Everyone is stressed occasionally, and when this occurs is quite common to clench or grind your teeth. Occasional bruxism or clenching and grinding will not cause any long-term damage, but when it becomes a habit it can be quite destructive. One of the problems with bruxism is that it's often unnoticed until it is sufficiently severe to cause various symptoms including damaged teeth, headaches and jaw pain.
Most people will grind or clench in their sleep and this is one of the reasons why this condition often goes undiagnosed until complications develop. Some people will only seek treatment because their sleeping partner has complained about the noise, while others will be diagnosed by their dentist during routine dental care or will have sought help due to experiencing unpleasant symptoms.
Up until fairly recently it was often a mystery as to why some people would develop bruxism, but scientific studies are increasingly linking this condition to sleep disturbances. As a result treatment might need to be partially focused on resolving any sleep disturbances.
What Are the Warning Signs of Bruxism?
It's worth being aware of the early symptoms of teeth grinding, and to seek help if you think you may have bruxism. These early signs can include:
Noticing your teeth have become more sensitive to hot and cold foods
You might begin waking up with a sore, painful jaw
You may notice your teeth look chipped, worn down or shorter than before
You might begin waking up with dull headaches, or you could develop earache or chronic facial pain
Your sleeping partner may begin to complain you are waking them up with the noise of your teeth grinding
If you think you might have bruxism then it's important to get a diagnosis as soon as you can. Teeth grinding or clenching creates enormous pressure on your teeth, your facial muscles and your jaw. Early treatment can help to limit this damage and will help save your teeth and jaws from permanent damage.
What Causes Bruxism?
Bruxism and Sleep Apnea and Upper Airway Resistance Syndrome
Bruxism is thought to be a learned behaviour, and it's not completely clear as to why it develops. However it is now thought that bruxism can be due to Obstructive Sleep Apnea (OSA), or Upper Airway Resistance Syndrome (UARS) which is a more subtle form of airway obstruction. Both of these conditions cause changes to the airway while asleep, so it becomes less stable, disturbing normal sleep patterns.
When we fall asleep the muscles in the upper airway relax, the soft tissues begin to collapse inwards and the tongue becomes less tense, falling towards the back of the throat. The lower jaw or mandible is also held in position with muscles, and as they relax during sleep the lower jaw regresses backwards. The base of the tongue is attached to the lower jaw, so it further regresses towards the back of the throat. One possible reaction against the airway closing up is to clench the teeth as this holds the lower jaw in position, helping to prevent the airway from becoming so obstructed.
Managing Sleep Apnea Can Help Treat Bruxism
Recent research into the link between OSA and bruxism has shown that treating sleep apnea can help to lessen the symptoms of bruxism. If you have been diagnosed with bruxism then it might be worthwhile seeing a sleep specialist to see if your airway is restricted during sleep. An overnight sleep study will enable the type of sleep disorder to be identified so the correct treatment can be prescribed.
Studies have found treating sleep apnoea with Continuous Positive Airway Pressure (CPAP) can help improve bruxism or can completely resolve this issue. CPAP is where a mask is worn during sleep, and this is attached to a small pump that provides air under a gentle pressure.
Additional Possible Contributors to Bruxism
As well as being linked to OSA and UARS, bruxism may be links to the following physical or psychological causes that include:
Being stressed, extremely tense or anxious
Having suppressed anger or frustration
Being overly competitive or hyperactive
Having malocclusion where the upper and lower teeth don't meet together correctly
Having other sleep problems
As a side effect of some psychiatric medications including some antidepressants
As a side effect of certain disorders including Parkinson's disease and Huntington's disease
The risk of bruxism can also be increased through smoking tobacco, through drinking alcohol or caffeinated beverages, or through taking certain illegal drugs such as ecstasy or methamphetamine.
Getting Treatment for Bruxism
Your dentist will examine your mouth for any signs of wear and tear on your teeth that could include fractured or chipped teeth, or dental restorations that have become broken down. They may also check to see if your jaw muscles feel particularly tender, and will want to make sure your teeth meet together correctly.
Treatment will generally involve the use of a mouthguard or mouth splint that's constructed out of a hard thermoplastic material and which fits over your upper or lower teeth. There are several different types of mouth splint available to help treat this condition. This helps to prevent your teeth from coming into contact, alleviating the damage to teeth and the pressure placed on your jaw joints. Sometimes it might be necessary for your dentist to adjust the way your teeth bite together, or they may recommend orthodontic treatment. Your dentist may need to restore teeth with crowns, inlays or onlays to help you chew more effectively.
If stress is a factor in your bruxism, then taking action to try to reduce your stress levels will be helpful as will avoiding the use of stimulating substances in the evening such as coffee, tea and alcohol. Exercise or meditation or professional counselling can all be useful strategies in reducing stress levels. If the condition is being caused by certain medications it might be possible for your doctor to change your prescription, or to prescribe a different drug to help counteract your bruxism.