What is Bruxism (Teeth Grinding)?

What is Bruxism?

Bruxism is also called as Teeth Grinding, Teeth Clenching, Teeth Gnashing or  Teeth Gritting. Bruxism is the third most common sleep disorder (after snoring and sleep talking) among population. It’s a worldwide phenomenon that occurs in every race, socio-economic level and in both sexes.

15 – 38% of young children and 5-20% of adults brux. Today the statistics show that one out of every four dental patients has bruxism.

Effects Of Bruxism:

Bruxism affects sufferers in many ways. Some of the adverse effects are short-term and disappear when the bruxism stops. Others are long-term or even permanent.

• Short-term effects of bruxism
  1. Headache
  2. Facial myalgia (aching jaw & facial muscles)
  3. Ear ache
  4. Tightness/stiffness of the shoulders
  5. Limitation of mouth opening
  6. Sleep disruption
  7. Sleep disruption of bed partner due to noise
  8. Excess tooth mobility
  9. Inflamed & receding gums
• Long-term effects of bruxism
  1. Temporo-mandibular Joint Disorder
  2. Tooth wear & breakage

Causes of Bruxism:

1. Emotions, such as anxiety, stress, anger, frustration or tension
2. Aggressive, competitive or hyperactive personality type
3. Abnormal alignment of upper and lower teeth (malocclusion)
4. Other sleep problems, such as sleep apnea
5. Response to pain from an earache or teething (in children)
6. Stomach acid reflux into the esophagus
7. An uncommon side effect of some psychiatric medications, such as phenothiazines or certain antidepressants
8. A coping strategy or focusing habit
9. Complication resulting from a disorder such as Huntington’s disease or Parkinson’s disease

Signs and Symptoms of Bruxism:

1. Teeth grinding or clenching, which may be loud enough to awaken your sleep partner
2. Teeth that are flattened, fractured, chipped or loose
3. Worn tooth enamel, exposing deeper layers of your tooth
4. Increased tooth sensitivity
5. Jaw or face pain or soreness
6. Tired or tight jaw muscles
7. Pain that feels like an earache, though it’s actually not a problem with your ear
8. Dull headache originating in the temples
9. Damage from chewing on the inside of your cheek
10. Indentations on your tongue

Treatments of Bruxism:

Dental approaches:

• Splints and mouth guards. These are designed to keep teeth separated to avoid the damage caused by clenching and grinding. They can be constructed of hard acrylic or soft materials and fit over your upper or lower teeth.

• Dental correction. Correcting teeth that aren’t properly aligned may help if your bruxism seems to be related to dental problems. In severe cases — when tooth wear has led to sensitivity or the inability to chew properly — your dentist may need to reshape the chewing surfaces of your teeth or use crowns. In certain cases, your dentist may recommend braces or oral surgery.

Therapies:

• Stress management. If you grind your teeth because of stress, you may be able to prevent the problem with professional counseling or strategies that promote relaxation, such as exercise or meditation.
• Behavior therapy. Once you discover that you have bruxism, you may be able to change the behavior by practicing proper mouth and jaw position. Ask your dentist to show you the best position for your mouth and jaw.
• Biofeedback. If you’re having a hard time changing your habits, you may benefit from biofeedback, a form of complementary medicine that uses monitoring procedures and equipment to teach you to control muscle activity in your jaw.

Medications:

• Muscle relaxants. In some cases, your doctor may suggest taking a muscle relaxant before bedtime, for a short period of time.
• Botox injections. Botox injections may help some people with severe bruxism who don’t respond to other treatments.

Lifestyle and Home Remedies:

• Reduce stress. Listening to music, taking a warm bath or exercising can help you relax and may reduce your risk of developing bruxism.
• Avoid stimulating substances in the evening. Don’t drink caffeinated coffee or caffeinated tea after dinner, and avoid alcohol and smoking during the evening, as they may worsen bruxism.
• Practice good sleep habits. Getting a good night’s sleep, which may include treatment for sleep problems, may help reduce bruxism.
• Talk to your sleep partner. If you have a sleeping partner, ask him or her to be aware of any grinding or clicking sounds that you might make while sleeping so that you can report this to your doctor.
• Schedule regular dental exams. Dental exams are the best way to identify bruxism. Your dentist can spot signs of bruxism in your mouth and jaw with regular visits and exams.

When to see a Dentist?

See your dentist if:

1. Your teeth are worn, damaged or sensitive
2. You have pain in your jaw, face or ear
3. Others complain that you make a grinding noise while you sleep
4. You have a locked jaw that won’t open or close completely

Article written by,

Dr. Wong Kee Cheong (Tommy)
Dental Surgeon
BDS (AIMST), MBA (SEGi), YCDP