Bruxism (Teeth Grinding)

What is Bruxism?

Bruxism is defined as the habit of clenching, grinding, and gnashing the teeth, typically during sleep. People who grind their teeth are referred to as “bruxers,” but most people don’t realize they have the disorder.

About half of adults in the U.S. grind their teeth, usually while sleeping. Although, only 20 percent of them are considered ‘bruxers,’ which means they grind their teeth enough to destroy tooth enamel.

Men and women over 25 years of age grind their teeth more often than children. Since a child’s jaw and teeth grow quickly, teeth grinding typically isn’t a damaging habit. This is because children who develop minor bruxism usually outgrow it before pain and damage occur.

For adults, the problem can be more severe and typically requires treatment because tooth damage will occur over time.

Untreated bruxism can lead to both minor and severe dental issues. Common bruxism-related conditions include:

• Jaw disorders, such as temporomandibular joint dysfunction (TMD)
• Severe facial pain.
• Frequent headaches and pain in the temples.
• Damage to tooth enamel, crowns, and dental restorations
• Chipped or cracked teeth
• Shortened teeth due to enamel loss
• Tooth loss

Causes

Doctors and dentists are not quite sure what causes bruxism. Teeth grinding may be related to psychological, physical, and hereditary factors such as stress, respiratory infections, allergies, earaches, and certain medications.

Teeth grinding typically occurs while sleeping. Some people also grind their teeth while they are awake. There are two types of bruxism, including:

1. Sleep Bruxism — sleep bruxism is teeth grinding and clenching associated with arousals during sleep
2. Awake Bruxism — awake bruxism is teeth grinding and clenching associated with stress, anxiety, anger, or tension

Risk Factors

Some people are more prone to developing bruxism than others. The most common factors that increase a person's risk of developing this condition include:

• Anxiety and Stress — high stress or anxiety levels can lead to increased teeth grinding when you are awake.
• Medications — certain medications, such as antidepressants, can increase teeth grinding.
• Alcohol — drinking alcohol excessively doubles a person’s chance of developing bruxism.
• Smoking — smokers are twice as likely to develop bruxism since nicotine releases dopamine. People who do not smoke have a lower chance of developing the condition.
• Caffeinated Beverages — excessive caffeine consumption speeds up the heart rate and releases dopamine, which may be linked to excessive teeth grinding.
• Drugs — stimulants, such as cocaine, ecstasy, and amphetamines, can cause severe awake and sleep bruxism. These drugs can also damage tooth structure and cause cavities over time.
• Hereditary — sleep bruxism tends to occur in families, which means the condition can be passed down through generations.
• Disorders — dementia, Parkinson’s disease, night terrors, and attention-deficit/hyperactivity disorder (ADHD) are commonly linked to bruxism. Sleep apnea is also a risk factor of bruxism.
• Age — bruxism becomes more common as people age. Some children may develop the condition, but it is less common than adults.

Common Symptoms

Common symptoms of bruxism include:

• Teeth grinding and clenching
• Frequent headaches, which typically start in the temples
• Earaches
• Lockjaw, which is when the mouth cannot open or close completely
• Clicking or popping sounds in the jaw when chewing
• Loss of tooth enamel due to excessive grinding
• Flattened or worn out teeth
• Damage to cavity fillings
• Fractured, loose, or chipped teeth
• Tooth sensitivity, usually when consuming hot or cold substances
• Tooth pain due to worn down enamel
• Soreness in the jaw, face, and neck
• Damage on the inside of the cheeks due to chewing them
• Tongue indentations

Treatment Options for Bruxism

Treatment may include:

Mouthguards and Splints

Mouthguards and splints are both considered occlusal appliances because they help with teeth positioning and jaw alignment, especially while sleeping. They are made of hard acrylic because heavy bruxers will grind right through soft ones. The devices are also custom-made for every patient and are used to protect teeth from grinding, clenching, and gnashing. In addition, mouthguards also relieve jaw pain and discomfort.

Dental Corrections

Receiving regular dental exams (at least twice a year) can help catch damage caused by bruxism. If a patient’s teeth are cracked, missing, or misaligned, restorative treatment is also necessary. For example, dentures or dental crowns may be recommended by a dentist depending on the severity of bruxism damage.

Medications

Medications are a very effective treatment option for bruxism. Commonly prescribed medications include muscle relaxants, botox injections, anti-anxiety medications, or antidepressants.

Stress and Anxiety Treatment

If the cause of bruxism is from stress, anxiety, or other psychological conditions, a doctor may recommend cognitive behavioral therapy (CBT). Behavior therapy and/or biofeedback treatment may also be necessary.