Bruxism (Teeth Grinding)

Evidence Based
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What is Bruxism?

Bruxism is defined as excessive teeth grinding, clenching, and/or gnashing. It is a type of sleep-related movement disorder, which causes involuntary movements during sleep.

Bruxism is not related to teeth grinding that can occur while talking or eating. People who grind their teeth are referred to as “bruxers,” but most people don’t realize they have the disorder.

bruxism

Bruxism is a very common condition. About half of adults in the U.S. grind their teeth. 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, tooth grinding is typically not a damaging habit. Children who develop minor bruxism usually outgrow it before pain and damage occur.

Bruxism is often more severe for adults. Treatment, such as a mouth guard, is typically recommended because tooth damage will occur over time without one.

Two Types of Bruxism

There are two types of bruxism, including:

  1. Sleep Bruxism (nocturnal bruxism) is when someone grinds their teeth while sleeping. This is the most common type of bruxism.
  2. Awake Bruxism is when someone grinds their teeth during the day. It is often associated with stress, anxiety, anger, or tension.

Causes of Bruxism

Dentists are not sure what causes bruxism. Teeth grinding may be related to mental, physical, and genetic factors. Stress, respiratory infections, allergies, earaches, and certain medications have also been linked to tooth-clenching.


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Some people are also more prone to developing bruxism than others. The most common factors that increase a person's risk of developing bruxism 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 Consumption — 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.
  • Genetics — 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. Obstructive sleep apnea (OSA) 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.

Bruxism vs. TMJ Disorders

Temporomandibular joint disorder (TMD) is a condition that causes pain and improper functioning of the temporomandibular joint (TMJ) and muscles that attach the lower jaw and skull.

Bruxism is a common side effect of TMD. However, bruxism can also cause, worsen, or turn into TMD over time.

Symptoms of Bruxism

Common symptoms of bruxism include:

  • Tooth clenching and grinding
  • Headaches, which typically start in the temples
  • Earaches
  • Sore jaw muscles
  • Soreness in the face and neck
  • Lockjaw, which is when the mouth cannot open or close completely
  • Clicking or popping sounds in the jaw when chewing
  • Loss of tooth enamel (tooth wear)
  • Flattened out teeth
  • Damage to cavity fillings
  • Fractured, loose, or chipped teeth
  • Tooth sensitivity
  • Tooth pain due to worn down enamel
  • Chewed cheeks
  • Tongue indentations

Risk Factors of Untreated Bruxism

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

Treatment Options for Bruxism

Some treatment options for bruxism include:

Mouth Guards and Splints

Mouth guards and splints are occlusal appliances. They help with teeth positioning and jaw alignment, especially while sleeping. Bruxism mouth guards are made of hard acrylic because heavy bruxers will grind through soft ones.

These mouth guards are also custom-made for every patient. They protect your teeth from grinding, clenching, and gnashing, while also relieving jaw pain and discomfort.

Dental Corrections

Regular dental exams (twice a year) can help catch damage caused by bruxism. If a patient’s teeth are cracked, misaligned, or teeth are missing, restorative treatment is necessary.

Dental crowns or dentures may be recommended, depending on the severity of bruxism damage.

Medications 

Medications are an effective treatment option for bruxism. Common medications include:

  • Muscle relaxants
  • Sleep medicine
  • Botox injections
  • Anti-anxiety medications
  • Antidepressants

Stress Management Treatment

If bruxism is linked to stress, anxiety, or other mental health conditions, your doctor may recommend:

  • Cognitive behavioral therapy (CBT)
  • Behavioral therapies
  • Stress management therapy
  • Biofeedback treatment
  • Relaxation techniques

Treating Associated Conditions

If your bruxism symptoms are linked to another sleep disorder, such as sleep apnea, your dentist may recommend treating that condition first. This is the same for medications and any underlying medical conditions, such as gastroesophageal reflux disease (GERD). 


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Resources

“Bruxism (Teeth Grinding).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 10 Aug. 2017, www.mayoclinic.org/diseases-conditions/bruxism/diagnosis-treatment/drc-20356100

Ferri, Fred F. Ferri's Clinical Advisor 2015. Elsevier Health Sciences., 2014.

Hollins, Carole. Basic Guide to Dental Procedures. John Wiley & Sons, Inc., 2015.

NHS Choices, NHS, www.nhs.uk/conditions/teeth-grinding/treatment/.

Syrbu, John DDS. The Complete Pre-Dental Guide to Modern Dentistry. 2013.

Updated on: September 4, 2020
Author
Alyssa Hill
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Medically Reviewed: September 30, 2019
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Lara Coseo
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