Teeth Grinding (Bruxism)

What is Teeth Grinding (Bruxism)?

Teeth grinding, or bruxism refers to the habitual grinding, gnashing, or clenching of the teeth. Bruxism can manifest when you’re awake (diurnal bruxism) or during sleep (nocturnal bruxism). While mild cases may not necessitate treatment, severe instances of bruxism can result in jaw disorders, headaches, damaged teeth, and other complications that require treatment and management.

Causes of Bruxism

The exact cause of bruxism remains a topic of ongoing research. However, it's widely accepted that bruxism likely arises from a blend of physical, psychological, and genetic factors. Here are some potential contributors to bruxism:

1. Emotional Factors: Stress, anxiety, anger, frustration, or tension can trigger episodes of bruxism, especially in individuals with stressful lifestyles or jobs.

2. Personality Traits: Those with aggressive, competitive, or hyperactive character traits may be more likely to develop bruxism.

3. Pain Response: Bruxism could be a reaction to pain from conditions like earaches or teething in children.

4. Medical and Psychiatric Disorders: Bruxism has been linked to several medical and psychiatric disorders, including Parkinson's disease, dementia, gastroesophageal reflux disorder (GERD), epilepsy, night terrors, sleep-related disorders such as sleep apnea, and attention deficit hyperactivity disorder (ADHD).

5. Certain Medications: Some medicines, particularly certain antidepressants, have been associated with bruxism.

6. Recreational drug use: Certain drugs, especially stimulants like cocaine and MDMA, have been shown to cause grinding.

7. Lifestyle Factors: Smoking, heavy caffeine intake, and alcohol consumption can heighten the risk of bruxism.

Symptoms and consequences of Bruxism

Recognizing the signs and symptoms of bruxism is a crucial step towards diagnosis and treatment. Here are some signs to watch for:

1. Teeth Grinding or Clenching: Sometimes you just know that you grind your teeth, especially if you do it loudly and your partner or someone in the house can hear/see you doing it.

2. Flattened, Fractured, Chipped, or Loose Teeth: Constant grinding can lead to physical changes in the structure and condition of your teeth as they rub against each other

3. Worn Tooth Enamel: Severe bruxism can wear down the enamel, exposing the deeper layers of your tooth and potentially leading to tooth sensitivity.

4. Increased Tooth Sensitivity: As bruxism erodes the protective enamel layer, the teeth may become more sensitive to temperature and pressure.

5. Jaw or Facial Pain: Bruxism can strain the muscles of the jaw, causing discomfort or pain in the jaw or face. This is also known as TMD. This pain can also present similar to an earache.

6. Tired or Tight Jaw Muscles: Overworked jaw muscles may feel stiff or fatigued, especially in the morning.

7. Dull Headache Originating in the Temples: Bruxism can cause tension-type headaches, typically felt in the temples.

8. Damage from Chewing on the Inside of Your Cheek: Bruxism may cause inadvertent biting of the inner cheeks.

Treatment and Management of Bruxism

Stopping the bruxism itself

Since the exact cause of grinding is extremely hard to determine and is due to a variety of factors, stopping the actual habit can be extremely difficult. You may need to speak to your GP or therapist for assistance.

1. Mental therapies: Behavioral therapies like biofeedback and cognitive-behavioural therapy (CBT) can help individuals become more aware of their grinding and develop habits to reduce it. Seeing a therapist to manage your stress and anxiety can help with reducing grinding

2. Physical therapy: Exercises may also be beneficial to reduce grinding

3. Lifestyle changes: This involves stress management techniques, good sleep hygiene, avoiding stimulating substances in the evening, and maintaining a healthy diet and regular exercise regimen. You may even need to consider changing your job or where you live!

4. Medications: While medications are typically not the first line of treatment for bruxism, in some cases, muscle relaxants or Botox injections may be recommended.

Managing the dental consequences of grinding

The main aspect of a dentist's job in managing grinding is to protect and restore your teeth and look after your jaw health. Dental treatments may include:

1. Mouthguards and splints: A few different kinds of mouthguards may be used if you are grinding your teeth. All of them will protect your teeth from contacting each other and stop them from chipping and wearing down, and some mouthguards will be shaped to improve the way your jaw joints move (if you are experiencing jaw issues).

2. Botox injections: Botox is a muscle relaxant, and your dentist may be able to inject your facial muscles (the masseters) with Botox to relax them and reduce the amount of force they apply on your jaws when you grind.

3. Composite bonding: If your teeth are worn down, your dentist may carry out some composite bonding to reshape the edges of some of your teeth to improve how they bite/grind together. Often this involves placing some composite on your canine teeth to prevent your back teeth from rubbing against each other as you grind your teeth sideways. These are known as ‘canine risers.’ Composite bonding can also be used to cover exposed tooth tissue that has been worn away and is now sensitive

4. Composite rehabilitation: If your teeth are severely worn down, your dentist may need to rebuild and restore your teeth using composite resin to build your teeth back up again.

5. Crowns: Similar to the composite resin but using crowns which are made from porcelain

Conclusion

Understanding teeth grinding, or bruxism, is the first step towards obtaining effective treatment. If you suspect you have bruxism, it's crucial to consult your dentist or doctor, who can examine your mouth and jaw for signs of the condition, help identify potential causes, and suggest suitable treatment options. With the right approach, bruxism can be managed effectively, allowing you to maintain a good night's sleep and a healthy smile.