Bruxism or teeth grinding is a disorder in which a person unconsciously clenches, grinds and grits his/her teeth. Individuals who suffer from bruxism clench their teeth during day time (day bruxism) and/or during sleep (i.e. night bruxism). Night bruxism is a sleep related movement disorder and the affected individuals may also report other sleeping disorders such as snoring and sleep apnea due to (or independent of) bruxism.
If bruxism is mild or asymptomatic, you may not require any treatment. However, severe and frequent bruxism may cause headache, damaged/ chipped teeth and jaw disorders.
What are some classic Signs and symptoms of Bruxism?
It is important to know the signs and symptoms because sometimes people with sleep bruxism remains unaware of their condition until they develop serious complications. According to latest statistics reported by American Sleep Association, the prevalence of bruxism in general population is 10%. According to another study, 8 to 34% of the adults suffer from chronic bruxism.
Classic bruxism Sign and symptoms include:
- Teeth grinding or clenching which is loud enough to wake your partner
- Chipped or fractured tooth
- Pain or soreness on face and jaw
- Tired jaw muscles
- Worn out tooth enamel
- Grooves or depressions on tongue
- Persistent and recurring headaches which originates from temple and are dull in character
- Increased tooth sensitivity
- Recurrent onset of boils or cuts on the underside of cheek (due to chewing/ biting activity during sleep)
- Pain that seems to be earache (without any signs of ear infection)
What causes teeth grinding while sleeping?
Although the exact etiology is not understood completely but experts suggests that a complex interplay of psychological and physical factors can cause bruxism; some common etiological factors include:
- Chronic state of anxiety, stress or tension
- Frustration or anger
- Aggressive, hyperactive or competitive personality type
- For some people it is a focusing habit or a strategy to cope with stressful situations
- As part of other sleep disorder such as sleep apnea
- Malocclusion i.e. upper and lower teeth are aligned abnormally
- As an associated symptom of earache, especially in children
- Though uncommon but some psychiatric medications and antidepressants can also cause bruxism as a side effect. For example, according to a new study reported in the Clinical Neuropharmacology journal, approximately 24.3% of all the patients who consume antidepressants develops bruxism.
- Bruxism can be a complication of Parkinson’s disease and Huntington’s disease
- Reflux of stomach acid into esophagus
What may aggravate your risk of developing Bruxism?
It is more common in children and may resolves spontaneously after puberty. Some people experience bruxism in certain sleeping positions only. Other common risk factors include:
- The risk of developing bruxism is fairly high if you have hyperactive, aggressive or competitive personality.
- Emotions like stress, fear, anxiety and anger can also increase the risk of developing bruxism.
- Caffeinated beverages, alcohol, tobacco and drugs like methamphetamine or Ecstasy also aggravates the risk of bruxism.
Why should you be concerned?
Poorly managed bruxism can lead to a wide range of complications. Statistics suggests that despite high prevalence, very few people seek medical help in early stages. You should see your doctor if you are suspecting bruxism to minimize the risk of following complications:
- Chronic facial pain leading to low productivity.
- Permanent damage to teeth, crown or jaw
- Recurring onset of tension-type headaches
- High risk of developing temporomandibular joints (TMJs). The TMJ joint is located just in front of your ears. People who develop TMJD experience clicking sound when opening or closing the mouth.
How to stop grinding teeth at night
In children bruxism outgrows with age and in most cases no treatment is needed. If bruxism is severe then its treatment is necessary which includes pharmacological management as well as additional therapies.
How to stop bruxism with different therapies?
- Behavioral Therapy:
Practicing proper jaw and mouth training can help in changing the acquired behavior. Once you know that you have bruxism you can ask a dentist to show you the best exercises for jaw and mouth motion to control this habit.
- Stress Management:
If bruxism is due to stress then you should go for meditations or exercises to help with stress management. If necessary, you can also get benefitted with counseling by professionals.
- Biofeedback Training:
Biofeedback is a type of complementary medicine which teaches how to control muscle activity of jaw by using monitoring procedures and equipment. The biofeedback device can prove exceptionally helpful in individuals who have difficulty in changing their teeth grinding habits.
- Dental Approaches/ Procedures:
A dentist can suggest ways to improve and preserve your teeth. This may not stop bruxism but at least it will minimize the wear and tear of your teeth.
- Splints and Mouth Guards:
These devices are made up of hard acrylic or soft (silicone type) materials and are placed over your upper and/or lower teeth. The purpose of splints and dental night mouthguard is to keep teeth separate in order to prevent damage due to teeth clenching.
- Dental Correction:
If bruxism is due to dental problems then proper alignment of teeth is usually helpful.
- Reshaping of teeth:
Sometimes when bruxism becomes complicated it may create problems in chewing (while also increasing the sensitivity of teeth). In that case, dentist may advise reshaping of your teeth. Braces or oral surgery may be needed in severe cases of bruxism.
How to stop clenching teeth with Pharmacological Regimens?
- Muscle relaxants:
In acute and severe cases of bruxism, muscle relaxants before bed time may be prescribed (until other therapies yield positive results).
- OnabotulinumtoxinA (Botox) injections:
When bruxism gets severe and doesn’t responds to any other treatments then Botox injections can be used as a viable option.
If bruxism symptoms are due to side effect of a prescription medication, you can ask your doctor for an alternative pharmacological agent.
If you are experiencing recurrent episodes of headaches or facial pain with/without negative changes in the enamel/ strength of teeth, book an appointment with your dentist for complete evaluation and treatment.