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The involuntary tendency to grind, clench, or gnash your teeth, often without even realizing it, is medically referred to as bruxism. This condition is fairly common and can affect people of all ages.
The spasmodic jaw contractions exert recurrent pressure, similar to putting a weight of nearly 1,200 pounds, on your teeth and underlying structures at frequent intervals. This causes your teeth to clamp together, which paves the way for considerable dental damage over time.
Types of Bruxism
Bruxism can affect you at any time of the day. Depending upon the time of occurrence, this condition is broadly classified into daily bruxism and nightly or nocturnal bruxism.
1. Daily bruxism
Daily bruxism, or bruxomania, refers to the unintentional teeth clenching/grinding that you experience when you are fully conscious during the day.
2. Nocturnal bruxism
Nocturnal bruxism is much more imperceptible as it occurs when you are in a state of slumber. (1)
It is common for the jaw to clench tightly during sleep, often accompanied by involuntary teeth grinding. This night-time exacerbation of bruxism can interfere with your sleep and trigger other health problems. (2)
What Causes Bruxism?
Teeth grinding can be a result of one or more of the following factors:
- People with misaligned teeth or abnormal jaw alignment are increasingly prone to bruxism.
- Excessive or incorrect dental restorations can also contribute to the development of bruxism.
- Certain other local factors that can pave the way for bruxism include occlusal trauma or periodontal injury, the buildup of periodontal calculus, deformed lips, loose teeth, and gingival overgrowth around the teeth (gingival hyperplasia).
Neurological and systemic factors
The common factors that can contribute to the development of bruxism include:
- Excessive caffeine intake: Drinking more than 6 cups of caffeinated beverages in a day. (3)
- Unhealthy habits: Smoking, excessive alcohol consumption, and the use of recreational drugs, such as ecstasy and cocaine.
- Neurological disorders: Disorders that cause sudden and involuntary tics or motor movements, such as Parkinson’s disease and epilepsy.
- Certain medications: Antianxiety drugs and antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and some types of selective serotonin-norepinephrine reuptake inhibitors (SSNRIs).
- Sleep disorders: Nocturnal bruxism often affects people who snore or have a sleep disorder, such as obstructive sleep apnea (OSA).
- Systemic factors: Allergies, gastrointestinal problems, unchecked enzymatic digestion, and nutritional deficiencies. In such cases, your doctor will most probably switch your medication to a more suitable alternative or reduce your dosage. However, these changes do not guarantee a considerable improvement in your condition. (4)(5)(6)(7)
- Other medical conditions: Down syndrome, parasitosis, brain damage, mental retardation, or central paralysis. People generally associate bruxism with structural defects such as misaligned or missing teeth. However, emotional and mental dispositions also have bearings on the development of such involuntary physical tendencies. People who are prone to stress and anxiety or suffer from mood disorders are more likely to develop bruxism.
The following factors can also make you susceptible to bruxism
- Insufficient intake of calcium, magnesium, and vital vitamins
- Chronic and parasitic colon diseases
- Breathing through the mouth
- Asthma
- Hypothyroidism
- Consistent and recurrent urinary dysfunction
- Hormonal changes during puberty (8)
Signs and Symptoms
Excessive clenching, grinding, or gnashing of teeth can chip away the tooth enamel and can lead to the following physical signs and symptoms:
- Grinding sound in your sleep
- Toothache, which tends to be particularly intense in the morning after you wake up
- Pain and stiffness in the facial muscles and around the temples soon after waking up
- Generalized tooth sensitivity, especially to extreme temperatures
- Headache
- Soreness and pain in the jaw upon waking up in the morning or while chewing
- Ear pain
- Stiffness in the neck, which can result in neck pain
- Swollen or raised tissue on the inner lining of the cheek due to involuntary biting
- Teeth marks on the tongue
- Loose teeth
- Cracks and chips on the teeth, in extreme cases
Some other signs include spontaneous or repeated breaking or fracturing of existing restorative work in the patient’s mouth, which includes crowns, veneers, and fillings.
People with bruxism also usually struggle with emotional problems such as anxiety, stress, tension, depression, and eating disorders.
Bruxism can also occur without any noticeable symptoms. In such asymptomatic cases, the patients remain oblivious of their condition until a family member hears them grind their teeth in their sleep.
Medical Treatment for Teeth Grinding (Bruxism)
A serious case of bruxism can induce progressive dental damage, which can make your teeth structurally weakened, worn out, and extremely sensitive.
However, multiple treatment strategies can be used to resolve this condition. The treatment may vary depending upon the underlying cause and severity of the problem, as well as the age of the patient.
1. Medications
The commonly prescribed medications for bruxism include:
- Muscle relaxants: To reduce excessive muscle activity and spasticity during sleep.
- Medication for anxiety or stress: To manage the emotional triggers that may be responsible for your bruxism.
2. Biofeedback
Biofeedback is a noninvasive alternative therapy that uses an electronic instrument to monitor different physiological functions. (9) The readings are used to modify or regulate the problem behaviors that may trigger involuntary or excessive muscle activity responsible for daytime bruxism. (10)
3. Botox injections
In severe cases of bruxism, when the patient does not respond to any other treatment, Botox injections may be administered to relax the masseter muscle, which is responsible for jaw movement.
The injection contains botulinum toxin, which can help control the involuntary grinding of the teeth and clenching of the jaw by weakening the underlying muscle. Your dentist will take into account all the relevant factors and outline an appropriate treatment plan accordingly.
Diagnosing Bruxism
In order to diagnose bruxism, your doctor will conduct a quick physical exam of your oral cavity to check for chipped or cracked teeth, teeth indentations on the tongue, or bite marks on the inside of the cheek. The doctor may also order X-rays to assess the severity of the problem properly.
While a general dentist can be the first contact for diagnosing bruxism, there are specialists such as oral medicine dentists, oral surgeons, or orthodontists who can make definitive diagnoses and render specialized treatment.
Possible Complications
Bruxism is unlikely to pose any major health risk if treated timely, but long-term teeth grinding can give rise to some serious consequences, such as:
- Permanent damage to the teeth, periodontium, and oral lining
- Damage to the masticatory or chewing muscles
- Cervical pain
- Earaches
Extreme complications include:
- Temporomandibular joint and muscle disorder (TMJ) as well as hearing disorders
- Complete tooth loss
- Increased incidence of mood disorders such as depression and anxiety (11)
When to See a Doctor
Early treatment is the best way to prevent any serious damage caused by excessive teeth grinding. So, if you notice any potential symptom of bruxism, visit your dentist for a thorough checkup.
The dentist will review your symptoms, examine your teeth and jaw for signs of teeth grinding, and recommend the proper treatment for your case.
Final Word
While bruxism is usually associated with stress in adults but this may not be the case for children. It is advised to consult your child’s dentist about the possible causes and get appropriate treatment.
Regardless of age, all cases of prolonged bruxism should be checked by a doctor to avoid complications.
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