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.