What is bruxism?
Bruxism, or teeth grinding, is a condition whereby patients either press, clench or grind the lower and upper teeth against each other when they are asleep, although some people brux in the daytime. Teeth grinding makes a disconcerting, gnashing sound.
Consequences of bruxism
Both children and adults may grind their teeth, usually only for a temporary amount of time. Prolonged periods of tooth-to-tooth contact can cause wear and tear, such as chipped teeth and damage to enamel or cavities. People with serious teeth grinding can end up with completely worn down surfaces and even loose or missing teeth. Bruxism is the leading cause of tooth damage, along with tooth decay and gum disease.
Teeth grinding can also cause jaw pain as well as headache, neck pain, ear pain and facial pain due to strain on the masseter muscles.
What are the symptoms of bruxism?
Bruxism can go unnoticed for long periods of time. People who grind their teeth at night often do so unconsciously. In many cases, dentists or partners are the first to notice. Teeth grinding can cause tooth pain or discomfort in masseter muscles, headache or pain in the neck or shoulders, which is often when tooth grinders become aware of their habit.
Signs and symptoms of bruxism include:
- Jaw or face muscle pain or soreness
- Clicking or popping sounds in the jaw joint below the temple
- Bite marks on the inside of the cheek
- Face pain
- Increased tooth sensitivity
- Worn teeth
- Chipped teeth, damage to cavities
- Teeth that are flattened
- Bigger jaw muscles
- Dislocated jaw
What causes bruxism?
It isn’t fully known why people grind their teeth. But several factors seem to contribute to the problem. Stress and anxiety can cause teeth grinding, but the condition also occurs due to an abnormal alignment of upper and lower teeth (malocclusion).
Recent research findings point to the possibility of a link between bruxism and sleep disorders. Teeth grinders seem to be prone to snoring and obstructive sleep apnoea syndrome (OSAS). OSAS is a serious disorder which can become a major health risk if not treated.
Possible physical or psychological causes of bruxism include:
- Emotions, such as anxiety, stress, anger, frustration or tension
- Alcohol use
- Certain medications, such as Prozac
- Drugs such as XTC, cocaine and speed
- Excessive caffeine use
- Sleep problems, snoring, OSAS
- Abnormal alignment of upper and lower teeth (malocclusion)
- Hereditary predisposition: 40 to 60% of teeth grinders have parents that also grind their teeth
- Disorders affecting the central nervous system, such as Huntington’s disease or Parkinson’s disease
Nocturnal bruxism can only be diagnosed by means of a testing process with special equipment, involving monitoring muscle tension of the masseters, breathing patterns and brain activity. This test is rarely done because it’s very expensive. Usually, a dentist checks for signs of teeth grinding during regular dental exams. If you have any signs of abnormal wear and tear, he/she will look for changes in your teeth and mouth over the next visits to see if the process is progressive and to determine whether you need treatment. Often, sleeping partners of tooth grinders are the first to discover the activity.
Bruxism cannot be cured, but there are ways to reduce teeth grinding. Here are some of the best methods for reducing bruxism:
- Bite plate. Bite plates are widely used by dentists to treat teeth grinding. They are made of hard plastic and fit snugly around the teeth, preventing the surfaces of the teeth from grinding together.
- Mouth guard. This device protects the teeth and reduces the noise of teeth grinding.
- Antisnoring mouthpiece. The mouthpiece positions the teeth and jaw in line, so that the upper and lower jaws don’t touch. It also limits movement of the lower jaw to prevent it from make a grinding motion.
- BruxStop therapy. The BruxStop is a new therapeutic device for the treatment of nocturnal bruxism. It consists of a device that emits pulses, which is connected to a sensor. The sensor is fitted into a custom-made mouthpiece which detects masticatory muscle activity and administers a very small electric pulse when the measured muscle activity fulfils certain conditions (e.g. muscle activity that exceeds the minimum duration of 2.5 seconds). The pulse elicits a mouth opening reflex and causes the muscles to relax.
- Botox. This treatment involves injecting Botox into the masseters. The injections help stop teeth grinding by reducing the strength of these muscles. Botox usually lasts several months, so repeated injections are necessary.
- Relaxation techniques. Pain in the jaw muscles or restriction jaw function (e.g. limited mouth opening) can be reduced with relaxation techniques under the supervision of a physiotherapist.
- Psychological treatment. A psychologist can help with the psychological causes of bruxism by helping tooth grinders deal with stress and teaching techniques to improve sleep quality.
Bruxism should be treated as soon as it is diagnosed to prevent or reduce damage to teeth. Treatment may be necessary to repair damaged teeth using white dental fillings. Dental crowns are the most durable way to restore badly damaged teeth.
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Last updated on July 14, 2016.