Teeth grinding - Bruxism (Teeth Grinding)

Teeth grinding
Better Health Channel Australia
October 2007

Teeth grinding (bruxism) is involuntary clenching, grinding and gnashing of the teeth. It is thought that about half of the population bruxes from time to time, while around five per cent are habitual and forceful tooth grinders. It generally happens during sleep, but some people experience it when they are awake.

Bruxism can be a physical expression of mental stress; for example, susceptible people tend to grind their teeth when they are angry, concentrating hard on a particular task or feeling anxious. Another cause may be incorrect tooth alignment.

Generally, the person doesnĚt realise that they grind their teeth in their sleep. The spouse or partner who shares their bed (and hears the grinding noises at night) is often the first to notice the problem.

Symptoms
The symptoms of bruxism include:

Audible grinding sounds while the person is asleep
Headache and/or ear pain
Aching teeth, particularly upon waking
Aching or stiffness in the jaws while chewing, particularly during breakfast
Clenching the jaw when angry, anxious or concentrating
Temperature-sensitive teeth
Cracked or chipped tooth enamel
Tooth indentations on the tongue
Raised tissue on the cheek mucosa caused by cheek biting (linea alba)
Inflammation of the tooth socket (periodontitis), including loose teeth.
Complications of bruxism
Teeth grinding can cause a range of dental problems, which may include:
Cracked tooth enamel
Excessive wear and tear on the teeth
Broken teeth
Tooth loss
Enlargement of the jaw muscles
Strain on the joints and soft tissue of the jaw joint (temporo-mandibular joint)
Damage to the disc that sits inside the temporo-mandibular joint
Arthritis of the temporo-mandibular joint (this is suspected although not yet proven)

Temporo-mandibular dysfunction syndrome.

A range of causes

Some of the many factors believed to trigger bruxism in susceptible people include:
Emotional stress, such as anger or anxiety
Mental concentration
Physical effort or stress, such as illness, nutritional deficiency or dehydration
Incorrect tooth alignment, including fillings that are too ÎhighĚ
Drug misuse
Alcohol misuse
Eruption of teeth (babies and children).
The link to another sleep disorder

The sleep disorder periodic limb movement disorder (PLMD) is characterised by uncontrollable jerking of the legs or arms during sleep. It is thought that bruxism and PLMS share an important characteristic. People with these disorders are more likely to Îact outĚ their dreams while sleeping. The reasons for this are not clear, although one theory is that brain centres which control masticatory (chewing) muscle movements lie close to those centres involved with dreaming.

Diagnosis
If you suspect you may grind your teeth, see your dentist as soon as possible. Your dentist will inspect your teeth and may take x-rays to gauge the severity of the problem and the damage done to teeth and bone. You may be asked to wear an electrical pressure device while you sleep to help measure the force of the grinding.

Dental treatment
You should consult your dental professional for their recommended course of treatment. Dental treatment options include:

Repair of tooth damage
Adjustment of fillings that may be too high and interfering with the bite
Devices such as braces or plates to correct tooth alignment
Mouth appliances to be worn at night (bite splints), so that you grind the device and not your teeth. However, in most cases these appliances will only provide temporary relief of the condition.
Other treatments
Other treatments that may help to manage teeth grinding include:
Stress management therapy
Relaxation techniques
Cognitive behaviour therapy
Regular exercise
Muscle relaxant medication.
Where to get help
Your dentist
Your doctor
Psychologist, to help with stress management.

Things to remember
Teeth grinding (bruxism) is involuntary clenching, grinding and gnashing of the teeth that usually happens during sleep.
Causes can include incorrect tooth alignment, stress and drug misuse.
Treatments include bite splints to be worn at night, repair of tooth damage, muscle relaxant medication and stress management therapy.