Bruxism – Teeth Clenching and Grinding

Teeth clenching and grinding, also called bruxism, causes excessive wear and damage to the teeth, resulting in cracks. It can also lead to facial and jaw muscle pain, temporomandibular joint disorders (TMD) and arthritic problems of the jaw.
What is bruxism?
Bruxism is the habit of clenching, gnashing or grinding your teeth. Your teeth are not meant to be clenched and in contact all the time. They should only briefly touch each other during swallowing or chewing. At all other times, your teeth are supposed to be apart with your jaw at rest. With our busy, stressful lifestyles, this certainly is not the case.

If they are in contact too often or too forcefully, it can wear down the tooth enamel. This is the outer layer that covers each tooth. Without this to protect the inner parts of your teeth, you may have dental problems. Clenching or grinding your teeth regularly can also lead to pain in the jaw or in the muscles of the face. Bruxism most commonly occurs during sleep, but some people also suffer from this when awake.

How do I know if I clench or grind? What are the signs and symptoms?
You may not know that you grind your teeth while you are asleep. A bed partner may be the first person to notice grinding sounds and noises. Those that grind will be giving their jaw muscles a ‘gym workout’, mostly during sleep. The facial and jaw muscles are powerful and result in your teeth being exposed to excessive forces over extended periods of time.

Some common signs and symptoms are:

  • Popping or clicking joint sounds
  • Jaw muscle pain or tightness
  • Difficulty opening the mouth wide
  • Dull headaches or long-lasting pain in the face
  • Wear patterns on teeth
  • Damage to the teeth and/or broken dental fillings
  • Bite marks inside the mouth including the tongue and cheeks
  • Sensitive teeth and fracture enamel at the gum line (abfraction)
What causes bruxism?
There are various factors that may cause bruxism. These include:

  • occlusal bite disorders
  • poor lifestyle habits – alcohol, smoking and drug use (e.g. stimulants), the wrong diet, sleep problems
  • emotional stress – anger, anxiety and depression, concentration
Some people can also get bruxism from medication-related side effects such as antidepressants. If you let your doctor know of this side effect, you may be changed to a different drug.

Sometimes there may be multiple contributing factors and sometimes these causes may be difficult to determine. Regardless of the origin, we can slow down the deterioration of teeth and jaw joints with appropriate treatment and management

How is bruxism managed?
There are many conservative treatments available for bruxism, including behavioural and relaxation techniques. Counselling may help to relieve stress in your life. Improving the quality of your sleep can be of benefit, which 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. Treating sleep apnoea in some people may also help to control sleep bruxism.

We can prevent the problems associated with clenching and grinding with a customised night guard also called an occlusal splint. An occlusal splint may also be indicated if you have had a history of pain and dysfunction associated with your bite or temporomandibular joints (TMJ) or have completed a full mouth reconstruction.

Do you grind your teeth? Can it get worse?
Many cases of bruxism are mild and cause little harm. However, more serious cases may damage the teeth and result in TMD (temporomandibular disorders).

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