BRUXISM:

Teeth grinding causes and treatments

Bruxism (BRUK-siz-um) is a condition in which you grind, gnash or clench your teeth. If you have bruxism, you may unconsciously clench your teeth when you’re awake (awake bruxism) or clench or grind them during sleep (sleep bruxism).
Sleep bruxism is considered a sleep-related movement disorder. People who clench or grind their teeth (brux) during sleep are more likely to have other sleep disorders, such as snoring and pauses in breathing (sleep apnea).

Mild bruxism may not require treatment. However, in some people, bruxism can be frequent and severe enough to lead to jaw disorders, headaches, damaged teeth and other problems.

Because you may have sleep bruxism and be unaware of it until complications develop, it’s important to know the signs and symptoms of bruxism and to seek regular dental care.

1. Symptoms

Signs and symptoms of bruxism may include:

• Teeth grinding or clenching, which may be loud enough to wake up your sleep partner
• Teeth that are flattened, fractured, chipped or loose
• Worn tooth enamel, exposing deeper layers of your tooth
• Increased tooth pain or sensitivity
• Tired or tight jaw muscles, or a locked jaw that won’t open or close completely
• Jaw, neck or face pain or soreness
• Pain that feels like an earache, though it’s actually not a problem with your ear
• Dull headache starting in the temples
• Damage from chewing on the inside of your cheek
• Sleep disruption

2. Causes

It may be due to a combination of physical, psychological and genetic factors.

• Awake bruxism may be due to emotions such as anxiety, stress, anger, frustration or tension. Or it may be a coping strategy or a habit during deep concentration.
• Sleep bruxism may be a sleep-related chewing activity associated with arousals during sleep.

3. Risks Factors

These factors increase your risk of bruxism :

• Stress. Increased anxiety or stress can lead to teeth grinding. So can anger and frustration.
• Age. Bruxism is common in young children, but it usually goes away by adulthood.
• Personality type. Having a personality type that’s aggressive, competitive or hyperactive can increase your risk of bruxism.
• Medications and other substances. Bruxism may be an uncommon side effect of some psychiatric medications, such as certain antidepressants. Smoking tobacco, drinking caffeinated beverages or alcohol, or using recreational drugs may increase the risk of bruxism.
• vFamily members with bruxism. Sleep bruxism tends to occur in families. If you have bruxism, other members of your family also may have bruxism or a history of it.
• Other disorders. Bruxism can be associated with some mental health and medical disorders, such as Parkinson’s disease, dementia, gastroesophageal reflux disorder (GERD), epilepsy, night terrors, sleep-related disorders such as sleep apnea, and attention-deficit/hyperactivity disorder (ADHD)

Do you suffer from any of the following ?

4. Complications

In most cases, bruxism doesn’t cause serious complications. But severe bruxism may lead to:

• Damage to your teeth, restorations, crowns or jaw
• Tension-type headaches
• Severe facial or jaw pain
• Disorders that occur in the temporomandibular joints (TMJs), located just in front of your ears, which may sound like clicking when you open and close your mouth

5. Determining the Cause

If our dentist suspects that you have bruxism, he or she tries to determine its cause by asking questions about your general dental health, medications, daily routines and sleep habits.
To evaluate the extent of bruxism, your dentist may check for:

• Tenderness in your jaw muscles
• Obvious dental abnormalities, such as broken or missing teeth
• Other damage to your teeth, the underlying bone and the inside of your cheeks, usually with the help of X-rays

A dental exam may detect other disorders that can cause similar jaw or ear pain, such as temporomandibular joint (TMJ) disorders, other dental problems or health conditions.

6. Referral

If your bruxism seems to be related to major sleep issues, your doctor may recommend a sleep medicine specialist. A sleep medicine specialist can conduct more tests, such as a sleep study that will assess for episodes of teeth grinding and determine if you have sleep apnea or other sleep disorders.
If anxiety or other psychological issues seem related to your teeth grinding, you may be referred to a licensed therapist or counselor

7. Traditional Dental approach

If you or your child has bruxism, your doctor may suggest ways to preserve or improve your teeth. Although these methods may prevent or correct the wear to your teeth, they may not stop the bruxism:

• Splints and mouth guards. These are designed to keep teeth separated to avoid the damage caused by clenching and grinding. They can be constructed of hard acrylic or soft materials and fit over your upper or lower teeth.
• Dental correction. In severe cases – when tooth wear has led to sensitivity or the inability to chew properly – your dentist may need to reshape the chewing surfaces of your teeth or use crowns to repair the damage.

8. Our Functional approach :

One or more of these approaches may help relieve bruxism:

• Stress or anxiety management. If you grind your teeth because of stress, you may be able to prevent the problem by learning strategies that promote relaxation, such as meditation. If the bruxism is related to anxiety, advice from a licensed therapist or counselor may help.
• Behavior change. Once you discover that you have bruxism, you may be able to change the behavior by practicing proper mouth and jaw position. Ask your dentist to show you the best position for your mouth and jaw.
• Biofeedback. If you’re having a hard time changing your habits, you may benefit from biofeedback, a method that uses monitoring procedures and equipment to teach you to control muscle activity in your jaw.

9. Medications

In general, medications aren’t very effective for treatment of bruxism, and more research is needed to determine their effectiveness. Examples of medications that may be used for bruxism include:

• Muscle relaxants. In some cases, your doctor may suggest taking a muscle relaxant before bedtime, for a short period of time.
• Botox injections. Injections of Botox, a form of botulinum toxin, may help some people with severe bruxism who don’t respond to other treatments.
• Medication for anxiety or stress. Your doctor may recommend short-term use of antidepressants or anti-anxiety medications to help you deal with stress or other emotional issues that may be causing your bruxism.

10. Treating associated disorders

• Medications. If you develop bruxism as a side effect of a drug, your doctor may change your medication or prescribe a different one.
• Sleep-related disorders. Addressing sleep-related disorders such as sleep apnea may improve sleep bruxism.
• Medical conditions. If an underlying medical condition, such as gastroesophageal reflux disease (GERD), is identified as the cause, treating this condition may improve bruxism.

THE TAKEAWAY :

In most cases, bruxism can be successfully treated so do not hesitate to contact us if you need further information. Our Treatment may involve:

• Behavior changes. You may be taught how to rest your tongue, teeth, and lips properly. You may also learn how to rest the tongue upward to relieve discomfort on the jaw while keeping the teeth apart and lips closed.
• Mouthguard. You may be fitted for a plastic mouthguard that you can wear at night to absorb the force of biting. It can be worn in the day if you grind your teeth while awake. This mouthguard may help prevent future damage to the teeth and aid in changing behavior.
• Biofeedback. Biofeedback involves an electronic instrument that measures the amount of muscle activity of the mouth and jaw. It then signals you when there is too much muscle activity so you can take steps to change that behavior. This is especially helpful for daytime bruxism.
• Medicine. Some medicines may be helpful in regulating the neurotransmitters. Changing medicines may be needed if antidepressant medicines are found to be the cause of bruxism.