All About Bruxism: Symptoms, Causes, Dangers, and Treatment Options

What is Bruxism?

Bruxism is defined as a habitual or involuntary grinding or clenching of the teeth. Often simply referred to as “teeth grinding,” it is estimated to affect around 8-10% of the population. Bruxism can occur during the day or night and can affect people of all ages, though it is most frequently seen in individuals aged 25-44.

Awake bruxism is grinding or clenching of the teeth and jaw that occurs while the individual is awake and alert. It is usually in response to a stimulus. For example, a person experiencing high levels of work-related stress may find themselves involuntarily grinding their teeth together or clenching their jaw during the work day.

Sleep bruxism is grinding or clenching that occurs while a person is asleep. Also automatic and involuntary, this form of grinding is often associated with a host of other sleep disorders such as obstructive sleep apnea (where an individual periodically and repeatedly stops breathing while asleep).

Signs and Symptoms

Bruxism affects different people in different ways, but some of the most common signs and symptoms of teeth grinding and clenching include:

• Visible or audible grinding or clenching of the teeth
• Worn or damaged tooth enamel
• Teeth that appear flattened, fractured, chipped, or become loose
• Headache and earache
• Tight, sore, or tired jaw and facial muscles
• Tight neck or shoulder muscles
• Increased tooth sensitivity to hot and cold liquids or sweets
• Difficulty opening the mouth

If teeth grinding occurs at night or while asleep, it is often accompanied by a spectrum of other symptoms, such as snoring, gasping, sleep talking or mumbling, and sleepiness during the day.

Dangers and Complications

Bruxism, especially when left untreated for a long period of time, can cause a variety of different oral health problems. Since grinding physically wears away the enamel, affected teeth are more susceptible to extreme sensitivity, decay, and infections. Similarly, clenching of teeth can result in cracked or broken teeth or cracked fillings, which can be painful and require extensive dental work to repair. Extreme bruxism can even cause teeth to become loose and fall out or require extraction. Additionally, teeth that have been substantially worn down from grinding may cause an improper bite, which, in severe cases, may require surgery to correct.

Bruxism can cause issues in the jaw as well. Repeated clenching and grinding puts stress on the bones and muscles of the jaw, which can cause temporomandibular joint syndrome (TMJ) and other similarly painful disorders.

Causes

Bruxism can be caused by a variety of different factors and identifying the specific cause of an individual’s grinding usually requires an in-depth analysis of their medical/dental history and lifestyle as well as an oral evaluation.

• Physical causes: having teeth of different sizes or an improperly aligned bite as a result of natural development or trauma can result in involuntary grinding.
• Physiological causes: bruxism can be a complication of certain disorders and conditions such as Huntington’s disease and Parkinson’s disease.
• Psychological causes: high levels of stress and anxiety can cause grinding or clenching, as can having an aggressive, highly competitive, or hyperactive personality. Bruxism can also be caused by depression.
• Medication-Related Causes: some people experience bruxism as a side effect of certain medications, especially drugs used for psychiatric conditions and antidepressants.
• Sleep-Related Causes: obstructive sleep apnea, REM disorders, and other sleep disorders can cause sleep bruxism.
• Lifestyle Causes: individuals who smoke, drink alcohol excessively, use recreational drugs, or consume excessive amounts of caffeine (6+ cups per day) often experience bruxism as a result.

Treatment

Treatments for bruxism are largely dependent on what’s causing the condition in the first place. If you are diagnosed with a misaligned bite, your dentist may recommend altering the way your teeth fit together via crowns, new fillings, or orthodontics. If your teeth grinding is a result of stress or anxiety, finding ways to reduce these things in your life can be helpful. Your doctor may recommend coping techniques, stress reduction methods, therapy, or medication, based on your unique situation.

For involuntary sleep bruxism, many dentists recommend a mouth guard or other oral appliance to prevent grinding. These options, ranging from moldable mouth guards available in drugstores to custom appliances fitted by dentists, act as a buffer between the teeth, preventing further damage. Additionally, if your sleep bruxism is a result of another sleep disorder, oftentimes treatment for the primary condition will help manage the symptoms of the grinding as well.

Getting Treatment for Your Bruxism

If you believe you might be suffering from bruxism, it’s important to set up an appointment with your dentist right away. Letting teeth grinding go untreated can lead to significant and severe problems in the future. During your appointment, be sure to explain your concerns and bring any questions that you might have. Your dentist will evaluate your teeth and work with you to develop a custom treatment plan that is specific to you — your symptoms, your causes, and your lifestyle.