Teeth Grinding (Bruxism)

Many people are grinding their teeth unconsciously either during the day or during sleep at night. Bruxism is the habit of clenching or grinding teeth together leading to loss or reduction of Enamel with time, thus exposing the sensitive Dentin resulting in tooth sensitivity & pain. Bruxism at night is usually accompanied with other sleep disorders like snoring or pauses in breathing.

Figure 1: Bruxism
Figure 1: Bruxism

 

Minor bruxism don’t usually require a medical treatment. However, when bruxism is severe it may lead to jaw problems, headache, & other tooth related problems.

Because bruxism at night is done unconsciously while the person is sleeping, a development of complications might take place. Thus, knowing the symptoms of bruxism may give you a clue to seek a medical treatment.

  • Symptoms

The symptoms of bruxism may include all or some of these indications:

  1. Teeth grinding or clenching, which may be loud enough to awaken your sleep partner.
  2. Teeth that are flattened, fractured, chipped or loose.
  3. Worn tooth enamel, exposing deeper layers of your tooth.
  4. Increased tooth sensitivity.
  5. Jaw or face pain or soreness.
  6. Tired or tight jaw muscles.
  7. Pain that feels like an earache, though it’s actually not a problem with your ear.
  8. Dull headache originating in the temples.
  9. Damage from chewing on the inside of your cheek.
  10. Indentations on your tongue.

If you are already having some of the above symptoms, make sure to see your doctor as soon as possible.

  • Causes

Doctors don’t know exactly the cause of bruxism. However, it is believed that a number of factors, when present, can cause teeth grinding. These factors include:

  1. Emotions, such as anxiety, stress, anger, frustration or tension.
  2. Aggressive, competitive or hyperactive personality type.
  3. Abnormal alignment of upper and lower teeth.
  4. Other sleep problems, such as sleep apnea.
  5. Response to pain from an earache or teething (in children).
  6. Stomach acid reflux into the esophagus
  7. An uncommon side effect of some psychiatric medications, such as phenothiazines or certain antidepressants.
  8. A coping strategy or focusing habit.
  9. Complication resulting from a disorder such as Huntington’s disease or Parkinson’s disease.

Not all of these factors may be present but some of them will.

  • Risk Factors

A number of risk factors can increase the incidence of teeth grinding. Thus, reducing these factors may reduce the risk of having of your teeth clenched. These factors include:

  1. Stress. Increased anxiety or stress can lead to teeth grinding. So can anger and frustration.
  2. Age. Bruxism is common in young children, but it usually goes away by the teen years.
  3. Personality type. Having a personality type that is aggressive, competitive or hyperactive can increase your risk of bruxism.
  4. Stimulating substances. Smoking tobacco, drinking caffeinated beverages or alcohol, or taking illegal drugs such as methamphetamine or Ecstasy may increase the risk of bruxism.
  • Complications

In most cases, bruxism don’t cause serious complications. But severe teeth grinding may lead to:

  1. Damage to your teeth, restorations, crowns or jaw.
  2. Tension-type headaches.
  3. Facial pain.
  4. Disorders that occur in the temporomandibular joints (TMJs), located just in front of your ears, which may sound like clicking when you open and close your mouth.
  • Tests & Diagnosis

During regular dental exams, your dentist will look for signs of bruxism. If a sign is present, your dentist might need to see you after a while to check if its causing teeth grinding. Your dentist will ask you some questions regarding the symptoms of bruxism & including your general health.

Your dentist might also check for other signs such as:

  1. Tenderness in your jaw muscles.
  2. Obvious dental abnormalities, such as broken or missing teeth or poor tooth alignment.
  3. Damage to your teeth, the underlying bone and the inside of your cheeks, usually with the help of X-rays.

Your dentist might perform other tests as well for disorders that mimic jaw pain in order to rule them out. These include:

  1. Temporomandibular joint (TMJ) disorders.
  2. Other dental problems.
  3. Ear infection.

Your dentist might refer you to a therapist or sleep specialist if your bruxism has a major psychological component. He/she might perform other tests such as assessment for sleep apnea, video monitoring and measuring how often your jaw muscles tighten while you sleep.

  • Treatment & Drugs

Minor bruxism don’t usually require a medical treatment. In individuals with severe & continuous bruxism, a number of treatment options is available that should depends specifically to your case. Talk with your doctor about which might be best for you.

  • Splints & mouth guards: may be used to prevent or reduce the effects of bruxism on your teeth. It will not stop bruxism since this will only reduce the harmful effects of teeth clenching.
Figure 2: Mouth Guard
Figure 2: Mouth guard

Your dentist can make a special mouth guard designed specifically for your teeth. He/she will take an impression of your teeth & bite, & send it to the lab for fabrication process.

  • Dental correction: In some cases, reshaping or modifying the tooth structure might solve the issue if it has been found to be causing bruxism. A dental braces or oral surgery might be indicated for other certain cases. If your teeth are worn, an artificial crowns may be used to preserve & protect the remaining tooth structure.
  • Medications: are not very effective in treating bruxism. These include:
  1. Muscle Relaxants: your doctor may prescribe a muscle relaxant to be taken before sleep for a short period of time.
  2. OnabotulinumtoxinA (Botox) injections: Botox injections may help some people with severe bruxism who don’t respond to other treatments.
  3. If your bruxism is caused by a drug of which you are using, your doctor might replace it or tells you to stop using it. Don’t forget to tell your doctor about all the medications that you are using!
  • Life Style & Home Remedies

These self-care steps may prevent or help treat bruxism:

  • Reduce stress. Listening to music, taking a warm bath or exercising can help you relax and may reduce your risk of developing bruxism.
  • Avoid stimulating substances in the evening. Don’t drink caffeinated coffee or caffeinated tea after dinner, and avoid alcohol and smoking during the evening, as they may worsen bruxism.
  • Practice good sleep habits. Getting a good night’s sleep, which may include treatment for sleep problems, may help reduce bruxism.
  • Talk to your sleep partner. If you have a sleeping partner, ask him or her to be aware of any grinding or clicking sounds that you might make while sleeping so that you can report this to your doctor.
  • Schedule regular dental exams. Dental exams are the best way to identify bruxism. Your dentist can spot signs of bruxism in your mouth and jaw with regular visits and exams.

Reference: http://www.mayoclinic.org/diseases-conditions/bruxism/basics/definition/con-20029395

Now i want to hear from you!

Have you ever suffered from bruxism & what did you to treat it?

I read each & every comment.

Haider Maitham, DDS

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