Teeth grinding and clenching is a common issue. But this doesn’t mean the condition isn’t serious, as it can have major repercussions on a patient’s dental health. This article explores the notion of bruxism, its causes, its consequences, and the solutions available to treat it.
What Is Bruxism: Definition
Bruxism is a condition that causes the patient to grind their teeth – or clench them – without being aware of it. This often happens during sleep, but can also occur during the day. In both cases, there is no way to control these movements consciously.
Over time, the surface of the teeth gets worn down and flattened, and the individual experiences symptoms that range from aesthetic issues to physical pain and damaged teeth.
An Overview on Bruxism
Most people are completely unaware that they are experiencing bruxism. In many cases, it takes a sleeping partner, a family member, or a dental check-up to reveal the condition.
A common misconception is that bruxism is incompatible with braces or aligners. The good news is that bruxism and orthodontic treatment are not mutually exclusive. In fact, aligners tend to minimise the damage!
Types of Bruxism
In some patients, bruxism takes the form of teeth clenching, where the individual keeps their jaw tightly shut, exerting pressure on the teeth that remain in close contact without any movement.
Other people move their jaws from side to side as they clench, grinding their teeth against each other. This is where most of the damage occurs, as the teeth get worn down and flattened.
Sleep bruxism tends to happen during non-REM sleep stages 1 and 2 (the initial stages of a sleep cycle). For some, however, it can also take place during REM sleep.
Symptoms of Bruxism
Not all patients exhibit the exact same symptoms, but signs of bruxism include:
- Sounds that may disturb a sleeping partner, such as teeth clenching or grinding sounds
- Worn down, chipped, or cracked teeth
- Receding gums or swollen gums
- Wear facets, which are the flattened biting surfaces created by the grinding action
- Weaken or worn enamel, leading to tooth sensitivity
- Pain, soreness, or stiffness in the jaw
- Clicking sound from the jaw when the mouth opens and closes (TMJ disorder)
- Headaches
- Facial discomfort or pain
- Tight or sore shoulders and neck
While either one of these symptoms should encourage individuals to consult their dentist, it is often the latter who diagnoses the condition based on the visible signs. In advanced cases, the patient may be referred to a maxillofacial surgeon. Fortunately, solutions to manage the condition and treatment to address any damage already done do exist.
What Causes Bruxism?
The exact cause of bruxism remains unknown. That said, several contributors and risk factors have been identified:
- Stress and high levels of anxiety, anger, and frustration are among the factors most commonly associated with teeth grinding and clenching.
- Sleep disorders such as snoring and sleep apnoea are common triggers.
- Lifestyle and habits including smoking, caffeine, alcohol, and recreational drug use are known to increase the risk of bruxism.
- A misaligned bite can lead to bruxism by causing the jaw to work harder, which is why a clear orthodontic solution, as aligners, can be instrumental in the treatment of bruxism.
- Medical conditions, particularly neurological disorders such as epilepsy, dementia, or Parkinson’s disease, can contribute to the development of bruxism. It is also more prominent among those who suffer from gastro-oesophageal reflux disorder (GERD), night terrors, and attention-deficit/hyperactivity disorder (ADHD).
- Certain medications include a heightened risk of bruxism as a side effect. It is uncommon, but worth noting that some psychiatric medications – such as antidepressants – have been linked to the condition.
- Genetic predisposition can play a role in bruxism, particularly sleeping bruxism.
- Bruxism in young children is common and usually goes away by adulthood.
What Are the Consequences of Bruxism?
In most cases, bruxism doesn’t cause severe complications. But, as we briefly mentioned when discussing the symptoms associated with the condition, its consequences shouldn’t be ignored.
Overall Health Consequences
Left unchecked, bruxism can lead to tension-type headaches, severe facial or jaw pain, and soreness in the neck and shoulder muscles.
Oral Health Consequences
However, the main issues related to bruxism pertain to oral health. Constant grinding and clenching can wear down the enamel, resulting in shortened or flattened teeth, tooth sensitivity, and uneven biting surfaces. Weakened teeth are at a higher risk of fracture, and those who suffer from the condition are also likely to experience temporomandibular joint (TMJ) disorders. These popping, clicking, or locking effects in the jaw may contribute to facial muscle fatigue and headaches.
Bruxism puts the patient at risk of periodontal issues such as gum infections and bone damage. It alters bite alignment and the worn-down surface of the teeth can impair oral hygiene by making it more difficult to brush and floss.
Finally, bruxism places excessive stress on restorations such as fillings and crowns, leading them to fail prematurely. Dental implants are also at risk of failing or loosening.
What Are the Available Treatment Options for Bruxism?
Effective treatment options and tips are available to help alleviate bruxism and its consequences. Some solutions, such as clear aligners with the right teeth attachments, offer a practical approach that counters the mechanics of the issue. Others, focus on lifestyle changes that can mitigate the severity of the condition.
Aligners and Orthodontic Devices
Clear aligners for kids and clear aligners for adults are perfectly compatible with bruxism. They can even go a long way towards protecting a patient’s teeth. This is because, in essence, aligners share several design characteristics with mouthguards. Made from a resilient memory material, clear aligners form a protective layer between the teeth. They can also work towards breaking the habit, as the patient who unconsciously begins grinding their teeth will find that the aligner gets in the way.
For individuals with bruxism, aligners are most useful during the day, when they will notice their habit. During the night, it makes more sense to swap the aligner out for a mouthguard made of stronger plastic. These devices are designed to protect the teeth from further sleep bruxism damage by absorbing the excessive biting force.
Lifestyle Changes
As bruxism is directly linked to stress, aiming to lead a balanced lifestyle can be a good preventive approach. Reducing alcohol and stimulant consumption is recommended, as is taking up regular exercise.
It is also possible to exercise the jaw to alleviate the pain and enhance the range of motion. Depending on the severity of the case, various movements may be prescribed.
Medication remains an avenue. Dentists may temporarily prescribe drugs that alter the activity of the neurotransmitters, thus reducing teeth grinding. If, on the other hand, medications are suspected as the cause of the bruxism, the patient may wish to try different treatments.
Finally, daytime bruxism can be addressed thanks to a technique known as “biofeedback”. Through strategically placed electronic devices that measure the activity of the jaw muscles, the patient receives immediate feedback whenever abnormal actions are detected. This gives the individual the opportunity to understand potential patterns. They can use the information to correct their behaviour as soon as it happens.