Teeth grinding/Bruxism
Introduction
Bruxism is the medical term for teeth grinding, gnashing or clenching your teeth. The condition affects both children and adults.
Some people with bruxism unconsciously clench their teeth together during the day, often when they feel anxious or tense. This is different from tooth grinding or clenching that occurs at night, which is called sleep bruxism. Most children who are bruxers do so at night, while adults are either daytime or nighttime bruxers.
Teeth grinding may be mild and may not even require treatment. However, it can be frequent and severe enough to lead to jaw disorders, headaches, damaged teeth and other problems. Unfortunately, people with sleep bruxism usually aren't aware of the habit, so they aren't diagnosed with the condition until complications occur. That's why it's important to know the signs and symptoms of bruxism and to seek regular dental care.
Signs and symptoms
The signs and symptoms of teeth grinding may include:
- Teeth grinding or clenching, which may be loud enough to wake your sleep partner
- Teeth that are worn down, flattened or chipped
- Worn tooth enamel, exposing the inside of your tooth
- Increased tooth sensitivity
- Jaw pain or tightness in your jaw muscles
- Earache — because of severe jaw muscle contractions, not a problem with your ear
- Headache
- Chronic facial pain
- Chewed tissue on the inside of your cheek
Doctors don't completely understand the causes of teeth grinding. For daytime bruxism, it has been thought that abnormal alignment of upper and lower teeth (malocclusion) may contribute to the problem, though this hasn't been confirmed in research studies. Sleep bruxism is believed to be related to changes that occur during sleep cycles in some individuals, and this is an active area of current research.
In adults, psychological factors seem to be associated with teeth grinding, including:
- Anxiety, stress or tension
- Suppressed anger or frustration
- Aggressive, competitive or hyperactive personality type
In some cases, bruxism isn't caused by stress or dental problems. It can be a complication of another disorder, such as Huntington's disease or Parkinson's disease. It can also be an uncommon side effect of some psychiatric medications including certain antidepressants.
Complications
In most cases, bruxism doesn't cause serious complications. But severe bruxism may lead to:
- Damage to your teeth (including restorations and crowns) or jaw
- Tension-type headaches
- Facial pain
- Temporomandibular disorders — which occur in the temporomandibular joints (TMJs), located just in front of your ears and felt when opening and closing your mouth
In many cases, no treatment is necessary. Many kids outgrow bruxism without special treatment, and many adults don't brux badly enough to require therapy. However, if the problem is severe, treatment options include:
- Stress management. If you grind your teeth because of stress, you may be able to prevent the problem with professional counseling or strategies that promote relaxation, such as exercise and meditation. If your child grinds his or her teeth because of tension or fear, it may help your child to talk about his or her fears just before bed or to relax with a warm bath or a favorite book.
- Dental approaches. If you or your child has bruxism, your doctor may suggest a mouth guard or protective dental appliance (splint) to prevent damage to the teeth. Your dentist can make a custom mouth guard to fit your mouth. Over-the-counter mouth guards are available and they're less expensive than custom guards, but they generally don't fit well and can dislodge during bruxing.
If your bruxism seems to be associated with dental problems, your dentist may also correct misaligned teeth. In severe cases — when tooth wear has led to sensitivity or the inability to chew properly — your dentist may need to use overlays or crowns to entirely reshape the chewing surfaces of your teeth. Reconstructive treatment can be quite extensive and though it will correct the wear, it may not stop the bruxism. - Behavior therapy. Once you discover that you have teeth grinding, you may be able to change the behavior by practicing proper mouth and jaw position. Concentrate on resting your tongue upward with your teeth apart and your lips closed. This should keep your teeth from grinding and your jaw from clenching. If you're having a hard time changing your habits, you may benefit from biofeedback, a form of complementary and alternative medicine that uses a variety of monitoring procedures and equipment to teach you to control involuntary body responses.
During a biofeedback session, a therapist applies electrical sensors to different parts of your body. These sensors monitor your body's physiological responses to stress — such as teeth grinding — and then feed the information back to you via auditory and visual cues. These cues may take the form of a beeping sound or a flashing light. With this feedback, you'll start to associate teeth grinding or clenching with stress and learn to change your behavior. You may also be given a portable biofeedback device that you use at home. Your therapist will explain how it works. - Medications. In general, medications aren't very effective for treatment of teeth grinding. In some cases, your doctor may suggest taking a muscle relaxant before bedtime. If you develop bruxism as a side effect of an antidepressant medication, your doctor may change your medication or prescribe another medication to counteract your bruxism. Botulinum toxin (Botox) injections may help some people with severe bruxism that hasn't responded to other treatments.
Credit: National Institute of Health.