What is Bruxism?
Bruxism is excessive clenching or grinding of the teeth that is not a part of normal chewing movements. It can lead to excessive wear on the teeth and may cause permanent damage to the teeth and the jaw joints.
Causes of Bruxism
Bruxism is believed to be caused by a combination of physical and psychological factors. Physical stress such as illness, nutritional deficiencies or dehydration, particularly in children and psychological stress, anxiety and tension in adults and children are often involved. Studies have also shown that night bruxism is a sleep disorder.
Abnormal anatomy of the teeth or jaws (including high spots on fillings) can cause an improper bite and lead to bruxism behaviour
The signs and symptoms of bruxism
Signs and symptoms may include:
- The teeth may become painful and sensitive to heat and cold
- Intense muscle contraction may lead to chronic facial pain and tension headaches
- Partners, friends or relatives, may notice the noise that occurs as the teeth are ground together
- Tooth surfaces may became flattened and worn, which may reveal the underlying yellow dentine layer
- Micro-fractures of the tooth enamel may occur
- Teeth may become broken or chipped
- Teeth may be loosened with possible damage to the tooth sockets
- Stiffness and pain in the jaw joint muscles can cause restricted opening and difficulty chewing. Sometimes, the tempero-mandibular joint (TMJ or jaw joint) may suffer damage that is slow to heal
- Earache or pain in the jaw joint may occur
The variation in signs and symptoms reflects the strength of clenching and grinding involved in bruxism.
People who clench their teeth tightly may experience tension-related headaches, but may have little or no damage to the teeth or jaw joint.
Those who experience severe grinding may have damaged teeth and jaw joint problems.
People with mild tooth grinding may have worn tooth surfaces but no jaw joint pain or tooth sensitivity. These individuals may not realise that they suffer from bruxism.
Treatment of Bruxism
Treatment aims to:
- Remove the causes of bruxism
- Change the behaviour that causes bruxism
- Repair the damage that bruxism often causes
Your dentist may prescribe painkillers for muscular facial pain, headaches and jaw joint pain. They may also prescribe muscle relaxant medication to help relax the jaw muscles. You may be recommended to seek counselling, stress management or relaxation methods for stress-related causes of bruxism.
Changing Bruxism Behaviour
An occlusal splint or night guard is an option for someone with mild to severe grinding behaviour. Worn at night, the splint is made from moulded hard plastic that fits over the upper or lower teeth. It prevents further wear of the tooth surfaces.
Biofeedback is a treatment option for people who primarily clench their teeth during the day. Biofeedback techniques use electronic monitors to measure tension in the jaw muscles. People use the monitors to learn how to relax their muscles and reduce tension. Newer biofeedback techniques are under development to treat night-time clenching.
Muscle relaxants may be required by some patients at night.
Hypnosis has long been under review and some bruxists have found profound relief from problems related to sleep bruxism. One study reviewed the long-terms effects of hypnosis and a positive outcome was still applicable even after 36 months. This treatment has promise, and for some it may be successful.
Repairing Damaged Teeth
Treatment may be necessary to repair damaged teeth using dental fillings, crowns or inlays to replace damaged tooth surfaces. Where tooth fractures extend into the pulp root canal treatment may be required. In extreme cases, extraction of badly damaged teeth may be the only option and implants, bridges or partial dentures can then be used to replace missing teeth. Orthodontic treatment can realign misplaced and crooked teeth.