Bruxism is excessive grinding or clenching of teeth against one another. There are two main types of bruxism—daytime/diurnal bruxism (one that occurs when people are awake) and sleep/nocturnal bruxism (one that occurs during sleep). Bruxism occurs in adults and children, with an incidence of 18.6% in adults and 30% in children. Bruxism can lead to excessive wear on teeth and in some cases lead to pain in the jaw or muscles of the face.
How do you know you have it?
People who grind their teeth may be unaware of the habit because it typically occurs while they sleep. Common symptoms that people experience with clenching/grinding habits is morning symptoms of a dull headache, jaw muscles that hurt or are tight, trouble opening the mouth wide, long-lasting pain in the face, damage to the teeth—worn tooth surface, loose teeth and broken dental fillings. Sometimes, partners or parents can hear the grinding noises at night.
What causes it?
The common causes for bruxism are emotional stress (anxiety and anger), drug use (e.g. stimulants), physical stress (illness, nutritional deficiencies or dehydration), sleep problems, teething (in babies), bad tooth alignment and problems with dental work. Some people can also get bruxism as a side effect of antidepressants.
How to treat bruxism
There are many ways to treat bruxism.
Stress and other psychosocial parameters can cause daytime bruxism. Typically, this is managed by interventions including habit modification, relaxation therapy, awareness techniques and biofeedback. Counselling may reduce stressors in life which can then reduce bruxism.
In patients with sleep bruxism, appropriate intervention might include mouth appliance therapy and medication. In patients with medication or drug-induced bruxism, medication withdrawal or a change of type of medication to a less likely cause of bruxism should be considered. In the case of street drugs being used, any intervention includes psychological counselling.
Dental mouthguard (night guard or bite splint) might be prescribed by your dentist to protect your teeth and jaw. These are worn at night and works by creating a barrier between upper and lower teeth. It can prevent tooth wear, tooth injury and reduce night-time clenching.
Treating sleep apnoea in some people may also help to control sleep bruxism. Improving the quality of sleep is very important. This may include reducing the use of stimulants such as caffeine and nicotine, having enough sleep, making sure you have a good bedtime routine and relaxing before bed.
Muscle deterioration can occur with the overworked muscles of the jaw. This can sometimes require neuromuscular therapy to restore the health of the muscles. Adjunct therapies such as physiotherapy, chiropractic, botox and acupuncture have been found beneficial for such patients.
In severe cases, clients can experience jaw dysfunction called Temporomandibular Disorder (TMD). These clients are referred to our specialist Dr Michael Burgess who specialises in jaw joint (TMJ) surgeries. An arthroscope (small camera) is used through a small incision in the skin to see inside the joint. The surgeon can insert surgical instruments through the arthroscope to do surgery on the joint. They can remove scar tissue and thickened cartilage, reshape parts of the jawbone, reposition the disc, flush the joint and insert an anti-inflammatory medicine.
What should I do if I am concerned?
We are seeing more and more clients developing clenching or grinding habits when experiencing stressful situations in life. If you are one of them, have a chat with us! Our Bite Dentists can do a comprehensive exam, assess the jaw joint, review the symptoms, and organise a pathway to help you manage the issue.
