Tooth Grinding (Bruxism) - All You Need To Know

Do you often wake up with painful jaw joints, loose teeth or a severe headache? Chances are that you may be grinding your teeth during sleep. If you or your loved ones notice that you grind your teeth, it is important to seek treatment. This article explains everything you need to know about tooth grinding, how it affects your oral health and how it is treated.

What is bruxism?

Tooth grinding, medically known as bruxism, is a common condition characterized by the involuntary clenching or grinding of teeth, often occurring during sleep. This repetitive behavior can lead to various dental problems, including worn tooth enamel, tooth sensitivity, and even tooth damage. Bruxism can also cause discomfort in the jaw muscles, leading to jaw pain and potentially contributing to temporomandibular joint (TMJ) disorders. While some individuals may grind their teeth during waking hours, others may only experience it while asleep, known as sleep bruxism.

Bruxism is a condition that involves excessive grinding of teeth, which is not related to normal dental functions such as chewing or swallowing. Although some people tend to grind their teeth during the day, most people who have bruxism grind or clench their teeth during sleep. The most common cause of bruxism is anxiety and depression. However, it can also occur as a result of sleep related disorders or due to an abnormal tooth bite. 

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How do I know if I have bruxism?

The exact causes of bruxism are not fully understood, but several risk factors have been identified, including stress, certain medications, and sleep disorders like obstructive sleep apnea. Additionally, lifestyle factors such as alcohol consumption and recreational drug use may exacerbate bruxism symptoms. Children can also develop bruxism, which is often attributed to stress or improper jaw alignment. In some cases, underlying medical conditions such as gastroesophageal reflux disorder (GERD) or attention deficit hyperactivity disorder (ADHD) may contribute to tooth grinding.

You may be having bruxism if you are having any of the following symptoms¹.

• Facial Pain: This occurs because your facial muscles remain under tension while you grind your teeth, hence leading to facial pain.
• Headaches and Earaches: It occurs due to the excessive straining of the muscles of the scalp and the head.
• Temporomandibular Joint Disorders: When you grind your teeth, you are actually putting a lot of pressure on the joints of your jaws. The more you grind your teeth, the higher will be the wearing and damage to the TMJ, resulting in problems such as difficult or painful mouth opening, clicking sounds, or even jaw dislocation.
• Sleep Disruption: The sound of tooth grinding is often so high that it can disrupt your sleep as well as your partner’s.
• Worn Down Teeth: Due to physical grinding between the opposing teeth, the biting surfaces of the teeth become flattened.
  
  

Diagnosing bruxism typically involves a comprehensive dental examination, including assessing tooth wear and muscle activity. A sleep study may be recommended to evaluate bruxism patterns during sleep. Treatment options for bruxism aim to alleviate symptoms and prevent further dental damage. This may include lifestyle modifications to manage stress, wearing a mouth guard or mouth splint to protect teeth during sleep, and practicing good sleep hygiene. In severe cases, muscle relaxants or talk therapy may be prescribed to address underlying stress or anxiety contributing to tooth grinding. It's essential for individuals experiencing symptoms of bruxism to consult with a healthcare provider or dentist for proper diagnosis and treatment to prevent complications and promote oral health.

What are the consequences of bruxism?

Mild bruxism is one of the “bad” dental habits which can develop into severe bruxism and this has proven to be extremely dangerous for your oral and physical health. Let’s take a look at severe cases of how bruxism teeth grinding can affect you.

• Sensitive Teeth: Perhaps, the most common problem associated with bruxism is tooth sensitivity. This happens because every time you grind your teeth, a layer of the protective enamel layer is lost from their chewing surfaces. A time comes when the enamel layer is completely destroyed, and the underlying sensitive dentin become exposed, making your teeth sensitive and vulnerable to getting cavities.
• Tooth Fractures: During bruxism, your teeth come under a lot of pressure. Persistent grinding forces on your teeth can result in the development of vertical fractures in your teeth. These fractures can result in significant damage to the tooth structure and can also result in spontaneous exposure and inflammation of the pulp.
• Periodontal Problems: Bruxism also result in the inflammation of the periodontal tissues which surround and support the teeth in their sockets. If this condition is not corrected in a timely manner, your teeth may become shaky and unsupported.
• Damage to Restorations: Tooth grinding or clenching can also damage any tooth fillings, crowns, bridges or any other restorations of the teeth. This is because of the excessive pressure the restorations have to bear during teeth grinding, which is often beyond their capacity to withstand.
• Temporomandibular Joint Disorders (TMDs): TMDs, in case of bruxism can arise due to two reasons; either exacerbated by an improper bite or due excessive pressure on the joints. Whatever the reason, bruxism damages the joints and can result in limited or painful mouth opening, difficulty in chewing, headaches and earaches. Also, due to the excessive pressure on the facial muscles, individuals who have bruxism often wake up with severe pain in their facial or temple region. Even if pain is not severe, bruxism may already be occurring and causing damage.
  
  
  

How is bruxism treated?

Treatment of bruxism involves the identification and elimination of the main causes of teeth grinding as this behaviour is often responsible for tooth pain. At Dental Designs Clinic, we realize the importance of treating bruxism at an early stage, so the risk factor for damage to your teeth and other dental structures can be minimized. Here’s how our dentists treat problems related to primary bruxism due to tooth grinding.

• Identification of the Underlying Cause: The first step in the management of bruxism is to identify the cause, so that appropriate treatment may be performed. If your bruxism problem has a medical cause, we will work closely with your physician to eliminate the issue.
• Occlusal Splints and Mouthguards: Occlusal splints² are appliances which are worn over your teeth, and they prevent them from getting damaged because of bruxism. Similarly, mouthguards or nightguards also prevent your teeth damage from damage as a result of grinding during sleep. However, this only serves as a temporary solution while we treat the underlying cause.
• Dental Crowns: We may place dental crowns to protect and strengthen the teeth which have become fractured because of bruxism. In severe cases where the bite has been altered because of bruxism, a bite reprogramming can be performed to re-estabilish a healthy and balanced bite.
• Sleep Medicine: If you grind your teeth due to sleep disorders, then we can provide the necessary dental treatment to protect your teeth and refer you to a sleep medicine specialist for further treatment. Mild cases of sleep apnea may be able to be managed with a nightly dental appliance worn on the teeth, called a mandibular advancement splint. 
  
  

No doubt bruxism is bad for your teeth. Fortunately, this condition can be managed! In this case, prevention is definitely better than cure. 

References

1. Lal SJ, Weber, DDS KK. Bruxism Management. [Updated 2022 Oct 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482466/
2. Shetty S, Pitti V, Satish Babu CL, Surendra Kumar GP, Deepthi BC. Bruxism: a literature review. J Indian Prosthodont Soc. 2010 Sep;10(3):141-8. doi: 10.1007/s13191-011-0041-5. Epub 2011 Jan 22. PMID: 21886404; PMCID: PMC3081266.