Your dentist says you have a grinding problem...but what does that even mean? And no we are not referring to your high school prom antics. Let's discuss the ambiguity behind bruxism and how it is affecting you.
Bruxism: Defined
The action of grinding, clenching or gnashing your teeth while you sleep is called bruxism. Typically it happens during sleep, but can also happen when you're awake. This clenching and grinding affects both children and adults.
Two Types Of Bruxism
- Asleep
- This form of bruxism, which is known as sleep bruxism, is more common than "awake" bruxism. It is typically spontaneous and frequently occurs in connection with other comorbidities. For instance, sleep apnea, misaligned teeth, cross-bite, or missing teeth often contribute to bruxism. Loud grinding or clenching is typically observed as a manifestation of sleep bruxism.
- Awake
- This takes place while you are awake and is normally attributed to fear, anxiety, tension, or focus. Awake bruxism involves people who typically engage in either side-motion, forward motion, or other destructive positions with their teeth. Along with this grinding motion - people also tend to clench and strain their muscles in the jaw.
Okay..Doc, So Why Do I Brux?
Like many things in medicine, the exact etiology is not black and white. There seem to be a lot of factors at play. Annoyingly, we can't really "stop" the motion you involuntarily do at night with your jaw. Instead, we tend to more so try to protect the teeth, muscles, joints. I know this is confusing so let's discuss some possible "causes" of nocturnal bruxism.
Possible Contributing Factors
- Stress/Anxiety:
- Bruxism is mainly associated with people who experience high-stress and anxiety. High tension levels can sometimes manifest in jaw tension and grinding of the teeth. It may be an unconscious attempt to deal with personal and mental problems.
- Misaligned Teeth:
- Bruxism can also occur when the jaw tries to locate a better position because of misplaced teeth, a poor bite, or malocclusion. When teeth do not come together harmoniously - people tend to move them back and forth i.e. grind them. We often recommend invisalign, not only for esthetics, but mainly to protect future destruction of your teeth.
- Breathing Disorders:
- We are seeing more and more patients that are unknowingly experiencing bruxism because of an undiagnosed breathing problem. Patients that have large tongues, small airways, and snore are at a high risk for apneic events. When these patients struggle to breathe at night, they move their jaw around which leads to clenching and grinding of their teeth.
- Lifestyle Factors:
- High alcohol consumption, smoking, and recreational drugs are also contributing factors to bruxism.
Why Is Bruxism Bad?
Bruxism can cause various oral health problems such as tooth wear, enamel erosion, tooth sensitivity, jaw pain, headaches, and destruction of dental fillings. Without treatment, it may become severe leading to bigger dental issues - like cracked teeth, root canals etc.
Treatment options for bruxism typically focus on addressing the underlying causes and minimizing the harmful effects. There are treatment modalities that include help from your primary care and these focus mainly on psychotherapies.
How Do We Treat Bruxism?
Mouthguards/Splints:
Mouthguards and splints are custom fitted dental appliances that can be worn to form a protective barrier between the upper and the lower teeth. The idea is that these barriers protect your teeth from grinding which will in turn reduce muscle stress/tension. We want to protect the teeth to prevent unnecessary stress which can wear and fracture the teeth. There custom fit appliances are typically worn at night.
Stress Management:
Bruxism symptoms are often alleviated by teaching stress reduction methods, relaxation exercises, and sometimes seeking therapy or counseling for anxiety/stress related problems. We often lean on our colleagues in the medical community to aid in combating bruxism from a psychologic standpoint.
Dental Bite Corrections:
Orthodontics- whether that be Invisalign or traditional braces- is often used to align your teeth to prevent further destruction by bruxism habits. This is done by moving the teeth into an ideal position to where you cannot grind them down unknowingly. We create a harmonious occlusion scheme that essentially optimizes your bite. Creating this "protective bite" reduces the chance of wearing teeth in a destructive way and sets your jaw up for long term success.
Medications:
In severe cases, muscle relaxants or medications for anxiety or depression may be prescribed, but they are often applied as last resort. This treatment modality is usually in conjunction with your primary care provider.
Conclusion
Bruxism is typically an involuntary nocturnal habit. The exact etiology is unknown, but we know of many contributing factors that we often try to address if you suffer from bruxism. If you suspect you have bruxism, it is important to consult a dentist or a healthcare professional experienced in dental conditions. We can evaluate your symptoms, determine the underlying causes, and recommend an appropriate treatment plan tailored to your needs. As always, reach out with any questions!
