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Bruxism - Teeth Grinding

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Bruxism - Teeth Grinding

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Bruxism is a condition where people grind or clench their teeth unconsciously while awake or sleeping. Read below to learn more.

Medically reviewed by

Dr. Sneha Kannan

Published At March 7, 2020
Reviewed AtDecember 14, 2023

Introduction:

Teeth grinding, also known as bruxism, is a prevalent behavior observed in many individuals. It involves the involuntary clenching of jaws and grinding of teeth, producing an audible and often bothersome sound. This activity may occur both while awake and during sleep, affecting individuals in various ways. It can result in discomfort such as pain, persistent headaches, and the gradual wearing down of tooth surfaces.

What Is Bruxism?

Bruxism is clenching or grinding of the teeth, which is not a part of normal chewing movements. These clenching and grinding movements are not normal for the jaws. It can lead to excessive teeth wear and can cause permanent damage to the teeth and jaw joints. It can occur in adults or children, day or night. Patients cannot control this habit of excessive grinding, especially when it occurs at night, as it is involuntary.

The function of three muscle groups the jaws (temporalis, masseter, and lateral pterygoid) are associated with bruxism. The force with which the jaw is clenched determines the force of tooth grinding. Clenching or grinding of teeth does not occur if the individual clenches, or if the mouth is open. When the jaw is relaxed, movement occurs in a forward and backward direction and to either side.

What Are the Causes of Bruxism in Adults?

Both physical and psychological factors contribute to bruxism. Physical stress, illness, nutritional inadequacy or malnutrition, dehydration, psychological stress, anxiety, and tension can cause bruxism. Other causes include sleep disorders, abnormal anatomy of the teeth or jaws, and high points on fillings that can cause improper occlusion.

Why Do Children Grind and Clench Their Teeth?

The common reasons are:

  • Pain (teething or earaches).

  • Stress.

  • Hyperactivity.

  • Misaligned teeth.

  • Allergies.

  • Transition to permanent teeth.

  • Dehydration.

What Are the Risk Factors of Bruxism?

  • Stress and anxiety.

  • Malocclusion (misaligned teeth).

  • Age (more common in children).

  • Personality traits (aggression, hyperactivity).

  • Medications (psychotropic drugs, antidepressants).

  • Lifestyle factors (alcohol, tobacco, recreational drugs).

  • Family history.

  • Sleep disorders (sleep apnea).

  • Caffeine intake.

  • Medical conditions (Parkinson's disease, acid reflux).

What Are the Signs and Symptoms of Bruxism?

The Signs and symptoms of bruxism include:

  • Audible Grinding or Clenching:

    • Teeth grinding or clenching, possibly loud enough to disturb sleep partners.

  • Physical Dental Effects:

    • Flattened, fractured, chipped, or loose teeth.

    • Worn tooth enamel, exposing deeper layers.

  • Tooth Sensitivity and Pain:

    • Increased tooth pain or sensitivity, especially to heat and cold.

    • Chronic muscular facial pain and tension headaches due to intense muscle contraction.

  • Jaw-related Issues:

    • Tired or tight jaw muscles.

    • A locked jaw that will not open or close completely.

    • Stiffness and pain in the temporomandibular joint.

  • Facial and Head Discomfort:

    • Jaw, neck, or face pain or soreness.

    • Dull headache starting in the temples.

    • Pain that mimics an earache.

  • Damage and Irregularities:

    • Damage from chewing on the inside of the cheek.

    • An abnormal alignment of teeth due to uneven tooth wear.

    • Attrited, flattened, or worn-out tooth surfaces.

    • Tooth fracture, breakage, or chipping.

  • Sleep Disruption:

    • Sleep disruption, impacting overall sleep quality.

How Can One Identify if They Grind Their Teeth During the Night?

The presence of nighttime grinding involves paying attention to specific signs and indicators:

  • Individuals with nighttime grinding often wake up with a sore or tired jaw, which is a common symptom of nocturnal teeth grinding.

  • Persistent headaches and facial pain, especially around the forehead, are associated symptoms linked to teeth grinding during the night.

  • Increased sensitivity to cold or hot temperatures may signify enamel wear due to grinding, providing a clear indication of nighttime teeth grinding.

  • Observe for signs of damage such as tooth flattening, chipping, or fractures, which can be indicative of nighttime grinding.

  • Nocturnal teeth grinding often produces noticeable audible sounds that can be observed during the night.

  • Changes in the teeth, such as wear or damage, can be noticeable results of nighttime grinding.

  • Frequent disruptions in sleep patterns, including waking up during the night, may be associated with teeth grinding during sleep.

What Are Teeth Grinding Headache?

Teeth grinding, known as bruxism, is frequently linked to headaches. The repetitive clenching or grinding action places strain on the jaw muscles, often culminating in tension headaches. The sustained contraction of these muscles during grinding can induce discomfort in the forehead region, particularly noticeable upon waking in the morning. Diagnosing the underlying causes of bruxism and implementing management strategies to minimize stress and protect the teeth are crucial steps in alleviating headaches and enhancing overall oral health.

How to Diagnose Bruxism?

During a routine dental checkup, the dentist will likely examine for symptoms of bruxism. The proper diagnosis involves:

  • Assessment: The dentist carefully looks for changes in the teeth and oral condition during subsequent visits to assess progression and determine the need for treatment.

  • Identification of Causes: Bruxism can occur due to various root causes, and the dentist investigates them. This includes an assessment of overall dental health, medication usage, daily routines, and sleep patterns.

  • Diagnostic Measures: To measure the extent of bruxism, the dentist inspects for tenderness in the jaw muscles and visible dental irregularities, such as broken or missing teeth. Additionally, they look for additional damage to the teeth, underlying bone, and inner cheek, possibly using X-rays.

  • Diagnosis of Related Disorders: The dentist examines for related disorders, such as temporomandibular joint disorders, other dental issues, or underlying health conditions that may contribute to bruxism.

  • Referral: When a connection between bruxism and sleep problems is suspected, a sleep study is recommended to assess teeth-grinding episodes and identify potential sleep disorders like sleep apnea.

  • Psychological Considerations: Factors like anxiety or other psychological issues can contribute to teeth grinding, and these may be explored during the diagnostic process.

How Is Bruxism Treated?

  • Finding and Removing the Causes of Bruxism: Dentists will look for local problems that are likely to lead to abnormal contact between upper and lower teeth. The bite may need to be improved. If pain is a symptom, the dentist will look for related causes, such as an ear infection or a temporomandibular disorder. Based on the underlying cause, medications are prescribed.

  • Medication: Painkillers for muscular facial pain and muscle relaxant medication to help relax the jaw muscles. In cases having general health problems, an examination by a medical practitioner, counseling, and stress management are necessary.

  • Changing Bruxism Behavior: Therapy aims to achieve changes in behavior by educating the patient on how to rest the mouth. An occlusal splint or night guard is an option for someone with mild to severe grinding behavior and is worn at night. The splint is molded plastic that fits over the upper or lower teeth. It prevents further wear of the tooth surfaces.

  • Biofeedback techniques use electronic monitors to measure tension in the jaw muscles so that people use the monitors to learn how to relax their muscles and reduce tension.

  • Repairing Damaged Teeth: Specific dental treatments are carried out based on the condition of the teeth. It includes:

    • For damaged tooth surfaces - Dental fillings, crowns, and inlay.

    • Cases with fracture extended to pulp-root canal treatment.

    • Badly damaged teeth - Extraction.

    • Missing teeth replacement - Partial dentures, dental bridges, and implants.

    • Orthodontic treatment can realign misplaced teeth.

What Are the Home Remedies for Bruxism?

Apart from mouthguards to prevent further damage to the teeth from bruxism, the following are some other helpful steps to relieve the pain. The following are some self-care steps that can be carried out at home.

  • Facial and jaw muscle relaxation during the daytime.

  • Neck, shoulder and face muscle massage.

  • Stretching exercise targeting the head and neck area.

  • Stay away from hard foods like nuts, candies, or steak.

  • Drink plenty of water every day.

  • Reduce mental stress and learn relaxation techniques.

  • Get plenty of sleep.

Conclusion

Bruxism, commonly known as teeth grinding, can result from various factors such as stress, anxiety, sleeping disorders, and misalignment of the teeth and jaw. It is a prevalent issue, often detected during routine dental checkups. A thorough understanding of the causes and effective management is essential for addressing the condition. Successful management often requires collaboration across multiple specialties. Treating bruxism not only contributes to improved oral health but also enhances overall well-being. Neglecting this issue is not advisable, highlighting the importance of proactive intervention and care.

Frequently Asked Questions

1.

How Can We Withdraw Bruxism?

- Wear a night-time mouthguard.
- Stress-counselling.
- Starting regular exercises.
- Getting muscle relaxants.
- Relax jaw muscles at night by placing a warm washcloth against the cheek.
- Avoid caffeine.
- Avoid alcohol.
- Avoid chewing on items other than food.

2.

Which Medication Causes Bruxism?

Antipsychotic drugs and antidepressants, in specific, selective serotonin reuptake inhibitors like Fluoxetine, Paroxetine, and Sertraline, cause bruxism.

3.

How Can Bruxism Be Fixed At Home?

- Doing muscle stretching exercises.
- Using warm compresses.
- Using a night guard.
- Practicing meditation and yoga.
- Drinking turmeric milk and herbal tea.
- Consuming magnesium-rich food.

4.

What Is the Cause of Bruxism?

Bruxism can be of two types, namely awake bruxism and sleep bruxism. Of which, awake bruxism is due to stress, anxiety, frustration, anger, or coping habits to gain concentration. Sleep bruxism is caused by arousals during sleep, an abnormal bite, stress, and malaligned teeth.

5.

What Is Meant by Bruxism Grinding?

Bruxism is involuntary grinding or clenching of the teeth unconsciously when you are awake or at night while sleeping, which is associated with fear, anxiety, stress, or occlusal irregularities.

6.

Which Muscle Contraction Occurs During Bruxism?

Temporalis muscles and masseter muscles which help in jaw-closing activity, and lateral pterygoid muscles, which help in lateral movements of the jaw, are involved in Bruxism. If the accessory muscles of the neck are involved in bruxism, it may cause head and neck pain.

7.

How Can We Fix Damage Caused by Bruxism?

In case of minor damage caused by bruxism, dental bonding or veneers help in fixing the damage. If the damage is severe, crown placement is the treatment of choice, as the extensive tooth structure is involved.

8.

How Can We Cure Bruxism?

Bruxism in children does not require any treatment and goes away on its own. Also, in adults with minimal grinding or clenching, treatment is not needed. However, if the problem is severe, then dental treatments, psychological therapies, and medications help in curing bruxism.

9.

Can Bruxism Be Fully Cured?

Although bruxism does not have a permanent cure, the frequency of bruxism and damage caused by bruxism can be reduced, and symptoms can be relieved with treatment.

10.

How Does Bruxism Pain Feel?

Bruxism pain in the jaws is present as a dull pain, while in the bone, it is felt as sharp, electric pain. In the jaw muscles, it is exhibited as pain and tension in the muscles.

11.

Is Bruxism Caused by Anxiety?

Anxiety increases the amount of adrenaline in the body which under immobilization of the body is utilized in teeth clenching. Bruxism is most often associated with stress and anxiety.

12.

Is Teeth Ruined by Bruxism?

Bruxism results in tooth enamel loss making the teeth more prone to decay, causing pain in the teeth, especially the back teeth and jaw pain.

13.

Is Bruxism a Severe Condition?

Bruxism is not always associated with severe complications, and it can damage the teeth, restorations, crowns, jaws and produce tension headaches.

14.

Which Vitamin Deficiency Causes Bruxism?

Deficiency of vitamin D and calcium may result in bruxism which can be dealt with by consuming a nutritious and well-balanced diet and taking nutritional supplements if needed.

15.

Can Muscle Relaxants Help With Bruxism?

Injecting a muscle relaxant in the masseter muscle helps in controlling bruxism.

16.

How Can Bruxism Be Stopped in Children?

Relaxing before going to bed by taking a warm bath, listening to soothing music, and reading a book may help in stopping bruxism in children, both in bruxism caused by physical and psychological reasons.

17.

What Causes Night Grinding in Children?

The exact cause of bruxism in children is not clearly known. However, it has been reported that it may be due to malaligned teeth, or it may be a response to teething or dental pain.

18.

What Is Meant by Bruxism Splint?

Bruxism splints are also known as mouthguards, which help in maintaining an even pressure in the jaws and reduce the contact between the upper and lower teeth, thereby reducing damage caused by bruxism.
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Dr. Kandi Disha Yermal
Dr. Kandi Disha Yermal

Dentistry

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