Teeth grinding and clenching, known as bruxism, is an involuntary condition where individuals unconsciously activate chewing muscles, tightening or thrusting the lower jaw and clenching or grinding teeth. Approximately one in six people experience nocturnal bruxism, while one in four do so while awake. Mild, occasional bruxism is typically not problematic. However, frequent or forceful grinding can lead to tooth damage, jaw joint issues, muscle pain, sleep disruption, tension headaches, and ear pain. Severe cases may result in fractured teeth.
Symptoms of Bruxism
Individuals with bruxism may experience:
- Soreness in the temple, face, jaw, or near the ear.
- Pain during mouth opening or chewing.
- Jaw locking, clicking, or becoming stuck.
- Chipped or worn-down teeth or fillings.
- White ridges inside cheeks or scallop-shaped indentations around the tongue.
- Shrunken or receded gums.
- Loose or displaced teeth.
Contributing Factors
Bruxism often results from a combination of physical, mental, and lifestyle factors. Increased likelihood of bruxism is associated with:
- Stress, anxiety, and depression.
- Certain medications, including those for schizophrenia, psychosis, and depression.
- High consumption of caffeine, nicotine, and/or alcohol.
- Interrupted sleep, potentially due to environmental noises.
- Sleep apnoea, a condition causing irregular breathing during sleep and oxygen deprivation. Low oxygen levels trigger stress hormones, increasing heart rate and muscle spasms, which can exacerbate grinding and clenching.
- Acid reflux, which softens tooth enamel, making teeth more susceptible to wear from grinding.
Diagnosis
A dentist can identify bruxism by reviewing health history, medications, and symptoms such as jaw pain, headaches, chewing difficulties, or jaw locking. Oral examination may reveal chipped or worn teeth and other physical signs. A doctor may also assess for sleep apnoea, potentially recommending a polysomnograph test, which is a standard diagnostic tool for sleep disorders.
Management and Treatment Options
Bruxism is a manageable condition. Healthcare practitioners can assist in identifying causes and managing symptoms.
- Medical Review: A doctor can review medications and investigate underlying issues like reflux, jaw arthritis, or sleep apnoea.
- Physiotherapy: A physiotherapist specializing in jaw pain can help with joint locking, clicking, or tension headaches through tailored exercises and stretching.
- Pain Relief: Over-the-counter or prescription pain medication may be used to manage discomfort.
- Dental Appliances: Dentists may recommend a custom-made night guard or occlusal splint to protect teeth from wear and reduce muscle tension and jaw clicking.
- Botox Injections: In cases where other options are ineffective, botox injections may be considered to block signals controlling specific jaw muscle movements, reducing clenching and pain. This is an expensive and temporary solution, requiring frequent application.
Conclusion
Consulting a doctor or dentist is recommended if bruxism is suspected. While treatments like physiotherapy, night guards, and painkillers address symptoms, it is also important to consider addressing the underlying causes. Reducing stress and adopting good sleep habits, such as limiting caffeine and alcohol intake and removing devices from the bedroom, can improve overall health and help prevent pain and costly treatments.