Teeth Grinding (Bruxism)

What is Bruxism?

Bruxism, also known as teeth grinding, teeth clenching, teeth gnashing or teeth gritting, is the third most common sleep disorder (after snoring and sleep talking), in both adults and children. It’s a worldwide phenomenon that occurs in every race, socio-economic level and in both sexes. 15 to 38% of young children and 5-20% of adults brux. Today the statistics show that one out of every four dental patients has bruxism.

1. Sleep Bruxism – This is a subconscious and involuntarily habit of teeth grinding and clenching which usually occurs during sleep, and is considered to be very common. It can occur on a regular basis, and sometimes it comes and goes. Normally, a nightly attack of bruxism lasts only 4 to 15 seconds, but in the average case, it occurs many times during the night (25 times per night). Thus, people who brux during sleep may grind their teeth for more than two minutes a night. In some cases the grinding is very loud, and in others it’s quiet.

2. Daytime Bruxism – It occurs during the day as a response to mental stress, anger or anxiety. Daytime bruxism is expressed mostly in clenching and not in grinding.

Frequently asked question is “What is the differences between grinding and clenching?”. Short answer: Grinding teeth means sliding or rubbing your teeth across one another while clenching is pretty much biting down your teeth. For longer answer enter here.

The chance that you are a bruxer is very high. Actually, the basic assumption is that everyone grinds their teeth (and not just in a metaphorical way) in one way or another. Two decades ago, teeth grinding was nicknamed in the USA as “the disease of the ‘80s”. About 40 million Americans grind their teeth and even though it’s a very widespread phenomenon, most people are not eager to talk about it or to even admit that it is a problem. Most reports regarding bruxism are from dentists, and not from the general public who are unaware of the problem. Nevertheless, only a small part of the huge number of teeth grinders actually suffer severe grinding with tooth damage. Most of the time, it will just disappear on its own.

Bruxism Signs and Symptoms

Many people are unaware that teeth grinding is a medical condition that has serious consequences. Unfortunately, most sufferers are unaware that they have the condition unless someone who lives closely with them tells them. There are many signs and symptoms that can indicate you have bruxism. The main symptoms are the following:

1. Intense grinding of teeth with loud and audible noises – This is usually the first and most obvious sign that a child, partner or other family member has bruxism. It happens normally during sleep without the person being aware that they are grinding their teeth. It can be so loud that their partner/spouse is awakened. Often a partner or parent becomes aware of bruxism in a sleeper before the sleeper does.

2. Flattened, worn down, fractured or chipped teeth – The first health consequence of teeth grinding is the effect it has on the mouth area. The teeth can become worn down and flattened and the enamel cracked ( tooth enamel is the hard layer on the surface of the teeth).

3. Teeth sensitivity – Another problem that can arise due to teeth grinding is sensitivity. The pain can be felt in the gums as well as the teeth when eating or drinking anything cold or hot. If your teeth are unusually sensitive to heat and cold, it could be because the enamel on the surface of the teeth has worn away.

4. Pain and tightness in your facial muscles and jaw – As well as damage and pain in the mouth area, the jaws and facial muscles can be affected. Tension is the main cause as the jaws and muscles are constantly moved and stretched during teeth grinding episodes.

5. Earaches, headaches and migraines – Earaches and headaches can be brought on by the tension caused from grinding teeth. Similarly, research has shown migraine headaches may be a consequence of muscle tension.

6. Cheek tissue damage – Cheek tissue damage is another complication that can arise. This normally occurs during sleep and most often when the head is in a sideway angle.

7. Bite damage to inside of cheek – In addition, it is common during teeth grinding to sustain bite damage to the inside of the cheek and bite marks can also appear on the tongue.

8. TMJ – Another condition resulting from teeth grinding is temporomandibular joint inflammation – TMJ for short. This is a painful condition that arises due to the joint securing the lower jaw to the skull becoming inflamed. The surrounding tissues and muscles may also be inflamed, leading to further pain and swelling.
For more symptoms of bruxism and further information please read title=”Teeth Grinding Symptoms” href=”https://mouthguardsforteethgrinding.com/teeth-grinding-symptoms/”>teeth grinding symptoms article.

How is Bruxism Diagnosed?

Option 1: Sleep Partner – Many times, bruxism can be identified by your sleep partner or spouse, who hears the grinding at night.

Option 2: Your Dentist – After reading all the signs and symptoms that can indicate you have bruxism, if you suspect or sure that you are grinding your teeth (and/or clenching teeth), the first thing to do is visit your dentist. Your dentist will try diagnosing bruxism by a basic examination (your teeth, mouth or jaw may have basic and unequivocal signs). In some cases, if your dentist thinks it’s necessary, you may also referred to a sleep specialist or to your family doctor for further diagnosis. Please read How to be well prepared for my appointment.

Option 3: Sleep Labs – Because tooth wear can be the result of several different issues, sometimes a more extensive test is needed to diagnose bruxism. Many doctors recommend sleep labs, where technicians measure EMG (electromyography) to monitor chewing muscle activity. These tests can show whether patients grind or clench their teeth while sleeping, and are one of the few ways to get a true accurate diagnosis.

Option 4: Biofeedback Headbands – Biofeedback headbands can also be used to monitor the total number of times a person clenches or grinds their teeth in a night, and allows doctors to see how severe one’s bruxism is. Though biofeedback headbands do not have as many electrodes or wires as the sleep labs, they do not record exact times and durations of clenching like EMG units do. However, both are reliable ways to diagnose bruxism, and should be used to confirm results based on observation. Check biofeedback headband article for further information.

Teeth Grinding Causes

Broadly speaking teeth grinding causes can be divided into two categories – emotional and physical. Below, we classify the different causes of this ailment, while also briefly explaining each of them.

Emotional reasons:

Stress is a major cause of bruxism, along with related emotions and reactions:

1. Stress and anxiety – Stress and anxiety are the major factors in teeth grinding. It has been found that teeth grinding is one way in which the body copes or tries to reduce levels of tension in the body. Life can be really fast at times, and your lifestyle can negatively affect your body in various ways, your mental health being one of them. Research has concluded that bruxism has developed a way for the body to mitigate stress. Bruxing, scientists say, is a subconscious attempt to decrease stress levels. In addition, studies have shown that during times of stress (health, family or job-related), adults with bruxism have increased their grinding.

2. Unexpressed frustration or anger – Research carried out by the Mayo Clinic in the USA found that people with unexpressed frustration or anger were more likely to clench and grind their teeth. Expressed or even suppressed anger could very well be a cause of bruxism. Such cases can be mild to severe, and consulting a professional in this field would be helpful.

3. Discomfort during sleep – Studies have shown that when people feel discomfort during sleep – for example if they have flu or their bed is simply uncomfortable – this can cause grinding teeth.

Physical Reasons:

There are a number of physical reasons why people grind their teeth:

1. Growth of new teeth – Children who are growing new teeth can also suffer from grinding until the bite becomes re-aligned after the teeth have stopped growing. Read Teeth grinding in children for further information on children’s bruxism.

2. Genetic reason – Research has shown that teeth grinding could be genetic. If parents clench and grind their teeth, then their children are more likely to do so.

3. Medications, drugs and medical conditions – Certain drugs, such as Ecstasy are known to be triggers for the ailment. Some medications such as anti-depressants are also a cause of teeth grinding. Additionally, Certain medical conditions such as dehydration, Parkinson’s disease and Huntington’s disease can be responsible for this disorder.

4. Diet & allergies – Dehydration is one of the most known causes of the disease. Dehydration, if left unattended, may eventually lead to several disorders like dry skin and headaches, and allergies, for example, rhinitis and asthma, also contribute to the condition. People who smoke cigarettes or consume alcohol run a high risk of being dehydrated, and thus suffering from bruxism. People who are prone to clenching and grinding their teeth should also avoid large volumes of caffeine and fizzy drinks such as cola. Cigarette smoking, dietary deficiencies and allergies can also induce teeth grinding episodes.

5. Misalignment of teeth – People who have an improper bite or misaligned teeth are known to have a higher incidence of grinding their teeth. An orthodontist should be consulted in situations like these, since they are the perfect solution for remedying misalignment.

For further information about the causes of teeth grinding please read teeth grinding causes article.

Bruxism in Children

The frequency of teeth grinding in children is more common than people realise. Almost 38 percents of children (ages of 0-17) will grind their teeth for various reasons – pain, misalignment of teeth while teeth are developing, illness, anxiety and stress.

Pain experienced by toddlers and older children during teeth growing phases may cause discomfort during sleep leading to grinding. Although many children stop when these phases pass, other children may continue to do so. Persistent teeth grinding will occur in children who have a serious misalignment or crooked teeth. Stress and anxiety is another reason for chronic teeth grinding. It has been shown that children who suffer from tension headaches are much more likely to display signs of teeth grinding than other children.

The good news is that by USA statistics, more than half of all children that brux between the ages of 3-10 had naturally stop bruxing by age 13. Otherwise, bruxing should stop with cessation of stress or realignment of teeth.

For further information about bruxism in children please read Teeth Grinding in Children article.

Risks and Complications

There are a number of teeth grinding complications that can arise. Pressure on the teeth leading to excessive wear and breaks is one of the main problems. When teeth are affected by severe pressure, they become misaligned, which could eventually lead to loss of teeth. Gums can recede, causing a further risk of tooth loss and excessive grinding increases the pain and inflammation of TMJ. These complications and risks resulting from untreated teeth grinding not only produce difficulties in eating and chewing, but may result in loss of appetite. This can bring about further health problems, particularly in vulnerable groups such as children. There are also additional factors such as chronic headaches and neuralgia (facial pain) that can be caused by chronic teeth grinding.

For further information please read Bruxism Risks and Complications article.

Bruxism Treatment

There are a number of options on how to stop grinding teeth.

Mouth guards and splints – Mouth guards and splints are a common form of treatment. Basically, they are appliances worn over the teeth that prevent grinding damages. There are several varieties of guard, each with slightly different attributes. Read more…
Biofeedback – Biofeedback is a treatment that aims to help the sufferer by ‘unlearning’ negative habits such as teeth grinding. It works by providing a stimulus to alert the person – either consciously or sub-consciously – when they have tension in the jaw. Learn More… | Visit Retailer’s Website
NTI-TSS – The Tension Suppression System, (NTI), is a small device that fits over the two top incisor teeth. This device prevents the top and bottom teeth from touching the lower ones and so decreases muscle tension.
‘taste-based-method’ – Another form of biofeedback is the ‘taste-based-method’. This involves the insertion of a small pack between the two back molars. When the mouth is clenched too tightly, the packs are ruptured releasing a foul tasting substance that alerts the person to the tension in the jaw. Learn more…
Stress therapy – Behaviour therapy and stress therapy are also treatments that have been used for teeth grinding. These remedies help by demonstrating relaxation techniques, mouth-jaw positioning exercises and behaviour therapy. The therapies aim not only to alleviate anxiety, but to understand the route cause of why the person is grinding their teeth. In severe cases of teeth grinding, doctors may prescribe muscle relaxants.

For further information about bruxism treatments please read How to Stop Grinding Teeth article.

References

1. Goss, L. A., & Inga, C.J. (2007). Teeth Grinding in Children. [Review].

2. Bruxism (Teeth Grinding). (2008). In Sleep Disorder Channel. Retrieved September 15, 2008, from http://www.sleepdisorderchannel.com/bruxism/index.shtml

3. Naor, R. (2002). Grinding Your Teeth. In NRG Health Magazine. Retrieved September 25, 2008, from www.nrg.co.il/online/archive/ART/312/383.html [With the kind help of translation services]

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Christopher

Christopher has been writing professionally for 17 years. He specializes in health and dentistry. He has written extensively on bruxism, mouth guards and alternative approaches.