When a person is not chewing, they grind or clench their teeth, which is known as bruxism. It normally happens when sleeping, although it can also happen throughout the day. A lot of the time, a person isn’t even aware that they’re doing it.
Teeth grinding is the act of rubbing the teeth against one other when eating. Clenching occurs when a person clenches their muscles and holds their teeth together without moving them back and forth.
People can clench or grind their teeth at any time of the day or night. According to the Bruxism Association of the United Kingdom, 8–10% of the population suffers from it.
The symptoms, diagnosis, and treatment of bruxism are discussed in this article. We also go through the distinctions between bruxism while sleeping and bruxism while awake.
Awake bruxism
Because it is not a sleep condition, awake bruxism differs from sleep bruxism. It’s more of an unconscious habit.
Teeth grinding is not always the result of awake bruxism. People are more inclined to clench their teeth or strain their jaw muscles instead. Aching around the jaw, dull headaches, and stiffness are all symptoms of awake bruxism. In cases when there is no grinding, however, the condition may not wear the teeth as much.
Awake bruxism occurs involuntarily, much like sleep bruxism. When people are concentrating or stressed, they may notice that they are more prone to it.
Sleep bruxism
A form of sleep disorder is sleep bruxism. When people are awake, they may notice the following signs of sleep bruxism:
- broken or loose fillings
- clicking, popping, or grinding noises when moving the jaw
- worn teeth
- jaw pain and stiffness
- a dull headache
- sensitive, loose, or broken teeth
- facial pain
People can also experience ear pain because the temporomandibular joint (TMJ) — the joint that allows the jaw to open and shut — is very close to the ear. Referred pain occurs when a person feels pain in a location other than the cause of the pain.
People who have bruxism during sleep may not be aware that they are clenching or grinding their teeth, but those who sleep nearby may be able to hear the sounds.
What are the causes of bruxism?
Bruxism may not usually have a single, obvious cause, but it is linked to a multitude of circumstances. Depending on the kind of bruxism, these factors differ.
Primary bruxism
Primary bruxism is not caused by another ailment and happens on its own. The following are some of the known factors that contribute to it:
- Growing teeth: Bruxism is common in young children, with up to 40% experiencing it, usually when their teeth are growing. However, because the teeth and jaw grow quickly during childhood, the bruxism usually resolves on its own without causing lasting damage.
- Misaligned bite: In some people, bruxism may happen because either a person’s bite is not aligned or they have missing teeth. Irritation in the mouth may also contribute to grinding or clenching.
- Stress: One of the main causes of bruxism in adults, whether it occurs during sleep or when awake, is stress. A 2020 systematic review found that there was a significant association between stress and bruxism, but more research is necessary to understand the relationship.
- Smoking, alcohol, and caffeine: A 2016 review of previous research found that the use of these substances was also associated with bruxism. People who smoked or drank alcohol regularly were about two times more likely to have bruxism, while those who drank more than 8 cups of coffee per day were 1.5 times more likely.
Secondary bruxism
Secondary bruxism occurs as a result of another medical condition or circumstance, such as:
- Mental health conditions: Anxiety and depression are associated with bruxism. This association may be due in part to stress, which can contribute to these conditions.
- Neurological conditions: Conditions such as Huntington’s disease and Parkinson’s disease can cause movement during sleep, which may result in bruxism.
- Medications: Bruxism can be a side effect of certain medications, including some antidepressants and antipsychotics. A 2018 study found a link between selective serotonin reuptake inhibitors (SSRIs) and bruxism. Fluoxetine (Prozac) and sertraline (Zoloft) were the most common culprits out of the studied drugs.
- Sleep apnea: Sleep apnea is a condition that causes breathing to stop temporarily during sleep. It can reduce sleep quality and cause frequent arousals, which may be why it is a risk factor for bruxism. By disturbing sleep, sleep apnea may promote teeth grinding or clenching.
What are the long-term effects of bruxism?
Long-term damage from bruxism may cause:
- tooth sensitivity, due to enamel wearing away
- gum inflammation or bleeding
- loose teeth
- damage to dental work, such as crowns and fillings
- flattened or short teeth
- tooth fractures
- TMJ syndrome, which causes pain, tension, and difficulty chewing
Diagnosis
A dental examination can help a dentist identify bruxism. It is possible that they will notice:
- worn tooth enamel
- flattened, fractured, or chipped teeth
- loose or damaged crowns and fillings
Tooth wear can also be caused by too vigorous brushing, abrasives in toothpaste, acidic soft beverages, and hard meals, but only a skilled expert can distinguish between the different wear patterns.
Treatment
Bruxism can be treated using a variety of therapies and strategies. These are some of them:
Mouthguard or mouth splint
To prevent the teeth from injury while sleeping, a dentist may prescribe wearing a mouth splint or mouthguard. These devices can aid by distributing pressure evenly across the jaw, creating a physical barrier between the teeth, and minimizing grinding noise.
Bruxism mouthguards are often made of flexible rubber or plastic. A dentist can custom-make one for a person’s teeth, or they can purchase an over-the-counter (OTC) version. The over-the-counter versions may be less comfortable.
Splints for the mouth are usually composed of a harder plastic and fit over the teeth. Some splints are designed to go over the top teeth, while others are designed to fit over the bottom teeth. A splint may retain the jaw in a more relaxed position or act as a barrier, causing damage to the splints rather than the teeth, depending on the design.
Generic mouthguards are not recommended for sports since they might be bulky and cause severe discomfort.
Medication
A nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen can help reduce the discomfort and swelling caused by bruxism.
In rare cases, a doctor may prescribe a prescription to relax the muscles and break the cycle of teeth grinding for a brief period of time. This method allows the jaw muscles to relax, which may help to alleviate discomfort.
If bruxism is a side effect of a medicine, a person should talk to their doctor about switching to a different one. Never stop taking a drug or modify the dosage without first visiting a doctor.
Biofeedback
Biofeedback is a sort of treatment that helps people become aware of and manage involuntary body processes such as breathing and heart rate.
There isn’t much data on biofeedback’s usefulness in treating bruxism, but a 2018 review found modest evidence that a specific biofeedback tool called contingent electrical stimulation alleviated symptoms after several nights of usage.
Botox
In severe cases of bruxism, injections of botulinum toxin, or Botox, can be used to paralyze the muscles that cause tooth grinding while sleeping. Botox, on the other hand, can be costly, and frequent injections are required to maintain the results.
Treatment for underlying conditions
If a person with bruxism also suffers from stress, anxiety, or depression, finding treatment for these issues may help them stop grinding their teeth.
Typically, these mental health disorders are treated with a mix of talk therapy and medicine to alleviate symptoms, but because some SSRIs can produce bruxism as a side effect, a person may choose to start with therapy first.
If a person has a disorder like sleep apnea, for example, discussing with a doctor about it may help them receive a diagnosis and treatment. To reduce sleep interruptions, some people with sleep apnea benefit from utilizing a continuous positive airway pressure equipment.
Prevention
Self-care may be able to help people with primary bruxism lessen or prevent symptoms. They could, for example, try:
- avoiding alcohol, tobacco, and caffeine
- refraining from chewing gum, as this may increase wear and tear or encourage more grinding
- applying gentle heat to the jaw to relieve pain and tension
- reducing avoidable stress and taking steps to manage unavoidable stress
Stress can be caused by external events and situations, but it can also be caused by how people interpret those experiences. In any instance, there are options for dealing with it.
Seeking help, setting aside time for relaxation, and practicing mindfulness can all be beneficial. Breathing exercises, meditation, yoga, and other relaxation people may also be beneficial.
Questions bruxism
Here are some answers to frequently asked questions concerning bruxism.
Can bruxism cause tinnitus?
There’s a chance that bruxism and tinnitus are connected. Tinnitus can develop if the TMJ is injured, according to the American Tinnitus Association. Tinnitus can be caused by bruxism since it directly affects this joint.
Is bruxism inherited?
According to an older analysis of previous research, there is some evidence that bruxism runs in families. However, no study has shown particular genes linked to it, and genetics is most likely just one of many contributing variables.
Conclusion
When a person grinds or clenches their teeth unconsciously, this is known as bruxism. It can happen when you’re awake or asleep, and it can cause face discomfort, jaw stiffness, and headaches. Teeth grinding can cause long-term damage to the teeth, gums, and jaw joint.
Bruxism can be detected during a dental exam by a dentist. The goal of treatment is to reduce tooth damage with a mouthguard or mouth splint, as well as to address any conditions that may be contributing to the bruxism. This may entail lowering stress, switching drugs, or addressing coexisting diseases like sleep apnea.
