Bruxism is excessive teeth grinding, often accompanied by jaw clenching. It is seen in both adults and children and is common with both sexes. Bruxism is often an unconscious act performed at night that results in rapid tooth wear. Dentists help prevent dental damage in bruxers by providing night guards.

Do I grind my teeth?

For some people, teeth grinding is simply a poor habit that they are aware needs to be broken.  During nervous, anxious or simply stressful times in their day, they find themselves grinding their teeth – similar to nail biting.

For the majority though, bruxism is a subconscious act performed at night while sleeping. So how can you tell if you grind your teeth? Here are some symptoms you should be aware of:

• Dull, constant headache when you wake in the mornings.
   

• Sore jaw and jaw joints (temporomandibular joint) particularly in the morning that resides by the end of the day.
   

• Your partner complains of overnight noises, or has even caught you grinding your teeth.
   

• Your dentist notices your teeth are worn down, and you have no explanation as to how it could have happened.
   

• Tooth sensitivity to hot or cold substances – begins as your teeth are worn down.

Alone, these symptoms are not very suggestive, but if you identify with several, then it is highly indicative of bruxism.

Bruxism has worn down this patient's enamel. This is the extreme end of the spectrum - do not wait until you are at this stage - consult your dentist.

Dental implications

You may consider teeth grinding to be harmless if it occurs at night and does not wake anyone – your dentist will surely disagree. Constant teeth grinding can result in fractures, loosening and even complete loss of teeth. If you have a crown, bridge, filling or any other dental work done, it too can become dislodged with time.

Chronic grinding may even wear teeth down to stumps. At this point, the enamel has worn away and the less protective dentin is visible. Tooth sensitivity is very common for these patients since dentin is partly innervated, unlike enamel.

When these events happen, bridges, crowns, root canals, implants, partial dentures, and even complete dentures may be needed. Now you see why your dentist is concerned.

Furthermore, not only can severe grinding damage teeth and result in tooth loss, it can also affect your jaws, result in hearing loss, cause or worsen TMD/TMJ, and even change the appearance of your face. TMJ dysfunction is a not so uncommon end result for untreated bruxism.

Possible causes

People can clench and grind without being aware of it during both the day and night, although sleep-related bruxism is often the bigger problem because it is harder to control.

The cause of bruxism is not completely agreed upon, but daily stress may be the trigger in many people. Some people probably clench their teeth and never feel symptoms. Whether or not bruxism causes pain and other problems may be a complicated mixture of factors, including your stress level, how long you clench/grind, and whether your teeth are misaligned.

Each person is different.

Treatment

Prevention (the next topic on this page) is the first means of treatment. There is no point treating the symptoms if preventive practices are not incorporated to avoid recurring problems.

The most popular management of bruxism is through the use of dental guards or night guards that are worn at night. These are plastic molds that are crafted to fit your teeth and create “buffer” room between them. Use of a night guard does not prevent bruxism, but your teeth and jaw joints are protected from its detrimental side effects. In turn, night guards get worn down with time and need replacement.

Rarely, some patients receive Botox treatments to help alleviate the grinding action itself. Botulinum toxin (Botox) is most commonly associated with cosmetic medicine where it is used to reduce facial wrinkles and creases.

Botox has a role in medicine as well though. Botox is used to treat diseases of muscle spasticity – like bruxism where the masseter muscle is hyperactive. Botox functions by weakening facial muscles (how wrinkles are removed) so that they cannot contract as effectively. With bruxism, Botox works very well to weaken the muscle enough to stop the grinding and clenching, but not so much as to interfere with chewing or facial expressions. To achieve this fine balance though, the drug needs to be dosed differently for each patient.

Your dentist can help you with the considerably more common night guard, while a physician’s consult is needed for Botox treatments.

Dental procedure for night guards

Creating a night guard is quick, painless and relatively cheap. Your dentist will begin by taking a dental impression of your mouth.  This impression is then used to create plastic moldings that custom-fit your teeth. The molds are usually made of acrylic and during the same appointment if your dentist has the equipment, or sent to a dental laboratory and are ready for the next appointment.

The night guard will be placed in the mouth, and your dentist will adjust them to achieve maximum comfort and function. With regular dental checkups, remember to bring your night guard so your dentist can monitor their wear, and make adjustments as necessary.

Remember to rinse or brush your night guard every morning.

Prevention

If stress is causing you to grind your teeth, ask your doctor or dentist about options to reduce your stress. Attending stress counseling, starting an exercise program, seeing a physical therapist or obtaining a prescription for muscle relaxants are among some of the options that may be offered.

Other tips to help you stop teeth grinding include:

• Consuming fewer caffeinated drinks such as coffee, cola, chocolate, energy drinks, etc.
   

• Avoid alcohol. Grinding tends to intensify after alcohol consumption.
   

• Stop habits such as chewing on pencils or pens – anything that is not food. Also try to avoid chewing gum.
   

• Train yourself not to clench or grind your teeth. If you notice that you clench or grind during the day, position the tip of your tongue between your teeth. This practice trains your jaw muscles to relax.