Medical experts believe that around 20% of people grind their teeth while they sleep. The medical name for it is bruxism. The reason why bruxism causes so much interest amongst the medical community is because it cannot be cured. Also, no-one really knows quite why some of us do grind our teeth. Some evidence suggests it is genetic. Other evidence suggests that it could be related to stress or anxiety. But because we don’t really know what causes it, we don’t really know how to cure it.

So how do you know if you have a case of bruxism? Normally, the sufferer sleeps through it and it is usually the person next to them who notices it first. As you would imagine, sleeping next to someone who is grinding their teeth all night is very difficult! However, the sufferer themselves may begin to notice some side-effects of their bruxism. They may wake up in the morning with aching teeth or a saw jaw, for example.

Bruxism is unusual in that it is both a medical problem and a dental problem. Therefore, if you are grinding your teeth on a regular basis, your first step should be to visit your GP. They will diagnose your condition in more detail to try and discover the extent of the problem. Don’t worry, they won’t have to attach sleep monitors. Usually, the diagnosis will involve making assumptions based on how you answer a number of questions. For example, do you wake up in the morning with headaches? If so, how severe are they – are they disrupting your everyday life? Other aches and pains, such as earache or a clicking jaw, can also be tell-tale signs that you are grinding your teeth at night.

Based on your answers to these questions, your GP will usually be able to evaluate how serious the bruxism is. Mild cases of bruxism may not require any treatment, though your GP may encourage you to look at your lifestyle and diet to see if you can make any adjustments. It could be that you could look at ways to relieve some of the stress in your professional or personal life, which may help. Alternatively, it could be something like giving up smoking or drinking caffeine which makes the difference.

If your GP believes you have a chronic case of bruxism which is seriously affecting your health or your partner’s quality of life, there are a number of treatment options at their disposal. As already mentioned, bruxism cannot be cured, so the treatment is usually based around finding ways to manage and reduce it, so that it does not continue to affect your quality of life.

Treatment for bruxism normally combines two different strategies. There is the dental aspect, which could involve being fitted for a dental guard or splint which protects the teeth against the nightly wear and tear caused by bruxism. This will involve a visit to your dentist so that you can be fitted for a suitable product. Of course, this will not help to cure your condition; it will simply ensure that the damage to your teeth is minimised in the long term.

The second part of the treatment normally involves exploring a variety of techniques to remove stress and anxiety and to improve relaxation before bedtime. It could include massage, for example, or working with a dietician to understand what you are eating before you go to bed. Some sufferers claim that behavioural therapies can help, such as autosuggestion techniques or hypnosis.

Although there is a shortage of research into bruxism, there is some evidence to suggest that it primarily occurs in the lighter stages of sleep. Therefore, much of your treatment should be focused around ensuring that you are going to bed relaxed and ready to sleep, so that you enter a deep sleep as quickly as possible. In the same way that thinking about you evening diet can help, some sufferers have found that exercise can reduce their teeth grinding.

Gender Differences

Teeth grinidng can produce some severe conditions, especially in women because the average woman’s jaw is weaker. The average man who clenches or grinds his teeth at night, called sleep bruxism, or clenches them in the day, destroys his teeth and wearing them down.

Usually, however, women who grind their teeth end up with more than just destroyed teeth. They get migraine headaches, pain in the jaw, lockjaw, grating or grinding sounds when opening or closing their mouths. That can lead to an entire imbalance of the neurology of the brain, which can affect many parts of a person’s life and their ability to function.

Why People Grind Their Teeth

It’s not known why people grind their teeth. On the East coast, it is claimed there is less problem with it than on the West coast. That is my observation. I was a dentist in New York for 20 years, and observed that during my time there and on the West coast where I am now.

We don’t know why exactly but I know for sure my patients in New York experienced one-tenth of the effects of teeth grinding than my patients here in California. It could have to do with lifestyle, or with irritants in the air. Any irritant can cause a person to clench or grind his teeth, as can and sleep emotional problems. Children who grind their teeth may do so in response to earache or because of the growth and development of their jaws and teeth.

Treatment for teeth grinding may require surgery. But usually all that is needed is that an individual wear a night guard to stop it from occurring. If you or someone you know suffers from teeth grinding, see your dentist as soon as possible to discuss what to do about it.

Why Does it Occur?
Many medical and dental professionals may not always know the exact cause, but bruxism can occur due to psychological stress that people may be dealing with during the week. Stress can be categorized in two ways — by internal and external factors.

Internal factors could be the foods you consume, your level of fitness, your emotional stability, overall health and well-being, and the amount of sleep you get each evening. External factors of psychological stress include the environment you are in each day, interaction with others, when you are at home and how you deal with challenges on a daily basis.

Bruxism’s Impact on the Mouth
There are several elements that can occur in the mouth when people are experiencing bruxism:

• Wearing away the tooth enamel and possibly the dentin
• Cracking or chipping teeth, bridgework or implants
• Tooth sensitivity can occur
• Teeth can become painful or loose
• Facial pain due to clenching of jaw muscles
• Headaches
• Overall facial fatigue
• Pain in the temporomandibular joint (jaw bone on either side of the mouth)

Treating the Problem
Most individuals suffering from bruxism should see their dental professional/specialist to determine why they are experiencing this problem. Your dental professional may recommend that you wear a mouth guard or a night guard to cushion the clenching or tooth grinding during sleeping. Additionally, your dental professional may suggest ways to reduce stress so you can decrease the level of bruxism. You should consider avoiding foods such as chocolate and drinks that contain caffeine and alcohol. Avoid chewing forcefully and your dentist or oral maxillofacial surgeon may suggest conducting exercises to relax your jaw muscles during the day. If your bruxism is more severe, an occlusal splint may be recommended as well as medication prescribed to help relax you or make you sleep more soundly. Your dental professional will be able to work with you to find the cause and the solution to alleviate this problem.

What Is It?

Bruxism is clenching or grinding your teeth, often without being aware that your are doing it. In the United States, bruxism affects an estimated 30 to 40 million children and adults.Some people grind their teeth only during sleep; this condition is called “nocturnal bruxism” or “sleep-related bruxism.” Others grind their teeth during the daytime as well, most often during situations that make them feel tense or anxious. People with severe bruxism can fracture dental fillings or cause other types of tooth damage. Severe bruxism has also been blamed for some cases of temporomandibular joint dysfunction (TMD), mysterious morning headaches and unexplained facial pain.

Bruxism can have a variety of psychological and physical causes. In many cases, it has been linked to stress, but it can also simply be the body’s reaction to the teeth being aligned wrong or a poor bite (the way the teeth come together). Bruxism can sometimes occur as a complication of severe brain injury, or a symptom of certain rare neuromuscular diseases involving the face. Bruxism also can be an uncommon side effect of some psychiatric medications, including antidepressant medications, including fluoxetine (Prozac), sertraline (Zoloft) and paroxetine (Paxil).

Symptoms

Symptoms of bruxism include:

• Rhythmic contractions of the jaw muscles
• A grinding sound at night, which may disturb the sleep of someone who shares a bedroom with a “bruxer”
• A dull morning headache
• Jaw muscles that are tight or painful, especially in the morning
• Chronic facial pain
• Damaged teeth, fractured dental fillings and injured gums

Diagnosis

Your dentist will ask about your current life stresses, your general dental health and your daily medications. He or she also will want to know whether you routinely drink beverages containing alcohol or caffeine, because both of these chemicals seem to increase the tendency to grind your teeth.If you share your bedroom, the dentist also may want to ask that person about your sleep habits, especially about any unusual grinding sounds heard during the night.

Your dentist will examine you, paying special attention to your mouth and jaw. During this exam, your dentist will check for tenderness in your jaw muscles, as well as for any obvious dental abnormalities, such as broken teeth, missing teeth or poor tooth alignment. If your dentist suspects that you have bruxism that is related to dental problems, he or she may conduct a more detailed assessment. In addition to checking your “bite,” the dentist will examine your teeth and gums for damage caused by bruxism. The dentist will also take a series of mouth X-rays.

If your child grinds or clenches his or her teeth, discuss the problem with your family dentist. Although many children eventually outgrow bruxism, even short-term tooth grinding can cause damage to your child’s permanent teeth.

Expected Duration

Of all children who brux between the ages of 3 and 10, more than half will stop spontaneously by age 13.In teenagers and adults, how long bruxism lasts depends on its cause. For example, bruxism can last for many years if it is related to a stressful life situation that doesn’t go away. However, if bruxism is being caused by a dental problem, it should stop when the teeth are repaired and realigned — often within a few dental visits.

Prevention

If your bruxism is related to stress, you may be able to prevent the problem by seeking professional counseling or by using strategies to help you learn to relax. Also, try cutting down on stimulants such as tobacco and caffeine.In both children and adults, tooth damage related to bruxism can be prevented by wearing a night bite plate or a bite splint (a dental appliance worn at night to stop teeth grinding).

Treatment

The treatment of bruxism varies depending on its cause:

• Stress — If you have bruxism that is stress-related, your dentist or physician may recommend professional counseling, psychotherapy, biofeedback exercises or other strategies to help you relax. Your dentist or physician also may prescribe muscle relaxant medications to temporarily ease the spasm in your clenched and overworked jaw. If conventional therapy does not help, your dentist may refer you to an oral surgeon who may inject botulinum toxin directly into your jaw muscles (to temporarily interfere with muscle contractions).
• Dental problems — If your bruxism is related to tooth problems, your dentist will probably treat it with occlusal therapy (to correct tooth alignment). In severe cases, your dentist may need to use onlays or crowns to entirely reshape the biting surfaces of your teeth.
• Brain injury or neuromuscular illness — Your bruxism may be especially hard to treat if you have these medical problems. Your oral surgeon may give you injections of botulinum toxin if more conservative treatments fail.
• Medication — If you develop bruxism as a side effect of antidepressant medications, your doctor either can switch you to a different drug or give you another medication to counteract your bruxism.

When To Call A Professional

Call your physician or dentist if you have symptoms of bruxism, or if you are told that you grind your teeth while you sleep.Also, make a dental appointment immediately if you fracture a tooth, lose a filling, or notice that your teeth are becoming abnormally loose in their sockets.

Prognosis

Even without special treatment, more than half of young children with bruxism stop grinding their teeth by age 13. Until your child stops bruxing on his or her own, your dentist can fit your child with a night bite plate to prevent excessive tooth wear. This device is effective in almost all children who use it as directed.In teenagers and adults, the outlook is excellent if bruxism is treated properly. Even if all other therapies fail, injections of botulinum toxin can temporarily stop bruxism in most patients.

How do I Know if I Have Bruxism?
For many people, bruxism is an unconscious habit. They may not even realize they’re doing it until someone comments that they make a horrible grinding sound while sleeping. For others, a routine dental checkup is when they discover their teeth are worn or their tooth enamel is fractured.

Other potential signs of bruxism include aching in the face, head and neck. Your dentist can make an accurate diagnosis and determine if the source of facial pain is a result from bruxism.

How is Bruxism Treated?
The appropriate treatment for you will depend on what is causing the problem. By asking careful questions and thoroughly examining your teeth, your dentist can help you determine the potential source of your bruxism. Based on the amount of tooth damage and its likely cause, your dentist may suggest:

• Wearing an appliance while sleeping — custom-made by your dentist to fit your teeth, the appliance slips over the upper teeth and protects them from grinding against the lower teeth. While an appliance is a good way to manage bruxism, it is not a cure.
• Finding ways to relax — Because everyday stress seems to be a major cause of bruxism, anything that reduces stress can help-listening to music, reading a book, taking a walk or a bath. It may help to seek counseling to learn effective ways for handling stressful situations. Also, applying a warm, wet washcloth to the side of your face can help relax muscles sore from clenching.
• Reducing the “high spots” of one or more teeth to even your bite — An abnormal bite, one in which teeth do not fit well together, may also be corrected with new fillings, crowns or orthodontics.