What exactly is Bruxism?
Teeth Grinding or Bruxism is an extremely common sleep disorder. It is a prevalent cause of disrupted sleep in both children and adults, after sleep talking and snoring. It doesn’t exclusively affect any particular socio-economic group, gender or race. Between 15 and 38% of children brux. In adults, figures range from 5 to 20%. Dental statistics indicate that one in four people who visit a dentist has this condition.
1. Bruxism during sleep – Many people grind and clench their teeth involuntarily whilst they are asleep. In some, this is a nightly occurrence, whereas others will only have episodes of bruxism. A single attack my only last between 4 and 15 seconds, however, the cumulative effect of these attacks can be disastrous, particularly when most people average 20 to 25 attacks per night. Also, at time, the grinding sound during an attack is loud enough to wake a sleeping partner!
2. Bruxism during waking hours – Sometimes, bruxism occurs in response to anxiety, anger or mental stress during waking hours. In these cases, there is more often a clenching response, as opposed to grinding.
One question that people often ask is “Is there any difference between clenching and grinding?” In short, the difference is simply in the definition of the terms. “Grinding” usually refers to a rubbing or sliding action, whereas “Clenching” is more of a downward, biting action. Both damage the teeth and cause pain in the jaw. See here for further information.
There is a very high chance you suffer from bruxism without realizing it. In fact, some dentists believe that everyone engages in bruxism to a certain extent. It is documented that 40 million people in the US alone grind or clench their teeth. Despite the common nature of this ailment, many people don’t like to discuss it or acknowledge that it may be a problem for them. Most of the statistics to hand come directly from dentists, rather than members of the public. Despite all of this, however, it is important to keep the perspective that in the majority of cases, bruxism is not ongoing and does clear up by itself.
Symptoms and Signs of Bruxism
Many people don’t realize that bruxism is actually a medical disorder that can have serious consequences if left untreated. In fact, most people don’t know that they even grind their teeth until somebody else points it out. However, the disorder has several tell-tale symptoms and signs. These are as follows:
1. Accompanying noises – Noises are an obvious indication of bruxism. Often, somebody who grinds their teeth during sleep will make an accompanying sound, which has been known to awaken others! If this is the case, a parent or partner usually notices the bruxism before the person suffering with the disorder does.
2. Damage to teeth – among the first side effects of grinding your teeth can be chipped, worn, flattened or fractured teeth. It is relatively easy to crack your tooth enamel , and when this occurs, bacteria can enter the tooth and cause cavities.
3. Sensitive Teeth – A further problem that arises from bruxism is a considerable increase in tooth sensitivity. This can lead to gum pain and aches or sharp pains in the teeth, often felt in response to extremes of temperature. Again, this is usually caused by initial damage to your tooth enamel.
4. Tension and aches in your jaw and other facial muscles – Grinding your teeth places a great deal of unnecessary strain on the facial muscles and jaws. Often, muscles can start to feel clenched and knotted, leading to pain.
5. Migraines or other headaches and earaches – Head and ear pain are further possible consequences of the increased muscle tension resulting from a bruxism habit. Research has found a direct link between some types of migraine headache and teeth grinding.
6. Damage to the cheek tissue – If you lie on your side during sleep, you risk wearing away at your cheek tissue when you brux. You may not notice this at first, but it soon becomes another painful side effect of teeth grinding.
7. Bite marks on the cheek and tongue – Aside from gradual wear and tear to the cheek tissue, grinding and clenching while sleeping often results in painful bites to the tongue and cheek, which very often bleed. This can be exceptionally painful if it occurs frequently.
8. TMJ – TMJ is short for a condition known as temporomandibular joint disorder. This uncomfortable arises when there is inflammation in the joint between the skull and lower jaw. Often, the inflammation spreads to the surrounding muscles and tissues, increasing swelling and pain. TMJ is frequently accompanied by jaw clicking and popping.
For further discussion on the symptoms of teeth grinding, refer to our article on bruxism symptoms.
How Do We Diagnose Bruxism?
Scenario 1 : Your Sleeping Partner – In the majority of cases, the person who sleeps next to you will hear you grinding your teeth and can alert you to the fact.
Scenario 2 : Diagnosis by a Dentist – If you are at all concerned that you might suffer from bruxism, it is imperative make a dental appointment. Your dentist can usually make a clear diagnosis after a short examination of your mouth, teeth and jaw. If your case is unclear, they may also refer you to a particular sleep clinic or to a GP for further assessment. Don’t be nervous about this, but think of it as a way to step closer to a cure. Please read our Tips on preparing for your appointment.
Scenario 3 : Attending a Sleep Lab – If your bruxism requires extensive testing to diagnose, you may find yourself with a referral to a specialized sleep clinic. Here, technicians use Electromyography (EMG) to measure the activity in your chewing muscles. It is a very accurate form of diagnosis.
Scenario 4 : Self-monitoring with a Biofeedback Headband – Special biofeedback headbands are also used in monitoring the frequency with which somebody grinds or clenches their teeth during the night. The data gathered allows your dentist or GP to assess the severity of your bruxism. Biofeedback headbands are excellent tools for confirming inferences about your bruxism habit. For more information, see our page on the biofeedback headband.
Causes of Teeth Grinding
Generally speaking, any cause of teeth grinding falls into one of two categories – either emotional or physical causes. Below, we list the various causes of bruxism, with brief explanations of each.
Stress is strongly linked to bruxism, together with any of its related emotions:
1. Anxiety – Anxiety is a major factor when it comes to teeth grinding. Grinding, or bruxism, is one of the body’s coping mechanisms to help it deal with nervous tension. The fast pace of our modern lifestyle often affects our wellbeing negatively and puts strain on our mental health. Research findings suggest that bruxism is one way that the body can mitigate emotional overload. Scientists conclude that teeth grinding is a mechanism that generally occurs subconsciously, in an attempt to lower stress levels. When under pressure, many people begin to grind their teeth, and those with an existing habit find that it gets worse.
2. Unexpressed anger and frustration – Research conducted at Minnesota’s Mayo Clinic revealed that individuals with unexpressed anger or frustration were particularly likely to grind or clench their teeth. There was enough evidence to suggest that anger can directly cause a bruxism habit. Cases range from severe to mild. If you find yourself suffering from persistent emotional issues such as anger and frustration, consulting a mental health professional can help you firstly to vent, and also to devise coping strategies.
3. Disturbances during sleep – Clinical studies show that any sleep disturbance (for instance illnesses or an uncomfortable mattress) can cause a person to clench or grind their teeth.
There can be a variety of physical causes behind a person’s bruxism habit:
1. Teething – Children whose adult teeth are beginning to cut through will frequently suffer from bruxism until the teeth stop growing and their bite is re-aligned. For further details regarding children’s bruxism, please read Children and Teeth Grinding.
2. Genetic disposition – New research suggests that certain people are genetically inclined to grind or clench their teeth. Parents who suffer from bruxism should be aware that their children will quite likely suffer from the same condition.
3. Use of particular drugs and medications, as well as certain medical illnesses – Certain medications, particularly anti-depressants, can cause teeth grinding. Illegal recreational drugs like Ecstasy are also well-known triggers of bruxism. Additionally, some medical conditions, including Huntington’s disease and Parkinson’s disease have bruxism as a presenting feature.
4. Allergies and Poor Diet – Dehydration is a very prevalent cause of teeth grinding. If it is left unchecked, dehydration can lead to a variety of complaints, including headaches and a flare-up of allergy symptoms. The accompanying stress from these ailments can trigger a bruxism attack. It is worth noting that smokers and heavy drinkers are generally quite dehydrated, and therefore prone to bruxism. If you already suffer from bruxism, it is important to minimize dehydration as much as possible, in order not to exacerbate the situation. Avoid fizzy colas and caffeine.
5. Dental Misalignment – People with an over or under bite, or those with misaligned teeth can be very prone to grind their teeth. If you have problems with dental misalignment, consult an orthodontist to remedy the problem.
Further details concerning the various causes of bruxism can be found here.
Children and Bruxism
Children grind their teeth far more frequently than you might think. Close to 38 percent of children below the age of 17 grind and clench their teeth. This occurs for a variety of reasons, including pain, dental misalignment (particularly when teeth are cutting through), anxiety, illness and stress.
As children are teething, regardless of whether it is their milk teeth or adult teeth cutting thorough, the associated pain can often cause clenching and grinding during sleep. Most children will stop this when their teeth come through. However, in some individuals, particularly those with misaligned teeth, a persistent grinding habit is formed. Statistics in the USA show that the majority of children found to grind their teeth will stop naturally by the age of 13.
Anxiety and stress are prime causes of bruxism in individuals of any age. Clinical studies show that children exhibiting tension headaches are very likely to have accompanying bruxism symptoms.
Complications and Risks
Several complications can arise if a bruxism habit is left untreated. When teeth are put under undue pressure for any length of time, they start to show breakages and other signs of wear. These can be costly and uncomfortable to repair. Pressure also causes misalignment, which in the long term can lead to a loss of the affected teeth. Receding gums can also begin to be a problem, leading to tooth loss as well. Additionally, teeth grinding will adversely affect the symptoms of TMJ, as it exacerbates inflammation and pain.
All of the complications listed above will lead to difficulty in chewing and eating. Particularly where children are concerned, this may bring a serious reduction in appetite, leading to heath problems. Neuralgia and headaches are also a common byproduct of the above complications.
For more information, please refer to our article on Teeth Grinding Complications.
Treatment for Bruxism
If you grind your teeth unconsciously, there are several options available to help you stop.
▪ Splints and Mouth Guards – These are probably the most common forms of treatment for teeth grinding. They are worn inside the mouth, in order to prevent the two rows of teeth meeting each other. Many models prove highly effective in breaking bruxism habits. There are a number of different splints and mouth guards on the market, and it is important to find one that suits you. Read more…
▪ Biofeedback – This is a method of treatment that aids people to ‘unlearn’ negative habits. It sends a stimulus (usually a short sound) to alert you, when you engage in the habit. Biofeedback headbands sense the beginnings of a clenching action in the muscles of the jaw, and emit a soft beep, enabling you to be aware of what you are doing and release the tension. Learn More… | Retailer’s Website.
▪ Taste Based Method – This is a further variation on biofeedback treatment. Patients insert a pack with a foul-tasting liquid inside between their back teeth. When they begin to grind, the pack is pierced, and the liquid is released into the mouth as a deterrent.
▪ Behavioral and Relaxation Therapy – Behavioral therapy can also be effective and is sometimes used to address bruxism. It reduces underlying anxiety, which is a cause of teeth grinding. In certain cases, doctors may also prescribe medications such as muscle relaxants. In relaxation therapy, a patient is taken through a variety of relaxation exercises and techniques, along with positioning exercises for the mouth and jaw. With repetition, these methods can be quite effective.
For further details, please refer to Stop Grinding Your Teeth.