Bruxism – Teeth Clenching and Grinding

What is Bruxism?

Bruxism is the unconscious habit of grinding and clenching your teeth. The word comes from the Greek language, brygmós, translating to the gnashing of teeth. You can either experience it during the day (awake bruxism) or, more commonly, at night when you are sleeping (nocturnal bruxism).

Bruxism can wear down the tooth enamel, which is the outer layer that covers and protects the inner parts of your teeth. Aside from when you are chewing or swallowing, your teeth should never be clenching or grinding. Instead, your upper and lower teeth should be separated to help relax your jaw muscles. However, our busy lifestyles have made bruxism a common method in helping to deal with stress.

As bruxism is an unconscious habit, it can make it hard for people to recognise signs and symptoms until they are experiencing noticeable facial pain.

Bruxism Symptoms and Signs

If you have bruxism, you may experience symptoms such as:

• Dull headaches that radiate from the temple (people with bruxism are three times more likely to experience headaches)
• Neck, shoulder and back pain
• Sore jaw
• Difficulty to open your jaw (lockjaw)
• Popping or clicking jaw joint
• Jaw aches or stiffness when eating (especially during breakfast)
• Toothaches (especially after waking)
• Earaches
• Automatically clenching your jaw when you're angry, anxious, stressed or concentrating
• Temperature-sensitive teeth
• Bite marks on the tongue and cheeks

You may not even be aware that you are grinding your teeth if you have sleep bruxism, making it hard to notice any signs or symptoms. Instead, sleeping partners may alert you due to the grinding sounds you make during the night.

These symptoms are medical guidelines and are not definitive indicators that you have bruxism. If you are experiencing these symptoms, you should book an appointment with your dentist for further examination.

When at a dentist, they may look for signs of:

• Cracked tooth enamel
• Visible wear on the teeth
• Broken teeth or restorations (e.g. fillings)
• Temporomandibular joint (TMJ) disorders

Bruxism Causes and Risk Factors

The leading cause of bruxism is yet to be established, making it hard to understand how the condition arises in people. However, studies have indicated that a range of risk factors can make you more likely to grind and clench your teeth involuntarily.

These risk factors include:

• Stress and anxiety: increased levels can lead to excessive grinding and clenching of the teeth.
• Age: bruxism is common in young children. However, it tends to go away with age.
• Alcohol consumption: interrupts sleep patterns and can promote hyperactive muscle movement in the jaw. Dehydration from excessive drinking can also contribute to bruxism.
• Smoking: nicotine is a stimulant that can overstimulate muscles in the jaw and contribute to teeth clenching or grinding.
• Snoring: the restriction of air entering the body can increase your body’s stress levels and tighten your jaw as a result.
• Consuming caffeine: the stimulant can increase muscle activity and promote jaw clenching.
• Recreational Drugs: amphetamines and cocaine cause muscle overstimulation, potentially leading to bruxism.
• Medications: antidepressants are also a stimulate that may cause bruxism.
• Genetic factors: sleep bruxism is a condition that may be passed down in your family.
• Medical disorders: Parkinson’s disease, dementia, epilepsy, sleep-related disorders (e.g. sleep apnea), gastroesophageal reflux disease (GERD) and ADHD have all been linked as potential contributors to increased teeth grinding and clenching.
• Occlusal bite disorders: misalignment of the teeth can increase your chances of bruxism.

Sometimes there may be multiple contributing factors and a singular cause may be difficult to determine.

Is there a Link Between Sleep Apnoea and Teeth Grinding?

While there isn't a conclusive answer to why bruxism and sleep disorders are linked, studies argue that obstructive sleep apnea contributes to unconscious teeth grinding and clenching habits.

A sleep study explains that a symptom of sleep apnea is the constriction of the airways, consequently increasing your body's stress levels. As a result, your body's natural response to stress is to involuntarily grind or clench your teeth.

Another potential explanation is that the body's natural response to open the airway is to chew and clench the jaw. This chewing action naturally opens the airway but also prompts teeth clenching, thus causing sleep related bruxism.

Other sleep disorders such as sleep talking, sleep paralysis, and night terrors are also linked to sleep bruxism.

The Impacts of Bruxism

In most cases, bruxism cannot cause serious damage to your teeth or jaw. However, excessive grinding and clenching over an extended period of time may be harmful.

The extent of the impact depends on a range of factors, including the length of time, the intensity of the grinding, pre-existing medical conditions (.e.g GERD) and the state of your dental health.

In severe bruxism cases, you may experience chronic pain in your teeth, which are highly sensitive due to the erosion of the enamel layer. Bruxism can increase your risk of temporomandibular joint (TMJ) disorders and chronic jaw pain. These disorders can make it extremely difficult to perform basic jaw functions such as chewing. It can also make your jaw pop or click whenever you open your mouth. Furthermore, it is not uncommon to damage dental restorations that you may have, such as fillings, crowns or dental implants.

There are several other impacts of bruxism; here are the most common.

The Link Between Jaw Clenching and Anxiety

Bruxism is closely related to your levels of stress and anxiety. In particular, teeth grinding stress situations can be a contributing factor to awake bruxism. These situations can include working or concentrating in stressful environments, prompting you to grind or clench your teeth involuntarily.

Furthermore, emotional stress and anxiety may also lead to sleep bruxism, forcing your body to grind or clench your teeth subconsciously during the night.

Bruxism Face Change

Teeth grinding bruxism may also change the shape of your face. A symptom of bruxism is the overuse of jaw muscles, consequently causing the strengthening of your lower jaw. As a result, bruxism can lead to a stronger jawline, making your face appear swollen or more square.

This impact can be reversed by minimising the grinding or clenching of teeth.

Bruxism and Tongue Biting

If you wake up with a bleeding, swollen or red tongue, it is likely that you're biting the interior of your mouth when sleeping.

The gnashing of teeth in sleep bruxism can cause you to bite or scrape the sides of your tongue and cheek. This can harm the tongue and indent its sides, leading to a condition called scalloped tongue.

Teeth Grinding and Sleep Quality

Another impact that occurs with sleep bruxism is the reduction of sleep quality. Patients may experience emotional stress over the unconscious teeth grinding habits, which can lead to insomnia.

The combination of stress, insomnia and bruxism can create a vicious cycle, potentially increasing the volume and intensity of teeth grinding or jaw clenching.

Sleep bruxism may also impact your bed partner, as the noise of clenching and grinding can disrupt their sleep patterns.

If you are concerned about the potential dental problems associated with bruxism, book an appointment with your dentist for an examination and discuss treatment options.

Bruxism Treatment

In most instances, treatment for bruxism isn’t necessary. However, in the case that you are excessively grinding your teeth or clenching your jaw, there are various treatment options available to help manage your bruxism.

Dental Treatment for Bruxism

Seeing a dentist is the first step to effectively managing bruxism as they can provide you with personalised care and offer the best-suited treatment options. In extreme cases, you may require a dental correction for your upper and lower teeth. A dental correction typically involves repairing the surfaces of your teeth, potentially installing crowns to correct any damage from tooth grinding.

Bruxism Mouth Guard

You can wear a customised mouth guard, called an occlusal splint, to prevent problems associated with sleep bruxism. Occlusal splints are designed with either hard acrylic or softer materials, helping separate your upper and lower teeth from clenching or grinding.

These mouth guards effectively reduce jaw muscle activity, grinding noises, and untimely wear on your teeth. Before sleeping, fit the splint over your teeth and enjoy the peace of mind knowing that your grinding habit cannot cause any dental harm.

You can also buy over the counter mouth guards if you are looking for a more cost-effective solution. However, while these guards can cushion your teeth, they may be less comfortable than a customised fit.

Botox for Teeth Grinding

Botox injections contain a botulinum toxin, a type of muscle relaxant that may help to minimise the pain and intensity of your teeth grinding habit.

When bruxism is related to overactive jaw muscles, dentists can administer a treatment involving the injection of Botox into the muscle that moves the jaw, known as the masseter. This will reduce the size of the muscle, and its ability to cause long term damage.

The effects from the Botox injections typically last 3-4 months and may require repeated doses to keep the masseter relaxed. The Botox for bruxism cost in Australia varies, depending on the dosage and frequency of injections.

While Botox can be effective in minimising symptoms like headaches, it won’t cure bruxism. The best option is to discuss the risks of the treatment with a medical professional before starting a series of injections.

Medication for Bruxism

There is limited research on medications and if they can effectively treat your bruxism. However, there are medications that can be prescribed to help when another medical disorder is the cause of bruxism.

For example, a medical professional can prescribe you medication to help you deal with anxiety or stress. These include antidepressant or anti-anxiety medicines, which help reduce stress, and potentially the volume of your teeth grinding and clenching.

In addition, if your bruxism is linked to sleeping disorders, your doctor may prescribe a sleep medicine to promote better quality sleep.

In some specific cases of sleep bruxism, a dentist may prescribe muscle relaxants before sleeping. This medication may help reduce muscle activity through the night and minimise the likelihood of grinding or clenching.

If you believe you are suffering from severe bruxism, book an appointment with a medical professional before taking any medications.

Homeopathic Remedies for Teeth Grinding

Homeopathy is the belief that the body can help itself without conventional medicine practices. Homeopathic remedies to treat bruxism aim to reduce stress and anxiety levels to minimise the intensity of your teeth grinding or tooth clenching, and while these approaches are safe, they are not proven to be effective.

Relaxation techniques such as meditation, deep breathing, massaging and the use of essential oils are a safe and potentially effective way to treat bruxism through stress reduction. Regular exercise is another remedy that releases natural chemicals that help reduce stress, ease pain, and promote better sleep quality. Furthermore, vitamins such as magnesium or vitamin B and C can also be effective measures in stress reduction. These vitamins may help your body better deal with stress, and may alleviate the intensity and frequency of your teeth grinding habit.

While these remedies are safe, there is no proven scientific link between homeopathy and a cure for bruxism. Before beginning any homeopathic remedies to treat bruxism, you should consult a medical professional to understand the risks and benefits of your desired treatment.

Bruxism in Children

If you have a child, you have likely heard them at some point grinding their teeth during the night. This is because children grind their teeth more than adults. Bruxism is common among children because their teeth are often misaligned and therefore promotes gnashing behaviours.

Bruxism is even more common if your child:

• Has any conditions related to emotional stress or anxiety
• Has ADHD
• Takes stimulant medications

However, there is no need to worry - children’s jaws and teeth are constantly changing, and as a result it is common that kids will outgrow bruxism before serious tooth damage occurs. Only in severe cases will your child need medical intervention.

Children Grinding Their Teeth in Sleep - What to Do as a Parent

If you are concerned that your child's bruxism is causing severe tooth wear, book an appointment with a dentist for an examination and discuss treatment options.

In the meantime, to minimise the intensity and frequency of their teeth grinding, you can:

• Ensure they brush their teeth regularly
• Avoid giving your child any drinks with caffeine
• Avoid screen time before bedtime
• Play soothing music or read a book before bedtime

These measures will help protect your child's teeth and avoid overstimulation before bed that may cause sleep bruxism.

When to see a Doctor

Many cases of bruxism are mild and cause little to no harm. However, in severe cases, you may experience temporomandibular joints inflammation or the swelling of facial muscles. If you are feeling noticeable pain, you should book an appointment with a dentist.

During your appointment, your dentist may complete an examination of your top and bottom teeth, looking for any noticeable tooth wear. After, they will suggest a range of treatment options that are best-suited for managing your bruxism.

Before your appointment you can ready yourself by:

• Organising any relevant information (e.g. if anyone in your family has suffered from bruxism)
• Listing your symptoms
• Listing the medications that you're currently taking (including vitamins, herbs or other supplements)
• Preparing any relevant questions

If you suspect that you are suffering from bruxism, our team of highly qualified specialists can provide you with the best treatment to manage your teeth grinding. Dr Daniel Tan is a specialist in Prosthodontics and an expert in managing temporomandibular joint disorders associated with bruxism.

For any enquires, please get in touch today.

Frequently Asked Questions About Bruxism and Teeth Grinding

What is Awake Bruxism?

Awake bruxism is when you are unconsciously grinding your teeth or clenching your jaw when you are awake. It is most common when you are concentrating on a task or are experiencing stress, anxiety or anger.

What is Sleep Bruxism?

Sleep bruxism is when you unknowingly grind your teeth or clench your jaw while you are sleeping. It is likely to awaken your sleeping partner in the night due to the grinding noises.

Is it Common to Grind my Teeth?

Yes. Teeth grinding (bruxism) is common, especially in children. However, most cases of bruxism are harmless, and only a small percentage of people who grind their teeth may require medical intervention.

How do I Know If I've Been Grinding my Teeth?

Some common symptoms of bruxism are a stiff jaw, sore facial muscles, dull headaches, earaches and temperature-sensitive teeth. Look to our full list of bruxism symptoms for more information.

Is there a Bruxism Cure?

There is no cure for bruxism. However, there is a range of treatments available that effectively reduce the frequency of your teeth grinding.

How Can I Stop Grinding My Teeth in my Sleep?

Reducing stress and anxiety with relaxation techniques is a key strategy when trying to stop grinding your teeth. In addition, your dentist may recommend a series of Botox injections or a mouth guard to reduce the chance of tooth wear from excessive grinding.

Why Do I Grind My Teeth in My Sleep?

High levels of stress or anxiety may cause you to grind your teeth when sleeping. Furthermore, people with sleeping disorders such as sleep related movement disorder or sleep apnea are more likely to suffer bruxism.

Why Do Kids Grind Their Teeth?

Kids are more likely to grind their teeth because their top and bottom teeth are not correctly aligned. It is also common for children to clench their jaw in reaction to pains such as earaches. However, most kids outgrow bruxism with age.

How Can I Stop Grinding My Teeth During Sleep Naturally?

Stress reduction techniques such as meditation, massaging, deep breathing, and essential oils are natural ways to help treat your bruxism. You can also increase your intake of magnesium as well as vitamin B and vitamin C.

How Can I Relax My Jaw?

There are a number of exercises that can help to relax the jaw.

For example: You can repeat mouth opening and closing exercises to stimulate the facial muscles. Then, with one finger, push your bottom teeth down slowly until you feel a small discomfort in your jaw joint. Hold this position for 30 seconds until slowly releasing back to the original position.