Teeth grinding is not a simple sleep disorder since if left untreated it can cause severe dental complications. Dentists help you by preventing early complications for putting an end excessive teeth grinding issues. they offer a thorough dental examination to formulate a treatment plan for the right Night Guard splint to keep the teeth from grinding.
Multiple factors influence the risk of bruxism, so it’s usually not possible to identify one single cause for why people grind their teeth. That said, certain risk factors are associated with a greater probability of bruxism.
- Strong and negative emotions– Too much stress, anxiety, anger or frustration can increase the occurrence of Bruxism during sleep.
- Age– It is usually common among children, but they can eventually outgrow the condition by adulthood.
- genetics– Researchers have determined that sleep bruxism has a genetic component and can run in families. As many as half of people with sleep bruxism will have a close family member who also experiences the condition.
- Personality type– People who tend to be aggressive, competitive or hyperactive has higher chances of developing excessive teeth grinding.
- Too much caffeine– Beverages that have caffeine can increase the risk of people suffering from bruxism especially with its excessive intake.
- Sleep pattern changes– Episodes of teeth grinding appear to be connected to changing sleep patterns or microarousals from sleep. Most teeth grinding is preceded by increases in brain and cardiovascular activity. This may explain the associations that have been found9 between sleep bruxism and obstructive sleep apnea (OSA), which causes temporary sleep interruptions from lapses in breathing.
- Other disorders – bruxism can be associated with some mental health and medical disorders including Parkinson’s disease, dementia, gastroesophageal reflux disorder (GERD), epilepsy, night terrors, and sleep-related disorders such as sleep apnoea
Symptoms of teeth grinding
If your condition is mild, you may not be aware that you are grinding your teeth. It might be that a friend or family member notices it first. Or perhaps symptoms of bruxism are noticed by your dentist, during a routine appointment. Some signs and symptoms that you may have bruxism include:
- Clenching or grinding your teeth, either awake or asleep
- Fractured or chipped teeth
- Tooth loss
- Flattened teeth or worn teethand enamel, exposing deeper layers of your tooth
- Increased tooth pain or sensitive teeth
- Tired or tight jaw muscles, or a locked jaw that won’t open or close completely
- Pain or soreness in your jaw, neck, face or ears
- Damage from chewing on the inside of your cheek
What Are the Symptoms of Sleep Bruxism?
The main symptom of sleep bruxism is involuntary clenching and grinding of the teeth during sleep. The movements resemble chewing but generally involve more force.
People with sleep bruxism don’t grind their teeth throughout the night. Instead, they have episodes of clenching and grinding. People may have very few episodes per night or up to 100. The frequency of episodes is often inconsistent, and teeth grinding may not occur every night.
Some amount of mouth movement is normal during sleep. Up to 60% of people make occasional chewing-like motions known as rhythmic masticatory muscle activities (RMMA), but in people with sleep bruxism, these occur with greater frequency and force. The majority of sleep bruxism takes place early in the sleep cycle during stages 1 and 2 of non-REM sleep. A small percentage of episodes can arise during REM sleep.
It’s normal for people who grind their teeth at night to not be cognizant of this symptom unless they are told about it by a family member or bed partner. However, other symptoms can be an indication of sleep bruxism.
Jaw pain and neck pain are two frequent signs of teeth grinding. These occur because of the tightening of these muscles during episodes of bruxism. Morning headaches that feel like tension headaches are another potential symptom. Unexplained damage to teeth can also be a sign of nighttime clenching and grinding of teeth.
Complications of Teeth Grinding
- Can cause damage to dental prostheses such as crown, bridges, veneers, fillings, and more– Excessive grinding can negatively affect tooth restorations compromising its overall function and appearance.
- Create a tension-type headache– Due to the excessive strain applied to the teeth and jaws, it can cause tension headaches every morning when waking up.
- Effects of proper chewing of foods and nutrition– Since bruxism can cause damage to the teeth, it can affect how a patient chew their foods and the types of foods they eat. Avoidance of certain foods can affect the nutrition being absorbed by the body causing poor overall health.
- Temporomandibular joint disorder (TMJ or TMJD) may occur– Excessive pressure applied to the jaw can affect the jaw joints that and muscles that control jaw movement causing pain and discomfort when chewing, talking, and even smiling.
When to see a dentist?
If in doubt, check it out.
Book an appointment to see a dentist as soon as possible if:
- You have pain that lasts longer than a day or two
- Your pain is severe or starts to become unbearable
- You have a fever, earache or pain when you open your mouth wide
- You have chipped or loose teeth
- You are concerned about teeth clenching or grinding
If dentists suspect bruxism, they’ll look for changes in the mouth and teeth over the next several visits to gauge if the condition is progressive. Routine checks are also done to determine if you need treatment.
Finding out the cause
To determine the cause of bruxism, dentists will ask questions about the patient’s general health, daily routine, medications, and sleep habits.
To evaluate the extent of the condition, the following will be looked into:
- Tenderness in the jaw muscles
- Glaring dental abnormalities (i.e. missing or broken teeth)
- Other damage to the teeth, the inside of the cheeks, and the underlying bone (usually through X-rays)
How is Sleep Bruxism Diagnosed?
An overnight study in a sleep clinic, known as polysomnography, is the most conclusive way to diagnose sleep bruxism. However, polysomnography can be time-consuming and expensive and may not be necessary in certain cases. Polysomnography can identify other sleep problems, like OSA, so it may be especially useful when a person has diverse sleep complaints.
For many people, the presence of symptoms like tooth damage and jaw pain combined with reports of teeth grinding from a bed partner may be sufficient to determine that a person has sleep bruxism.
Home observation tests can monitor for signs of teeth grinding, but these tests are considered to be less definitive than polysomnography.
What Are the Treatments for Bruxism?
Kids with bruxism usually outgrow the condition even without treatment. The condition is also not that severe in some adults that medical intervention is necessary. There are several approaches can decrease bruxism episodes and limit damage to the teeth and jaw. Some people who grind their teeth have no symptoms and may not need treatment. Other people may have symptoms or greater risk of long-term problems, and in these cases, treatment is usually necessary. In a lot of cases, treatment is not really necessary.
However, in cases where the condition is severe, possible interventions include therapies, medications, and dental approaches. This is done to relieve discomfort and avoid further damage. Lastly, discussing interventions with the dentist is recommended as they know what’s best for each case.
The best treatment for bruxism varies based on the individual and should always be overseen by a doctor or dentist who can explain the benefits and downsides of a therapy in the patient’s specific situation.
High levels of stress contribute to bruxism when awake and asleep, so taking steps to reduce and manage stress may help naturally decrease teeth grinding.
Reducing exposure to stressful situations is ideal, but of course, it’s impossible to completely eliminate stress. As a result, many approaches focus on combating negative responses to stress in order to reduce its impact.
Techniques for reframing negative thoughts are part of cognitive behavioral therapy for insomnia (CBT-I), a talk therapy for improving sleep that may address anxiety and stress as well. Improving sleep hygiene and employing relaxation techniques can have added benefits for falling asleep more easily.
Medications help some people reduce sleep bruxism. Most of these drugs work by altering brain chemicals to reduce muscle activity involved in teeth grinding. Botox injections are another way of limiting muscle movement and have shown effectiveness in more severe cases of sleep bruxism.
Most medications have side effects that may make them inappropriate for some patients or difficult to use over the long-term. It is important to talk with a doctor before taking any medication for sleep bruxism in order to best understand its potential benefits and side effects.
Various types of mouthpieces and mouthguards, sometimes called night guards, are used to reduce damage to the teeth and mouth that can occur because of sleep bruxism.
Dental splints can cover the teeth so that there is a barrier against the harmful impact of grinding. Splints are often specially designed by a dentist for the patient’s mouth but are also sold over-the-counter. They may cover just a section of teeth or cover a wider area, such as the whole upper or lower teeth.
Other types of splints and mouthpieces, including mandibular advancement devices (MAD), work to stabilize the mouth and jaw in a specific position and prevent clenching and grinding. MAD work by holding the lower jaw forward, and they are commonly used to reduce chronic snoring.
Another component of treatment is relieving symptoms to better cope with sleep bruxism.
Avoiding gum and hard foods can cut down on painful movements of the jaw. A hot compress or ice pack applied to the jaw may provide temporary pain relief.
Facial exercises help some people reduce the pain in their jaw or neck. Facial relaxation and massage of the head and neck area may further reduce muscle tension. A doctor or dentist may be able to suggest specific exercises or make a referral to an experienced physical therapist or massage therapist.