What is bruxism?
Bruxism is a condition in which you grind your teeth and clench your jaw, either while awake or asleep. It is most commonly associated with stress, anxiety, and anger, but can also be caused by certain medications, other medical conditions (e.g. sleep apnea), an aggressive personality type, and young age. Since bruxism can occur at night, when you are not aware of it, it is important to know the symptoms and get routine dental check-ups to prevent complications.
Symptoms
Symptoms of bruxism include:
- Sensitive teeth
- Worn-down teeth
- Fractured enamel
- Broken teeth or dental work
- Facial pain
- Jaw pain and stiffness
- Headaches
- Earaches
- Complaints from your partner about grinding sounds
Complications
If you have any of the symptoms above, it is important to see your dentist before more severe problems develop, which may include:
- Damage to your teeth and dental restorations
- Receding gums
- Bone loss
- Disorder of the Temporomandibular Joint (TMJ)
- Arthritis in your jaw
- Eating disorders
How do I know if I have bruxism?
Bruxism may not be noticed if it happens during sleep, unless someone else sees or hears it.
However, there are other possible symptoms that can be warning signs of bruxism or another problem. These include:
- Involuntarily grinding your teeth or clenching your jaw when you’re angry, anxious or concentrating
- Headache, earache or facial pain after waking up
- Pain or stiffness in the jaw or jaw joints (TMJ)
- Teeth feel painful or sensitive to temperature
- Teeth are worn, damaged or feel loose
- Bites on the tongue or inside of the cheeks
What causes teeth grinding?
There is no single cause for bruxism. Teeth grinding and clenching may be related to a physical issue with the teeth or jaws, an emotional issue or medical reasons. Your risk factor for bruxism will be higher if:
- you often feel angry, anxious or stressed
- you smoke or consume alcohol or caffeine
- you have missing teeth or an uneven or misaligned bite
- you have a sleep disorder such as obstructive sleep apnoea
- you have certain medical conditions, including cerebral palsy, dementia, epilepsy, gastroesophageal reflux disorder (GERD) or Parkinson’s disease
- you take certain drugs or medications, including antidepressants, antipsychotics or illegal drugs such as cocaine
- you have a family history of bruxism
Bruxism is more common in children than adults, particularly when the primary or secondary teeth are coming through or if they have attention-deficit/hyperactivity disorder (ADHD). Talk to a children’s dentist if you are worried about your child’s symptoms.
What are the dangers of bruxism?
Mild bruxism may not cause problems, but frequent and forceful grinding that puts the teeth and jaws under pressure may cause permanent damage or other problems that need treatment. Complications of bruxism can include:
- Chipped or cracked teeth
- Worn or flattened teeth
- Broken fillings, crowns or other dental restorations
- Temporomandibular joint (TMJ) dysfunction
- Tooth loss
A damaged or lost tooth or restoration is considered a dental emergency, as it may lead to further injuries or can leave the tooth exposed to infection without prompt treatment.
If you grind or clench your teeth, you also may not be a candidate for dental veneers or other cosmetic dentistry treatments until the condition can be managed or treated.
How is bruxism treated?
- If you think you or your child might have bruxism, make an appointment with your dentist. They will ask about your symptoms and examine your teeth for signs of wear and damage.
- They will then discuss appropriate treatments to address the cause and symptoms of bruxism, based on your individual situation. They may also recommend treatments for other problems related to bruxism, such as TMJ disorders or damaged teeth.
- Depending on the cause of bruxism, treatment options may include:
Therapeutic treatments
If bruxism is stress-related, your dentist may be able to recommend relaxation techniques or they may refer you to a licensed and qualified health professional.
Therapies recommended for bruxism may include:
- biofeedback
- cognitive behaviour therapy
- hypnotherapy
- meditation
Bite splint
If you grind or clench your teeth at night, your dentist may provide a custom-fitted bite splint or night guard to wear over your teeth during sleep. This is similar to a mouthguard and prevents your teeth from coming into contact.
A bite splint can help to relieve bruxism symptoms and protect your teeth from damage, but it may not cure the condition altogether.
Straightening teeth
If your teeth or jaws don’t come together normally, your dentist may discuss options for teeth straightening to treat bruxism and other complications of a misaligned bite.
Orthodontic treatments include metal or ceramic braces and removable aligners. Teeth straightening is a long term treatment that may take up to several years, depending on how much straightening is needed.
Restoring teeth
If the biting surface of your teeth is uneven because some of the teeth are worn, damaged or misshapen, these may be restored using strong fillings or dental crowns.
Your dentist may also recommend fitting crowns over teeth that have been weakened by grinding to protect them from further damage.
Replacing teeth
If you have any missing teeth, your dentist can discuss replacements such as dental implants or dentures, based on your preferences and your price range.
Teeth that have been too structurally damaged by teeth grinding may also benefit from being extracted and replaced. However, this is always a last resort for a dentist.
Other treatments
If bruxism may be a side effect of medication, a health condition or a sleep-related disorder, treating this underlying problem may also help to treat bruxism symptoms. Always talk to your doctor before making any changes to medications.
Some health professionals may recommend muscle relaxant medication or injections to help with bruxism symptoms, but there is currently limited evidence of their effectiveness.
How can I prevent bruxism?
You can lower your risk of developing bruxism or of the condition worsening by addressing the manageable risk factors. This could involve:
- improving your sleep routine
- getting plenty of exercise
- avoiding caffeine and alcohol in the evening
- trying to avoid situations that cause stress and anxiety
- keeping up with your regular dental check-ups so your dentist can monitor your progress
