Bruxism (Teeth Grinding): Symptoms, Causes And Treatment

Bruxism (bruk-siz-um) is the medical term to describe grinding or clenching teeth that aren’t part of normal chewing.

If you have bruxism, you may unconsciously clench your teeth when you’re awake (awake bruxism) or clench or grind them when you’re asleep (sleep bruxism). Sleep bruxism is considered a sleep-related movement disorder, and people who clench or grind their teeth during sleep are more likely to have other sleep disorders, such as snoring and sleep apnoea.

While some cases of bruxism are mild, for others, it can be so severe that it can lead to jaw disorders, headaches, damaged teeth and other issues. Anyone can develop bruxism, but it’s most common during childhood, adolescence and young adulthood.

So, what are the symptoms of bruxism, what causes it, and how can it be treated?

The Symptoms of Bruxism

Sometimes, you may not even know you have bruxism because you aren’t aware of the symptoms. However, sometimes, people see their doctor for headaches or a sore neck and find that bruxism is the cause. 

Some of the common symptoms of bruxism include 

• Teeth grinding or clenching, which may be loud enough to wake up your sleep partner
• Flattened, cracked, chipped or loose teeth
• Worn enamel, exposing deeper layers of your tooth 
• Painful jaw and neck muscles, especially in the morning 
• Damaged tooth fillings 
• Sensitive teeth 
• Temporomandibular joint dysfunction 
• Sleep disruption 
• Soft tissue changes in your mouth, such as cheek biting and scalloped edges of your tongue

What Causes Bruxism?

The grinding of teeth (bruxism) has many origins. The most recent literature shows bruxism originates from breathing obstruction (nasal and/or OSA), pain, drugs (prescribed and recreational), GI issues, and/or psychological problems.  All of these things negatively impact our sleep, placing pressure on our central nervous system and pushing our autonomic system into a “fight or flight” response. As a result of this, we grind and/or clench our teeth.

Some possible risk factors for bruxism include

• Psychological Stresses: Emotions such as stress, anxiety and anger are top risk factors for teeth-grinding.
• Age: Onset in males is sometimes younger than in females. However, children can also have OSA, and a common sign of this is bruxism.
• Weight: Excess weight places unnecessary pressure on our airways, affecting our breathing. As a result of an obstructed airway, we will grind our teeth.
• Food/Drink sensitivity: You don’t have to be allergic to something for your body to give you signs that it’s not good for you. Different tolerances for dairy, wheat, alcohol, etc., place pressure on your digestive tract, causing inflammation and pain. It can also cause an increase in mucus build-up, which can compromise your airways—compromised airways and pain from inflammation all link to bruxism
• Personality type: Having an aggressive, competitive or hyperactive personality can increase your risk of bruxism.
• Medications and other substances: specifically SSRI antidepressant drugs and recreational drugs/alcohol, are proven to increase bruxism.
• Family history: Bruxism, especially sleep bruxism, tends to run in families. So, if you have bruxism, it’s possible that other family members may have it or have a history of it. 
• Other disorders: Bruxism can also be associated with some mental health and medical disorders, such as Parkinson’s disease, dementia, epilepsy, night terrors, sleep apnoea and Attention Deficit Hyperactivity Disorder (ADHD). 

If you have bruxism, it is important to make an appointment with Dr Alex at Admire Dentistry for a consultation to determine the root cause.

Bruxism in children 

As mentioned earlier, bruxism is more common in children and adolescents. It’s easier to notice bruxism in children than adults, as many parents will have noticed the sound of the children grinding their teeth at some point, often as they sleep. 

In children, bruxism is a sign of a greater problem related to airway obstruction; it can also present with or without snoring or heavy breathing. A referral to an ENT is always recommended. Unfortunately, OSA in children is not uncommon. We can fix and cure children with OSA by ensuring a patent airway and positive craniofacial growth; if they grow into adults with these problems, we can only manage them.

Some of the main risk factors for teeth grinding in children include

• Pain when teeth are coming through 
• Airway obstruction
• Emotional stress and anxiety
• Medications such as antidepressants and antipsychotics 
• Medical conditions such as Attention Deficit Hyperactivity Disorder (ADHD)

An interesting note: OSA and ADHD have similar presentations in children. Our first step to diagnosis should be a simple ENT consult and/or sleep study to rule out sleep-disordered breathing. Once this is ruled out, we can proceed down the path to an ADHD diagnosis if necessary.

The Treatment Options for Jaw Clenching And Teeth Grinding

If you have mild and acute onset bruxism due to a recent stressful life change, you probably don’t need formal treatment. However, what are the treatment options if you’ve got severe bruxism and are in constant pain? 

The treatment options for bruxism fall under several categories, including 

Dental – we need to diagnose the root cause

• Sleep Study/ENT: If the cause of bruxism is airway-related
• Oral Orthotic: an oral appliance, usually worn at night, to decompress the jaw joint, allow healing, and protect the teeth. If an OSA diagnosis is present, the appliance can be created to additionally support the airway.
• Dental correction: In severe cases of bruxism, when a tooth has been damaged so badly that it has led to sensitivity or the inability to chew properly, your dentist may need to restore the damage. First, we need to correct and support your jaw to find your “correct” bite. Once this is achieved we can then work on restoring and correcting the teeth.

Medications 

• Muscle relaxant injections: Muscle relaxant injections are becoming increasingly popular for treating bruxism and relieving muscular pain associated with jaw clenching and teeth grinding. However, this treatment only works for muscular pain, not tooth pain. Muscle relaxant injections are patient and symptom-specific. A thorough consultation for suitability is required before a bespoke treatment plan can be created for you.
• Medication for anxiety or stress: Your doctor may recommend the short-term use of antidepressants or anti-anxiety medications to help you deal with stress that may be causing your bruxism. Unfortunately, long-term use of these has been proven to make bruxism worse. Again, a consultation with your dentist is required before using these medications for bruxism.

Other approaches 

• Sleep Hygiene: We know most bruxism is related to poor sleep; good sleep hygiene can make a world of difference in ensuring a good night’s sleep.
• Behaviour changes: Once you discover you have bruxism, you can make some behavioural changes, such as practising proper tongue and lip position to support the jaw and associated muscles. 
• Stress reduction techniques: If your bruxism is a result of stress, finding ways to reduce stress may also reduce your bruxism symptoms. Some ways to reduce stress can include meditation and exercise. 
• Lifestyle changes: Diet & Exercise are HUGE factors in managing bruxism & sleep disorders. If your bruxism is a result of caffeine or alcohol consumption, reducing your daily intake can help reduce the symptoms of teeth grinding and clenching. 

Diet – consider foods that do not cause inflammation and ensure you have a healthy and balanced diet.

Helpful tips – when shopping at the supermarket, try to avoid walking down the aisles (this is where a lot of sugary and processed foods are), and stick to the outside area of the supermarket. Also, look at your dinner plate; ensure you plan for ¼ protein and ¾ vegetables

Book A Consultation With Admire Dentistry

Bruxism is a condition that can lead to a variety of dental health issues, such as jaw pain, headaches and tooth damage. 

Understanding the symptoms and causes of bruxism is the first step towards addressing this often overlooked condition. With a range of treatment options available, from oral orthopedic appliances to muscle relaxant injections and lifestyle changes, there is hope for those suffering from this condition.

If you suspect you may be experiencing bruxism, it’s crucial to seek professional advice to prevent further dental health complications. 

At Admire Dentistry, our dentist, Dr Alexandra Davies, is committed to providing comprehensive care for those experiencing teeth grinding. After a thorough assessment of your teeth, Dr Alex will help you find the best treatment plan tailored to your needs.

Don’t let bruxism disrupt your life any longer. Book a consultation at Admire Dentistry today.