Bruxism: Teeth Grinding and Jaw Clenching
What is Bruxism?
Bruxism, also known as tooth grinding, is the condition of forcefully sliding the chewing surfaces of the bottom teeth over the chewing surfaces of the top teeth, generally in a sideways, back-and-forth movement. Bruxism is often accompanied by clenching which is tightly clamping the top and bottom teeth together. People who grind and clench their teeth are referred to as bruxers and they unintentionally bite down very forcefully subconsciously.
Why is Bruxism a Problem?
Over time the complications of bruxism may cause permanent damage to the teeth and uncomfortable oral and facial pain. During sleep the force of bruxing can be up to six times greater than normal waking biting pressure, approximately 250 pounds of force per square inch, and last for up to 40 minutes per hour of sleep. The complications of bruxism include:
- Damage to the teeth
- Broken fillings and other dental work
- Worsening of jaw joint problems
- Limitation or difficulty in jaw opening and closing
- Tooth sensitivity
- Tooth mobility
What Causes Bruxism?
The cause of bruxism is not completely agreed upon. Consuming stimulants such as caffeine appears to increase the risk of bruxism however a variety of psychological and physical factors are also thought to be responsible. In many cases, bruxism has been linked to stress, however bruxism be the body’s reaction to poor tooth alignment, an uncommon side effect of some psychiatric medications, a complication of severe brain injury or a symptom of certain rare neuromuscular diseases involving the face.
Who is Affected by Bruxism?
While approximately equal numbers of men and women brux during sleep, more women clench their teeth during the day. As many as 20% of adults and 18% of children brux while awake and 8% do so while they are asleep.
What are the Symptoms of Bruxism?
Symptoms of bruxism include:
- Pain or discomfort around the ears when yawning or chewing
- Jaw muscles that are tight or painful, especially in the morning.
- Dull morning headaches
- Rhythmic contractions of the jaw muscles.
- Teeth grinding, which may be loud enough to annoy a sleeping partner.
How Long Does Bruxism Last?
Of all the children who brux between the ages of 3 and 10, more than half will stop spontaneously by age 13. For teen-agers and adults, the duration of bruxism depends upon its cause. If bruxism is dental or medication related, a change in tooth alignment or medication usually resolves bruxism. If bruxism is related to stress, brain injury or illness it may last much longer as these problems can be more difficult to conquer.
How is Bruxism Treated?
There is no cure for bruxism, instead the condition is managed.
The first step is to have an examination by your dentist. During this exam, your dentist will check for tenderness in your jaw muscles, as well as for any dental and gum tissue abnormalities and damage caused by bruxism. Your dentist will also interview you in an attempt to arrive at a cause for your bruxism.
Generally, as a first, and sometimes only step, the pain and discomfort from bruxism is alleviated using a custom fitted nightguard.
Further management of bruxism varies depending upon its cause.
- Stress Related Bruxism – Professional counseling, psychotherapy, biofeedback exercises or other strategies provided by a psychologist or psychotherapist to help you relax may provide more long-lasting relief. Muscle relaxants or botulism toxin may temporarily ease spasm in clenched and overworked jaw muscles when more conservative treatments fail.
- Dental Related Bruxism – Occlusal therapy or orthodontics may provide relief related to bruxism due to poorly aligned teeth.
- Brain Injury or Neuromuscular Illness – Cooperation between your dentist and physician may result in combined therapy for these more complicated causes.
- Medication Related Bruxism – Your physician may be able to switch you to another medication to counteract your bruxism.