*Nothing in this article constitutes medical advice. Seek the guidance of a physician if you have any questions.*
Bruxism - also known as teeth grinding - is a relatively common disorder in the United States. According to a 2016 study, roughly 8.6% of the American and Canadian population suffer from a specific type of bruxism called “sleep bruxism.” For these affected individuals, almost half of them also reported difficulty sleeping or reduced quality of sleep. While the actual act of teeth grinding often is inconsequential on the overall health of many individuals, the decrease in sleep quality can have life-long implications. Today, let’s take a closer look at bruxism to better understand this condition that affects almost 30 million Americans.
What Is Bruxism?
Bruxism is the medical term for the conditional more commonly known as “teeth grinding.” Formally, the Mayo Clinic defines bruxism as “a condition in which you grind, gnash or clench your teeth.” It comes from the Greek word “brukhein,” meaning to “gnash the teeth.” Bruxism is generally divided into two categories: awake bruxism and sleep bruxism. While the conditions themselves are relatively similar, the causes are often different (more on that later).
Bruxism has at least one very obvious symptom - teeth clenching. Some of us may catch ourselves participating in this behavior from time to time, but bruxism typically involves teeth clenching that is detrimental to some other part of the patient’s life. Let’s take a look at some of the basic symptoms.
- Teeth grinding or clenching. This may be loud enough to wake up other individuals who are sleeping in the same bed or room.
- Teeth that are flattened, chipped, or fractured. This is often a symptom noticed by your dentist. Additionally, they may notice worn enamel, which exposes deeper layers of teeth
- Increased tooth sensitivity or pain
- Tired or tight jaw muscles, especially if noticed in the morning
- Lockjaw is significantly more common in patients who also experience bruxism
- Many individuals experience pain that feels much like an earache, although it is not an ear-related problem
- Headaches starting in the temples
- Pain, damage, and cuts from chewing on the inside of the cheek
- Sleep disruption or poor sleep quality
Unfortunately, the exact causes of bruxism are often hard to pinpoint for each patient. Generally, the range of possible triggers falls within three possible categories. These are not necessarily mutually exclusive, so be sure to contact your physician with any questions.
- Emotions: Especially with awake bruxism, the actual teeth grinding can be an emotional response. Stress, anxiety, and anger are all triggers that being episodes of teeth grinding. Given enough time, this can lead to more severe symptoms like lockjaw and tooth damage.
- Coping strategies: Some individuals grind their teeth as a concentration mechanism. This can be of particular frustration because it can be hard to catch. This is also much more strongly associated with awake bruxism.
- Microarousals: These occur when an individual wakes up many times during a night’s sleep. These microarousals are typically very short - microseconds to seconds. Often, the individual doesn’t even know that it is happening. This is a common symptom of obstructive sleep apnea, and physicians believe microarousals also increase the frequency of bruxism.
Bruxism is typically diagnosed via one of two pathways. First, an individual may report some of the symptoms listed above, and their physician may ask further questions to determine if bruxism is the specific cause. This route of diagnosis is somewhat less common because sleep bruxism is difficult to detect and many individuals may dismiss their awake bruxism as common.
The second, and more common, method of detection occurs in the dentist’s office. During routine teeth cleanings or orthodontists appointments, your dentist is likely to observe any severe signs of bruxism. Depending on your healthcare ecosystem, your dentist may refer you to another physician or sleep specialist for further evaluation.
For many individuals, treatment is not necessary. Children will often outgrow bruxism without any treatment and many adults have only mild bruxism that does not affect their quality of life. This is not the case for everyone, though. For patients requiring further care, treatment generally falls into one of three categories: dental, medicinal, or medical.
Dental Treatment Options
One of the easiest ways to prevent teeth grinding is to make sure that a patient’s teeth never come into contact with one another. Typically, this is accomplished with a mouth guard. This is a cheap and easy solution that identical to a typical mouth guard worn for contact sports. The downside of a mouth guard is that many individuals find it difficult to fall asleep during the first few weeks of usage.
In the most severe cases, dental correction may be necessary. Long-term undiagnosed cases of bruxism can result in tooth deformities and sensitivities. In these cases, dentists may need to reshape teeth to repair the chewing surface.
The use of certain medications to treat bruxism is still a grey area for many physicians. The clinical evidence that supports positive patient outcomes is rather thin, and many other treatment options are just as effective. The most common medication that is prescribed is typically muscle relaxants. This can help relieve tension in the jaw and lead to lower rates of teeth grinding.
Medical Treatment Options
Treatment options that are neither medicinal nor dental fall into this category. This typically involves treating the root cause of the disorder rather than treating the symptoms. For individuals with stress or anxiety disorders that are possibly driving their bruxism, this is a common starting point. For individuals whose bruxism is rooted in another sleeping disorder, that is the first place your physician or sleep specialist may start.