Bruxism: What it is and how it is treated

Bruxism or bruxism is the involuntary grinding and clenching of teeth. It usually occurs during sleep but can also occur during the day [1].

It is estimated that this condition affects 5-20% of the population regardless of gender and age, and more children – the lowest rates are in the elderly over 65. People who gnash their teeth when they sleep do not know it but those who are next to them they can hear the sounds of their teeth. The dentist, by examining the teeth, can understand if someone is gnashing them while sleeping, because of the consequences that this condition has.

Bruxism and indications

The pressure exerted by gnashing teeth at night can be up to six times greater than the pressure exerted during the day. This can cause damage to the enamel of the teeth, pain in the face, pain in the jaw muscles and headaches or migraines. Ear pain can also occur because the structures of the temporomandibular joint are affected. There may also be reflex pain in which a person feels pain in a different location from their source.

Of course, it does matter how intense and persistent bruxism is. Some people grind their teeth for as long as 40 minutes while they sleep. This if continued for a long time can permanently damage the jaw.

It is estimated that 20% of those who gnash their teeth have symptoms of a painful condition of the jaw called Temporomandibular Joint Disorders (TMD) that affects the movement of the temporomandibular joints. These joints connect your jaw to your skull, helping you to eat, chew and talk. But when you gnash your teeth incessantly, you strain those joints too much and it is possible to hear a clicking sound every time you open and close our mouth.

Bruxism and causes

Although bruxism is not uncommon – data from the American National Sleep Foundation show that 8% of adults and 14-20% of children under the age of 11 gnash their teeth at night – the causes are unclear. In young children it may be a response to the pain that accompanies teething or when they feel anxious.

It has been observed that squeaking often occurs in times of anger and stress. Research has shown that brain activity and heart rate can increase before a bruxism episode, suggesting that the central nervous system plays a role.

In some people it may be due to a spasm of the facial muscles during sleep. Bruxism can also be a side effect of certain treatments, including antidepressants and antipsychotics.

Neurological conditions such as Huntington’s disease or Parkinson’s disease can be causes. Factors that may be associated include fatigue, alcohol consumption, smoking, sleep apnea and snoring. According to some indications, chewing gum may encourage bruxism.

Bruxism and treatment

Teething or grinding of the teeth during the day can be improved with increased awareness but nighttime bruxism needs other strategies as it is out of the individual’s control.

Options are available to alleviate the symptoms and of course if the underlying cause is identified it can be treated. If the underlying problem is anxiety or sleep apnea, treating these conditions can help. One study found that treating sleep apnea reduced symptoms [3].

Splints are an option [1]. It is a mobile construction, which is applied by the dentist to the chewing surface and the cutting edge of the teeth of the upper or lower jaw, not allowing direct contact of the teeth. Using a splint relaxes the muscles so that they are not constantly in contraction and the body learns not to grit its teeth.

Finally, another option, for short-term use, is to take muscle relaxants. Avoiding foods and beverages that contain high levels of caffeine or alcohol can be beneficial [1].

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References

1. Tooth Clenching or Grinding.
2. Prevalence of Sleep-Related Bruxism (SB).
3. Sleep Bruxism Related to Obstructive Sleep Apnea: The Effect of Continuous Positive Airway Pressure.