December 27, 2018

Causes, Symptoms and Treatment of Teeth Grinding or Bruxism

What is Bruxism?

Bruxism comes from the Greek word “brychein” for “gnashing of the teeth”. This sleep-related movement disorder involves nighttime teeth grinding. Like other sleep-related movement disorders, bruxism is characterized by involuntary, unconscious movement during sleep.

While people also grind their teeth while awake, sleep bruxism is generally a bigger health concern. People with sleep bruxism may not know they’re grinding their teeth, so the behavior can continue for years. Left untreated, sleep bruxism can break, loosen, or wear down teeth, enamel, crowns, and fillings. It can also cause headaches, jaw pain, and Temporomandibular Joint (TMJ) disorder.

Sleep bruxism also interferes with sleep quality. The body needs to relax during sleep, and tooth grinding involves tensing the muscles, inhibiting the body’s ability to relax into a deep, restful sleep.

Symptoms of Bruxism

People with bruxism may not be aware of the condition. Here are the symptoms of nighttime teeth grinding:

  •    Tooth pain, jaw pain, unexplained facial pain, earaches, and headaches
  •    Pain and swelling in the jaw
  •    Broken or chipped teeth, crowns or fillings
  •    Changes in the shape of teeth
  •    Complaints of grinding or gnashing sounds at night from bed partners

How Common is Bruxism?

Rates of bruxism decrease with age. Prevalence in adults under the age of 30 is estimated at 13%, while rates for those over 60 drops to 3%. Bruxism is common in early childhood. This condition is usually outgrown by the time the permanent teeth start to erupt around age 5 or 6.

What Causes Bruxism?

Doctors still don’t know what causes bruxism. However, several risk factors increase the risk of bruxism, including genetics, stress, other sleep disorders such as sleep apnea, and regular alcohol, drug, or tobacco use.

70%of bruxism cases are related to anxiety and stress, and bruxism occurs at a higher rate in adults who are prone to intense emotions and have aggressive or hyperactive personalities. People may develop bruxism as a coping strategy similar to biting their cheeks, lips, or nails.

People with sleep-related breathing disorders like obstructive sleep apnea have a higher risk of bruxism.

Using nicotine, caffeine, alcohol and psychoactive drugs increase the risk of bruxism.

Diagnosis

Dentists are trained in all aspects of oral healthcare, which includes identifying early signs of bruxism. One of the best ways to diagnose sleep bruxism early and prevent long-term damage is with a twice-annual dental checkup.

Treatment

Bruxism has no cure. However, symptoms of bruxism and damage to the teeth can be reduced or eliminated through a combination of therapies.

Lifestyle modifications can help reduce symptoms and improve sleep quality for people experiencing bruxism. These include improving sleep hygiene and reducing stress.

  • Maintaining a consistent bedtime and wake-up time.
  • Meditation, yoga and deep breathing exercises can reduce stress.
  • Warm baths, warm compresses and facial massage can alleviate jaw tension.
  • Avoiding hard foods and chewing gum can keep jaw muscles more relaxed.
  • Reducing or eliminating caffeine, alcohol, and nicotine.

When lifestyle modifications don’t provide enough relief, dental devices or other therapies can help alleviate bruxism. Occlusal splints, occlusal bite guards, night guards, bite plates, and bruxism appliances are all custom fitted by a dentist.

A dentist takes an impression of the teeth, which is used to fit a device worn during sleep. These devices do not actually stop grinding, but they can prevent further damage by separating and protecting teeth and reducing grinding noise.

If the bruxism is a side effect of an anxiety disorder, treating underlying anxiety can eliminate bruxism symptoms. For example, combining cognitive behavioural therapy (CBT) with occlusal splints has proven more effective for treating sleep bruxism than occlusal splints alone, further reinforcing the connection between bruxism and stress and anxiety.

Can muscle relaxants help treat bruxism?

Muscle relaxants can help treat bruxism, but they are not considered to be as effective as other treatments, such as splints or mouth guards. When muscle relaxants are prescribed for bruxism, they will usually be prescribed to be taken before bed. In general, bruxism must be severe, and other types of treatments will have been tried first before muscle relaxants are prescribed.