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Bruxism is a condition characterized by the grinding, gnashing, or clenching of teeth. It can occur either during wakefulness (awake bruxism) or during sleep (sleep bruxism). While occasional teeth grinding is generally harmless, chronic bruxism can lead to various complications. Sleep bruxism, specifically, is considered a sleep-related movement disorder and is often associated with other sleep disorders like snoring and sleep apnea.
In mild cases, bruxism may not necessitate immediate treatment. However, for individuals experiencing frequent and severe grinding, it can lead to jaw disorders, headaches, and dental damage, among other problems. It is important to be aware of the signs and symptoms of bruxism and to seek regular dental care to address any potential complications.
Because bruxism can occur during sleep, many individuals may be unaware of their condition. It’s crucial to pay attention to common signs like jaw pain, worn-down teeth, and headaches, as they may indicate bruxism. By addressing bruxism early on, dental professionals can provide appropriate management strategies to alleviate symptoms, protect teeth, and prevent further complications associated with this condition.
Symptoms
Bruxism, or teeth grinding, may manifest with the following signs and symptoms:
- Audible teeth grinding or clenching, possibly loud enough to disturb your sleep partner.
- Flattened, fractured, chipped, or loose teeth.
- Worn tooth enamel, exposing deeper layers of the tooth.
- Increased tooth pain or sensitivity.
- Fatigued or tense jaw muscles, or difficulty fully opening or closing the jaw.
- Jaw, neck, or facial pain or soreness.
- Earache-like pain, unrelated to any actual ear problem.
- Dull headaches originating in the temples.
- Damage caused by chewing on the inside of the cheek.
- Disruption of sleep patterns.
If you or your child experience any of the symptoms mentioned above or have concerns about your teeth or jaw, it is crucial to consult your dentist or doctor. Additionally, if you notice your child grinding their teeth or displaying signs of bruxism, make sure to inform their dentist during their next appointment.
Causes
Bruxism, a condition characterized by teeth grinding, is not fully understood by doctors, but it is believed to stem from a combination of physical, psychological, and genetic factors. Awake bruxism often arises from emotional states like anxiety, stress, anger, frustration, or tension. It may also manifest as a coping mechanism or a habit during periods of deep concentration. On the other hand, sleep bruxism is a chewing activity that occurs during sleep and is associated with arousals from sleep.
Risk factors
Bruxism affects men and women at nearly the same rate. However, several factors are known to contribute to a higher risk of teeth grinding, such as:
- Age: While bruxism is a prevalent occurrence among young children, it typically resolves by the time they reach adulthood. However, there are instances where certain children persist in teeth grinding until their teenage years.
- Stress: Teeth grinding can be caused by increased worry, anger, frustration, or stress.
- Personality type: People who are highly motivated, aggressive, competitive, or hyperactive may be more prone to teeth grinding.
- Medications and other substances: Engaging in certain lifestyle habits, such as alcohol consumption, tobacco use, recreational drug use, and excessive intake can contribute to the occurrence of bruxism. Individuals who consume alcohol and smoke are twice as likely to experience teeth grinding compared to those who do not engage in these habits. Bruxism is also a rare adverse effect of various mental drugs, such as selective serotonin reuptake inhibitors (SSRIs), a type of anti-anxiety medication.
- Family history: One may be at a higher risk of bruxism if a family member also has or had one. Sleep bruxism is more common in families.
- Other disorders: Parkinson’s disease, dementia, gastroesophageal reflux disorder (GERD), epilepsy, night terrors, sleep-related disorders like sleep apnea, and attention-deficit/hyperactivity disorder (ADHD) are among the various mental health and medical conditions linked to bruxism.
Diagnosis
During regular dental check-ups, your dentist will look for signs of bruxism, a condition where you grind or clench your teeth. They will evaluate your teeth and mouth over multiple visits to see if the condition is getting worse and to decide if treatment is necessary.
To find out the cause of your bruxism, your dentist will ask you questions about your overall dental health, medications you take, your daily routines, and sleep habits.
To assess the extent of bruxism, your dentist may check for:
- Soreness in the muscles of your jaw
- Visible dental problems like broken or missing teeth
- Damage to your teeth, the underlying bone, and the inside of your cheeks, which may require X-rays to see.
During the dental exam, other issues that can cause similar jaw or ear pain, such as temporomandibular joint (TMJ) disorders, other dental problems, or general health conditions, may also be detected
If your bruxism appears to be related to sleep problems, your dentist may refer you to a sleep medicine specialist. The specialist can perform additional tests, like a sleep study, to evaluate teeth grinding episodes and check for sleep apnea or other sleep disorders. If anxiety or psychological issues seem to be linked to your teeth grinding, you might be referred to a licensed therapist or counselor.
Treatment
Currently, there is no specific medication available to directly stop teeth grinding, and in many instances, treatment may not be necessary. However, in severe cases of bruxism, a combination of dental techniques, therapies, and medications can be employed to prevent additional tooth damage and alleviate jaw pain or discomfort. These treatment options aim to address the underlying causes of bruxism and may include strategies such as dental splints or mouthguards, behavior modification techniques, stress management, physical therapy, and muscle relaxants. The appropriate treatment approach can be determined based on the individual’s specific circumstances and the severity of their condition.
Various management options may be recommended to effectively address the condition.
- Dental approaches: These procedures may prevent or cure tooth wear, but they may not stop bruxism. These are often advised to preserve and improve the teeth:
- Splints and mouth guards: A personalized orthotic device placed in the mouth before going to bed may be recommended. They can be made of hard acrylic or soft materials and can be worn on either the upper or lower teeth. It shields the teeth, muscles, and TMJs from the force generated by grinding. These are meant to maintain teeth apart to prevent clenching and grinding damage.
- Dental correction: The healthcare provider may need to take steps such as reshaping the chewing surfaces of the teeth or using crowns to effectively repair and restore the damage, in severe cases wherein the tooth wear has led to noticeable sensitivity or significant chewing difficulties.
- Other approaches: These approaches may help manage bruxism:
- Stress or anxiety management: If the bruxism is caused by anxiety, seeking help from a competent therapist or counselor may be beneficial. If it is caused by stress, cognitive behavioral therapy (CBT), exercise, and meditation are some of the relaxation techniques that may be utilized.
- Behavior changes: A healthcare provider can demonstrate the ideal position for the mouth and jaw. Being aware and practicing the proper position can help adjust bruxism-related behavior.
- Biofeedback: This method employs monitoring processes and equipment to assist one to control muscle activity in the jaw. This is recommended to those with trouble changing chewing behaviors.
- Medications: Further research is needed to establish usefulness of certain medications in treating bruxism, such as:
- Muscle relaxants: Taking a muscle relaxant before going to bed for a brief period may help manage the condition in some cases.
- Botox injections: This drug, a kind of botulinum toxin, is being tested to help patients with severe bruxism who have not responded to previous therapies.
- Medication for anxiety or stress: Bruxism triggered by stress or other emotional difficulties may be managed with antidepressants or anti-anxiety drugs for a specified period.
- Treating associated disorders: Bruxism triggered by another condition may be treated:
- Medications: If bruxism emerges because of medication, adjusting the current medication regimen or prescribing an alternative medication may be necessary to address the issue.
- Sleep-related disorders: Sleep bruxism may be managed by treating sleep-related disorders such as sleep apnea.
- Medical conditions: Treating the source of bruxism, particularly existing medical issue, such as gastroesophageal reflux disease (GERD) can be beneficial.
Sleep bruxism, often unnoticed by individuals, can give rise to various complications. Without proper treatment, teeth grinding can lead to issues affecting the teeth, jaw muscles, and jaw joints. If individuals experience headaches or jaw soreness upon waking up, it is recommended to consult a healthcare provider for evaluation. They can assess the situation and recommend appropriate treatment, which may involve the use of a night guard or dental splint during sleep. Furthermore, implementing stress management techniques can be beneficial in reducing teeth grinding episodes. Taking proactive steps in managing bruxism can help alleviate symptoms and prevent further complications.
