Teeth Grinding (Bruxism)

What is bruxism?

Bruxism refers to the grinding, clenching, or gnashing of teeth. This often happens without conscious awareness, either while awake or during sleep.

Most people clench their teeth occasionally, particularly when stressed. However, frequent grinding can place excessive strain on the jaws and teeth, leading to headaches, dental damage, and jaw pain, among other issues.

Although bruxism can affect anyone, it is more common in childhood, adolescence, and early adulthood. Determining the precise number of people who grind their teeth is difficult, as it often occurs during sleep.

Symptoms

Frequent teeth grinding may result in several symptoms, including:

• Facial pain or morning headaches
• Sore jaw muscles
• Earaches
• Tinnitus (ringing in the ears)
• Pain while eating
• Difficulty opening and closing the mouth

Types of Bruxism

Bruxism can occur while you're awake or asleep. Although the grinding action is similar, these are two distinct conditions:

• Awake bruxism: People who grind their teeth during waking hours may not require treatment, particularly if they can learn techniques to reduce stress and become more aware of the habit. Teeth grinding can be linked to anxiety, tension, or anger. You might also clench your jaw when focusing on something.
• Sleep bruxism: Clenching or grinding during sleep can be more damaging, as you are unaware of it. People with sleep bruxism often need treatment to manage the effects of grinding.

Causes

Medical experts do not fully understand why some individuals grind their teeth while others do not. Bruxism does not have a single cause but may result from several associated risk factors.

Risk Factors

These risk factors increase the likelihood of developing bruxism:

• Anxiety and stress: Stress, feeling overwhelmed, or experiencing mental health conditions like depression or anxiety increases the likelihood of bruxism.
• Lifestyle behaviours: Smoking, alcohol consumption, and excessive caffeine intake (more than 6 cups of coffee a day) can double the risk of teeth grinding.
• Certain medications: Some anti-anxiety medications, particularly selective serotonin reuptake inhibitors (SSRIs), may contribute to bruxism.
• Sleep apnoea: There is a known connection between sleep apnoea and bruxism, with many individuals experiencing both conditions. However, it remains unclear whether bruxism leads to sleep apnoea or vice versa.

Complications

If left untreated, bruxism can lead to:

• Sleep disorders
• Dental issues, such as fractured or loose teeth and tooth erosion
• Facial pain
• Temporomandibular joint (TMJ) disorder

Diagnosis and Tests

How do healthcare providers diagnose bruxism?

Healthcare providers, especially dentists, diagnose teeth grinding by evaluating symptoms and conducting a physical examination. In some cases, a sleep study (polysomnography) may be necessary. This overnight test is conducted in a sleep centre to confirm the diagnosis.

Management and Treatment

How is teeth grinding treated?

You may not need formal treatment if your teeth grinding is occasional or mild. However, for more severe cases, doctors may suggest the following options:

• Mouth guards: Your dentist can create a custom mouth guard to protect your teeth. This device also positions the jaw to reduce strain on the TMJ muscle. Mouth guards are typically worn during periods when teeth grinding is likely to occur.
• Stress-reduction strategies: Reducing or managing stress may help alleviate teeth grinding. Therapies such as cognitive behavioural therapy (CBT), exercise, and meditation can be effective.
• Lifestyle changes: Reducing alcohol or caffeine intake may help if these are the cause of your bruxism. Quitting smoking can also reduce grinding and improve sleep quality.
• Medications: Muscle relaxants may be prescribed to prevent or reduce teeth clenching. These are usually recommended for short-term use.
• Botulinum toxin injections: In severe cases, doctors may recommend Botox® injections. These temporarily relax the jaw muscles and reduce pain. Repeat injections, usually every three to four months, are needed to maintain results.

Prevention

Is bruxism preventable?

It’s challenging to completely prevent bruxism, particularly when it occurs during sleep. However, you can reduce your risk by:

• Practising mindfulness to manage daily stress.
• Scheduling regular dental check-ups to address any dental problems early.
• Avoiding smoking, recreational drugs, and excessive alcohol intake.

Outlook / Prognosis

What is the prognosis for people who grind their teeth?

While everyone’s experience with bruxism is different, the overall outlook is positive. Children often outgrow teeth grinding by the time they reach puberty. For adults, using a mouth guard can help. If your dentist provides one, ensure you wear it regularly.

Bruxism may resolve over time, but managing flare-ups and symptoms is important. Consult your healthcare provider for further assistance.

Living With

When should I consult my doctor about bruxism?

If you frequently grind your teeth or have persistent symptoms, it’s best to consult a healthcare provider. They can help determine if you need short-term treatment to manage stress or a longer-term solution, such as a mouth guard.

Additional Common Questions

Is bruxism a serious condition?

The severity of bruxism varies. Occasional teeth clenching is generally not a major concern. However, frequent or prolonged grinding can lead to significant health issues, such as headaches, cracked teeth, tinnitus, and TMJ disorder.

A Note from MD.co.uk

If you wake up with facial pain, constant headaches, or feel fatigued due to poor sleep, bruxism (teeth grinding) could be the cause. Your healthcare provider can confirm the diagnosis and suggest the best course of action to help you manage or prevent bruxism.