Awake Bruxism Causes & Treatment Options

What is Awake Bruxism? 

Awake bruxism, also called daytime bruxism, is a condition where you grind, gnash, or clench your teeth while awake This may be unconsciously or consciously. 

Daytime bruxism affects at least one-third of adults.¹⁰ However, most people grind or clench their teeth at times. Bruxism occurs in adults and children but is most common in 25 to 44-year-olds. 

What are the Types of Bruxism?

You can experience bruxism while you’re awake or in your sleep. The teeth grinding is the same in both sleep disorders, but they are considered two separate conditions:

• Awake bruxism: A condition where you grind, gnash, or clench their teeth throughout the day. Awake bruxism can worsen with stress or anxiety. Often, this type of bruxism doesn’t need treatment because you may notice when you’re doing it and stop grinding.
• Sleep bruxism: Similarly to awake bruxism, sleep bruxism involves the same type of teeth grinding. However, because you’re asleep and unaware that it’s happening, it can often last longer and be more intense. 

Signs and Symptoms of Awake Bruxism

It’s essential to know the signs and symptoms of this sleep disorder to prevent further complications.

• Teeth grinding or clenching
• Flattened, fractured, chipped, or loose teeth
• Worn tooth enamel
• Increased tooth pain or sensitivity
• Tired and tight jaw muscles
• Jaw pain
• A locked jaw unable to open or close completely
• A pain that feels like an earache
• A dull headache in the temples
• Chewing on the inside of the cheek

Is Awake Bruxism Harmful? 

In most cases, bruxism doesn’t lead to severe complications. However, bruxism can be severe. 

If frequent, bruxism can lead to various risk factors and medical conditions, especially if left untreated.

The risk factors and side effects of awake bruxism can include:

• Jaw disorders
• Tension-type Headaches
• Damages to your teeth, crowns, or restorations
• Severe facial or jaw muscle pain (orofacial pain)
• Temporomandibular joint disorders (TMJD)
• Sleep disorders
• Problems chewing, speaking, and swallowing
• Ear pain
• Muscle enlargement 
• Damage to teeth that requires dental treatment. This includes dental bonding, filling, crowns, or bridges 

Many people don’t realize they have awake bruxism until side effects and symptoms appear. The risks of problems from teeth grinding may increase if you leave bruxing untreated for a significant period.

Can Children Have Awake Bruxism?

Bruxism is common in young children and babies. Most children will outgrow bruxism but speak with your doctor if the issue doesn’t resolve itself. 

Longstanding bruxism can cause damage to a child’s teeth and jaw. Side effects can include:

• TMJD (temporomandibular joint disorder)
• Headaches
• Jaw pain
• Noticeable wear on teeth

7 Causes of Teeth Grinding During the Day

Doctors still don’t completely understand what causes awake bruxism. However, it may be due to a combination of genetic, physical, psychological, and psychosocial factors.

Daytime bruxism may be due to the following reasons:

1. Psychosocial Factors 

Emotions leading to anxiety, stress, anger, frustration, or tension can cause awake bruxism.

2. Age

Bruxism is common in young children. It usually calms by adulthood. However, adults and children alike are prone to awake bruxism.

3. Personality Type

People who are aggressive, hyperactive, or competitive are more likely to experience bruxism. 

4. Medications and Other Substances

Daytime bruxism can be an uncommon side effect of some medicines or substances. These can include certain antidepressants, ADHD medications, tobacco, alcohol, caffeinated drinks, and recreational drugs.

5. Genetics

Bruxism tends to occur in families, although this is usually sleeping bruxism. If you have bruxism, your family members may also experience it or have a history of it.

6. Coping Mechanism 

Awake bruxism may be used as a coping mechanism. Or, it may be a habit during deep concentration.

7. Other Disorders

Bruxism links to some mental health and medical illnesses. These include Parkinson’s disease, dementia, gastroesophageal reflux disorder (GERD), epilepsy, ADHD, or sleep disorders like sleep apnea, parasomnias, night terrors, and wakefulness.

How to Prevent Daytime Teeth Grinding and Clenching

You can use techniques to help stop or reduce daytime teeth grinding and clenching. Stress is one of the leading causes of daytime bruxism, so reducing stress levels is one of the most effective ways to prevent it.

Some ways to stop awake bruxism include:

• Acupuncture
• Yoga
• Deep breathing
• Meditation 
• Exercise
• Journaling 
• Avoiding caffeine and alcohol consumption
• Orthodontic treatment 

3 Treatment Options for Bruxism

If you experience any of the symptoms or side effects of bruxism, meet with your dentist, doctor, or orthodontist.

If your child is displaying any symptoms of bruxism, mention it at their next dental appointment.

If you experience tooth grinding, there are ways you can prevent it. Some remedies may be more effective than others, depending on the underlying cause of your awake bruxism and symptoms. 

Your doctor, dentist, or orthodontist can help you choose the best solution for your awake bruxism. 

Below are the most common treatment options for bruxism:

1. Mouth Guards (Occlusal Splints)

A mouthguard may be helpful for people with bruxism because it can reduce jaw pain. Occlusal splints work by cushioning your teeth and preventing them from grinding against each other. These are the most useful for those experiencing sleep bruxism, as they can be worn at night.

Occlusal splints can be custom-made by your dentist or orthodontist. Or, you can buy a generic one over the counter. Custom-made mouthguards, or personalized mouthguards, cost more than over-the-counter (OTC) options. 

Personalized mouthguards come in varying levels of thickness and fit precisely to your jaw’s exact size and shape. Custom-made mouthguards are usually more comfortable than shop-bought options because they are made of hard acrylic material.

OTC may not be as useful for severe bruxism as personalized options. These types of mouthguards may not be as comfortable as custom-made options because they are often made of plastic. 

Some people even find that an over-the-counter gaurd actually increases their muscle clenching or grinding due to the soft, squishy material. However, they are an affordable and viable treatment for bruxers experiencing minor teeth grinding.

If you decide to choose an over-the-counter mouthguard, select one made of soft plastic or an option that can be boiled to soften it. 

2. Botox Injections

Botulinum toxin (Botox) injections may reduce the pain and frequency of grinding. However, more research is required to confirm the safety and effectiveness of using Botox for awake bruxism.

During this treatment, a medical professional injects small amounts of the neurotoxic protein into the masseter muscle. This is a large muscle that controls muscle activity. 

Botox won’t cure bruxism, as it is simply a temporary muscle relaxant. However, it can help reduce teeth grinding and related side effects and symptoms. 

The benefits of Botox usually last 3 to 6 months. As such, treatment must be repeated to maintain results.

If you’re interested in using Botox to treat bruxism, discuss the benefits and risks with your doctor. 

3. Biofeedback Treatment

Biofeedback treatment helps people become aware of and eliminate a behavior. The treatment helps to reduce both awake and sleep bruxing.

During biofeedback treatment, a  therapist teaches bruxers how to control jaw muscle activity and movements. This training includes visual, vibratory, or auditory feedback from electromyography. 

Electromyography is an electrodiagnostic medicine technique. The procedure determines and records the electrical activity generated by skeletal muscles.

However, more research is required to understand the long-term advantages and effectiveness of biofeedback treatment.

However, more research is required to understand the long-term advantages and effectiveness of biofeedback treatment.