| |
Bruxism is a condition in which a person unconsciously grinds or clenches their teeth, often without realizing they are doing it. The teeth grind or rub together as the jaw forcefully moves from side to side or back and forth. Clenching occurs when a person holds their teeth together and tightens the jaw muscles, but without moving the teeth. Bruxism can happen during the day or night, with sleep-related bruxism being particularly difficult to control.
Bruxism is one of the most common sleep disorders and is considered an unconscious neuromuscular activity. It may lead to symptoms such as myofascial pain, temporomandibular joint dysfunction (TMJ), headaches, and in severe cases, arthritis of the temporomandibular joints.
Effects of Bruxism
Grinding can wear down the teeth, making them short, blunt, or fractured. Clenching places stress on the muscles, tissues, and surrounding structures of the jaw. Possible effects include:
- Jaw pain and stiffness
- Receding gums and bone loss
- Sensitive, worn, broken, or loose teeth
- Clicking, popping, or locking jaw joints
- Dull headaches
Earaches may occur due to the proximity of the temporomandibular joint to the ear canal, and referred pain (pain felt in a different area than the source) may also arise. Anxiety, depression, eating disorders, and insomnia are additional key symptoms.
Excessive grinding can damage the occlusal surfaces of teeth, particularly the molars, and contribute to TMJ syndrome. Some individuals may grind or clench their teeth without any noticeable symptoms.
Causes
The exact cause of bruxism is still unclear, but several factors may contribute:
- In children, it may result from teething pain or stress, especially in children with hyperactivity disorder.
- Stress, anger, anxiety, or intense concentration are common triggers in adults. Research shows that brain activity and heart rate often increase before an episode of bruxism, indicating involvement of the central nervous system.
- An abnormal bite or malocclusion (misaligned teeth) may also be a factor.
- Certain medications, such as antidepressants, antipsychotics, and amphetamines, can induce bruxism.
- Neurological conditions like Huntington’s or Parkinson’s disease may cause bruxism, and other factors such as fatigue, alcohol consumption, smoking, sleep apnea, and snoring may contribute.
Tooth wear can also result from vigorous brushing, abrasive toothpaste, acidic drinks and foods, a trained professional can distinguish between these wear patterns. In children, Dr. Kogan may ask about stress-related factors such as worries, anger, or anxiety at bedtime.
|
Diagnosis
Dr. Kogan will review the patient's history and perform a thorough examination. Signs of bruxism include:
- Jaw discomfort upon waking
- Tooth wear
- Indentations on tongue and cheeks from clenching
- Receding gums
- Enlarged jaw muscles
Tooth wear can also result from vigorous brushing, abrasive toothpaste, acidic drinks and foods, a trained professional can distinguish between these wear patterns. In children, Dr. Kogan may ask about stress-related factors such as worries, anger, or anxiety at bedtime. |
Treatment
There is no cure for bruxism, but treatments can help alleviate symptoms and address underlying causes. Daytime bruxism may improve with increased awareness, physical therapy, or exercises. However, nocturnal bruxism requires different strategies since it occurs unconsciously.
If stress or sleep apnea is the root cause, treating these conditions is essential. Lifestyle changes, such as ensuring adequate sleep or regular exercise, may help reduce bruxism.
A custom-made splint, or night guard, is often prescribed to manage bruxism during sleep. The American Dental Association and the American Academy of Oral Medicine recommend a hard oral appliance, specifically designed to fit the patient’s condition and unique anatomy, covering all teeth in either the upper or lower arch. This splint helps position the jaw in a relaxed state, absorbing the pressure from bruxism and protecting the teeth. Over-the-counter mouth guards are not advised, as they can be bulky, prone to dislodging during sleep, and can potentially worsen bruxism or lead to harmful changes in the jaw joints over time.
For some patients, short-term use of muscle relaxants may be an option. If bruxism is caused by a misaligned jaw or teeth, realignment with braces or Invisalign is advised.
Avoiding caffeine and alcohol, which can increase grinding, may also be helpful. Additionally, chewing gum should be avoided, as it can reinforce the grinding habit.
Applying warm compresses or heating pads may relax tense jaw muscles |
Prevention
Stress management techniques such as yoga, meditation, and exercise can help prevent bruxism in individuals prone to it. Good sleep hygiene is also important, and the National Sleep Foundation recommends sleeping in a cool, dark, and quiet room free of electronic devices. Relaxing before bed, perhaps with a warm bath, reading, or music, can further support a soothing bedtime routine. |
