Bruxism Is A Condition In Which You Grind, Gnash Or Clench Your Teeth
If you have bruxism, you may unconsciously clench your teeth when you’re awake (awake bruxism) or clench or grind them during sleep (sleep bruxism).
Sleep bruxism is considered a sleep-related movement disorder. People who clench or grind their teeth during sleep are more likely to have other sleep disorders, such as snoring and pauses in breathing (sleep apnea).
Why Do I Grind My Teeth at Night?
Every case of bruxism has a unique set of contributing factors. We work with you to determine what those are. Teeth grinding may stem from genetic, psychological, or physical factors. Grinding that occurs when you are awake is usually attributed to anxiety, tension, or stress. Nighttime grinding, on the other hand, is often associated with sleep apnea (a sleep condition that we can treat using an oral appliance) acid reflux, or hyperactivity. That hyperactivity could result from unmanaged stress. Additionally, there is a chance that smoking, alcohol consumption, caffeine, and various drugs may lead to bruxism.
What Causes Bruxism?
Bruxism isn’t completely understood, but it appears to be due to a combination of physical, psychological, and genetic factors.
Awake bruxism seems tied more to emotions such as stress, anxiety, anger, frustration, or tension. For some, it can be a coping mechanism or habit when they are in deep concentration.
Sleep bruxism seems to be a sleep-related activity associated with arousals during sleep.
What Risk Factors Contribute to The Development of Bruxism?
These factors make it more likely you’ll develop bruxism:
- Stress — Increased anxiety or stress can lead to bruxism, as can anger or frustration.
- Age — Bruxism is common in young children, but it usually goes away by adulthood.
- Personality type — Certain personality types, such as “type A personalities,” are more aggressive, competitive, or hyperactive. These all have a higher chance of bruxism.
- Medications and other substances — Certain psychiatric medications, such as antidepressants, can have a rare effect of causing bruxism. The same can be true of smoking, recreational drug use, and heavy amounts of caffeine or alcohol.
- Genetics — Bruxism tends to run in families.
- Other health issues — Bruxism can be associated with some mental health and medical disorders such as dementia, Parkinson’s, gastroesophageal reflux disorder, sleep apnea, and attention deficit/hyperactivity disorder, among others.
What Are The Symptoms of Bruxism?
Signs and symptoms of bruxism may include:
- Teeth grinding or clenching, which may be loud enough to wake up your sleep partner
- Teeth that are flattened, fractured, chipped or loose
- Worn tooth enamel, exposing deeper layers of your tooth
- Increased tooth pain or sensitivity
- Tired or tight jaw muscles, or a locked jaw that won’t open or close completely
- Jaw, neck or face pain or soreness
- Pain that feels like an earache, though it’s actually not a problem with your ear
- Dull headache starting in the temples
- Damage from chewing on the inside of your cheek
- Sleep disruption
How Do I Know if I Grind My Teeth at Night?
If you grind your teeth while you sleep, it's difficult to know because your grinding typically won't wake you up. However, nightly grinding will eventually reveal itself through other symptoms. We have a list of symptoms above. A few examples include waking with a sore jaw or having increased tooth sensitivity. If you feel that you may have bruxism, please don't hesitate to contact our office. We can determine if, in fact, you are grinding your teeth when you sleep and, if you are, what to do about it.
Why Is Bruxism So Harmful?
Sleep bruxism is the most common form of ongoing teeth grinding. When it continues over a long term this grinding can cause significant harm to your teeth. Teeth may become painful, eroded, and loose. Dental crowns, fillings, porcelain veneers, and implants can all become damaged from the pressures of nightly bruxism.
Beyond the teeth, bruxism also affects the temporomandibular joint (TMJ), the joint that connects the lower jaw to the skull. Problems with your TMJ can create chronic jaw pain, popping and clicking sounds when chewing, locking of the jaw, difficulty chewing, and other complications.
Beyond you, it’s likely nightly bruxism is also affecting the person sleeping next to you. Grinding can usually be heard throughout the night.
What’s the Difference Between Bruxism and TMJ?
TMJ Disorder is Temporomandibular Joint Disorder. These joints, the TMJs, sit just in front of your ears. They help you move your lower jaw up and down and side to side. If the joints are misaligned or inflamed, a number of symptoms can occur. These symptoms are very similar to the ones that are related to bruxism! With that, it can be difficult to discern where your symptoms are coming from. Your dentist can help. A thorough consultation and examination can help us better understand your jaw position, the function of your temporomandibular joints, and the condition of your teeth. Through a comprehensive checkup, we hope to be able to accurately identify if your symptoms come from bruxism alone, TMJ alone, or a combination of the two.
Who Develops Bruxism?
Bruxism may affect nearly anyone at any time in life. Research has not pinned down a direct cause of each case of teeth clenching and grinding, but studies have identified certain risk factors. Knowing these can help you and your dentist determine how to protect the integrity of your teeth, as well as your overall comfort!
How Do I Stop Grinding My Teeth?
There are several ways that you may reduce or eliminate teeth-grinding, but it can take some time. In many cases, the condition becomes something that you manage through the use of a nightguard worn over your teeth when you sleep. Even with a mouthguard, it can be beneficial to try a few lifestyle remedies to help reduce bruxism. Suggestions include finding ways to reduce your stress on a daily basis. This may be taking a walk, dancing, exercising, or any number of activities that help you gain a sense of calm. You can also talk to your dentist about finding your proper jaw position. Once this is identified, you can practice staying in it for increased increments of time. In some cases, it may be necessary to obtain dental treatment to correct misalignment or a bad bite before you can achieve proper jaw position.
How is it Diagnosed?
Your dentist may spot signs of bruxism during a routine dental checkup. Your teeth may look worn or you may develop chips, cracks, or gum recession as a result of the force of grinding. This is especially common on the molars, the teeth at the back of your mouth. You may also alert your dentist to potential bruxism by discussing the symptoms you experience, such as jaw soreness or fatigue when you wake.
How Is Bruxism Treated?
The need for treatment can vary. For instance, many of us have temporary stresses enter our lives, and they may cause jaw clenching and tooth grinding. But these often resolve when the stress goes away. But when the signs of bruxism are obvious and your teeth are being degraded, Dr. Bidabadi and our team may use some of these treatments:
- Splints and mouth guards — We custom fit a mouth guard or splint whose job is to keep your teeth separated. This stops the ability of the teeth to meet and grind against each other. These fit over the upper and lower teeth.
- Dental correction — When a person has severe bruxism, their tooth wear has led to sensitivity and it is affecting the bite. Now it’s necessary to place crowns over worn teeth. Inlays and onlays may also be successful.
- Stress management — Coping strategies allow the person to better handle the stress in their life, such as meditation.
- Behavior change — We can show you how your mouth and jaw should be positioned. You can then try and train your jaw to stay in this position.
- Biofeedback — This behavior modification system uses monitoring procedures and equipment to teach you how to control muscle activity in your jaw.
- Medications — In some patients, the best course may be a medication. These mediations work to relax the muscles. Botox, in particular, is showing excellent results. These are possible medications used for bruxism:
- Botox injections. Botox works by blocking nerve messages in the muscles. The brain doesn’t receive the message to contract the muscle, so the muscle stays relaxed. For bruxism, this calms the muscles responsible for clenching and grinding.
- Muscle relaxants. These can calm the muscles that clench your jaw and grind your teeth.
- Anxiety or stress medication. Short-term use of antidepressants or anti-anxiety medications can help you deal with stress or other emotional issues that are causing your bruxism.
What Happens If Bruxism Is Left Untreated?
While we all clench and occasionally grind our teeth, chronic bruxism can wreak havoc with your smile. The forces delivered when we clench and grind our teeth are very strong. Over time, these forces will grind down your teeth, and this will then cause your overall bite to become misaligned. Now the odds of suffering the jaw and facial pain of temporomandibular joint disorder rise dramatically.
Bruxism can break individual teeth, especially in chronic cases where the teeth weaken from the nightly stresses. It’s typical to break dental appliances such as bridges or partial dentures.
What Are the Benefits of Therapeutic Botox®?
One of the most common benefits of the procedure is the reduction in the frequency and intensity of your jaw clenching. It reduces the damage to your gums, teeth, and jaw joint, and decrease the pain and discomfort in your facial muscles.
By injecting small doses of Therapeutic Botox® directly into the masseter muscle (the large muscle that moves the jaw), the muscle is weakened enough to stop involuntary grinding of the teeth and clenching of the jaw. This significantly relaxes the muscle and reduces the wear and tear on the teeth due to grinding.
Is Botox Safe For Treating Bruxism?
Botox became a legendary brand name due to its FDA approval for aesthetic treatment of frown lines in 2002. What people don’t know is that Botox has also been approved for a variety of non-aesthetic uses. These include:
- Cervical dystonia (involuntary neck muscle contractions)
- Severe hyperhidrosis (excessive sweating)
- Strabismus (crossed eyes)
- Blepharospasm (involuntary eyelid spasms)
- Neurogenic detrusor overactivity (bladder dysfunction)
- Chronic migraine headaches
- Upper limb spasticity
It is used “off-label” by dentists for treating bruxism and symptoms of temporomandibular joint disorder (TMJ). Although not directly indicated in FDA approvals, Botox use for these problems is right in line with other muscle relaxing treatments. For bruxism, Botox keeps the muscles responsible for clenching and grinding relaxed, blocking their contractions.
Botox has proven to be safe and effective across its uses. This is evidenced by its injection millions of times all around the world.
How Does A Night Guard Work? Does It Prevent Clenching And Grinding?
A night guard is made just for you, customized by your dentist to fit your unique dentition. Custom-made night guards fit over your upper or lower teeth, covering every tooth from the very last molar to the front of the mouth and back again. The acrylic, though thin, prevents opposing teeth from making contact with each other when you involuntarily grind or clench while you sleep.
When wearing a night guard, your may still clench and grind. The difference is that you'll have a two to four-millimeter separation between your upper and lower arches. This separation can minimize the force that would normally be behind your unconscious habit. Also, because the jaw muscles cannot fully engage when the night guard is in place, the urge to grind and clench often decreases.
Can I Just Wear a Sports Mouth Guard for Teeth Grinding or Clenching?
It might be tempting to think of any mouthguard as a good option for dealing with bruxism. It would be a mistake to do so.
A night guard is not the same as a mouth guard. Yes, both appliances fit over your teeth. However, they aren't intended for the same purpose. Your custom-made night guard fits perfectly over your teeth to cushion areas that are most likely to be affected by your unconscious habit of clenching or grinding. A standard mouth guard is designed to reduce the force of impact from a blow to the face. Your custom-made night guard is made to protect your teeth from the vertical up-and-down force that's exerted when you clench and grind.
In addition to being made for the right kind of force, your night guard is also made to be comfortable for sleeping. A mouthguard that's worn during sports is thicker and bulkier in your mouth. This form could interrupt normal saliva flow. This may sound like a minor inconvenience that leaves you feeling parched, but there's more to it than that. While you sleep, saliva flows over your teeth to defend against plaque and tartar formation. Saliva also inhibits the activity of harmful oral bacteria. So, wearing a proper night guard, you not only feel more comfortable, but you can breathe more easily and enjoy all of the natural protections you'd have without your appliance.
Is A Night Guard Uncomfortable?
Your night guard is made to fit over your teeth. It won't move around in your mouth. While its purpose is to create a few millimeters of space in between your upper and lower teeth, your night guard is made to be ultra-thin so your jaw joints do not become stiff or sore. Keep in mind that it can take a few weeks to get used to your night guard. After that time, any minor discomfort that occurs should cease.
How Long Will A Night Guard Last?
Your night guard is put under a fair amount of stress for the hours that you sleep every night. It's important to have your appliance checked by your dentist every now and then. If you're a heavy clencher or grinder, you may need to have a new night guard made every year or two. If your bruxism is on the mild side, your night guard may last several years.