Bruxism, Grinding, & Clenching

Bruxism is the involuntary excessive grinding of the teeth and/or excessive clenching of the jaw. There are two types, Awake Bruxism and Sleep Bruxism

Synonyms - clenching, grinding, 

Symptoms
  • The symptoms for Sleep Bruxism tend to be worse on waking and improve during the course of the day. 
  • The symptoms of Awake Bruxism may not be present at all on waking, and then get worse during the day. 
  • Headaches 
  • Hypersensitive teeth 
  • Aching jaw muscles 
  • Earache 
  • Depression 
  • Insomnia 
  • Tooth Wear - teeth appearing flat, fractured, or chipped 
  • TMJ 
Causes 
  • Psychological Factors
    1. Stress 
    2. Anxiety
    3. Suppressed anger or frustration
  • Mechanical Factors
    1. Abnormal Bite
    2. Crooked Teeth 
  • Diet
    1. Alcohol consumption 
    2. Caffeine consumption 
Risk Factors 
  • Bruxism is most common in adults 25-44 years of age 
  • About 30% of children grind or clench their teeth. The rate is highest in children under age 5. If you notice your child clenching or grinding their teeth, discuss the problem with your family dentist. Most children eventually outgrow bruxism and suffer no permanent damage to their teeth. 
Diagnosis 
  • Although bruxism is not a life-threatening disorder, it can influence your quality of life, especially through dental problems, such as frequent fractures of dental restorations and pain in the orofacial region. Early assessment is essential. 
  • During regular dental visits, the teeth are examined for evidence of bruxism. If symptoms, such as tooth wear are present, the condition will be observed for changes over the next several visits before a treatment program is established. 
  • Sleep specialists can conduct additional tests, such as video monitoring and measuring how often your jaw muscles contract while you sleep. 
Treatment Options 
  • Medical Treatments 
    1. Night Guard - your dentist will make a plastic or acrylic appliance for you to wear at night. The night guard guard will redistribute the forces from grinding and protect your teeth from damage. 
    2. Biofeedback - An electronic instrument measures the amount of muscle activity of the mouth and jaw - indicating when too much muscle activity is taking place so that the behavior can be changed. This is especially helpful for daytime bruxers. 
    3. Splints are created by dental professionals and are shaped to fit over the teeth on the upper and lower jaw which prevents the teeth from grinding and clenching against each other. These are usually more effective than night guards as they are less likely to fall out during sleep. 
    4. Botox injections can cure bruxism in serious patients 
    5. Orthodontic dentistry can be used by adjusting the bite pattern in patients 
  • Self-Care Treatments 
    1. Apply ice or wet heat to sore jaw muscles 
    2. Avoid eating hard foods like nuts, candies, steak 
    3. Avoid food and drinks that contain caffeine 
    4. Avoid alcohol 
    5. Drink plenty of water every day 
    6. Get plenty of sleep 
    7. Learn physical therapy stretching exercises to help restore a normal balance to the action of the muscles and joints on each side of the head 
    8. Massage the muscles of the neck, shoulders, and face. Search carefully for small, painful nodules called trigger points that can cause pain throughout the head and face.
    9. Relax your face and jaw muscles throughout the day 
    10. Reduce daily stress and learn relaxation techniques
Resources