Bruxism
(Teeth Grinding)
Definition
Bruxism is the chronic, involuntary grinding or clenching of teeth. It usually occurs during sleep, but may also occur while awake.
Closed Jaw
Causes
The exact cause of bruxism is unknown, but it is believed to be related to:
- Stress and anxiety
- Abnormal alignment of the teeth or jaws
Risk Factors
A risk factor is something that increases your chances of getting a disease or condition.
Risk factors include:
- Chronic stress or anxiety
- Aggressive or competitive personality
- Abuse of drugs or alcohol —especially methamphetamines
- Post-traumatic stress disorder
- Age: 40 or younger; especially common in women aged 27-40
- Family member with bruxism
- Facial or oral trauma
- Use of psychiatric medications, especially antidepressants such as Zoloft, Paxil, and Prozac
- Prior serious head injury
Symptoms
Symptoms may include:
- Grinding sounds during sleep
- Teeth sensitive to heat, cold, or brushing
- Tense facial or jaw muscles
- Hairline crack of the enamel on some teeth
- Sore teeth
- Inflammation of the gums ( gingivitis )
- Headache especially if it is present when waking in the morning
- Damage to the inside of the cheek (from biting or chewing)
- Temporomandibular joint disorder (TMD)
Diagnosis
The doctor or dentist will ask about your symptoms and medical history and examine your teeth and jaw. With bruxism, teeth will have flattened tips, excessive wear, or thin enamel.
Treatment
Methods of treatment include:
Behavioral or Cognitive Treatment
This method focuses on changing behavior through various techniques, such as:
- Biofeedback
- Stress management
- Relaxation therapy or exercises
Orthodontic Treatment
Your dentist may recommend a protective mouth appliance, such as a night guard, that can absorb the pressure of constant night grinding.
Medication
Medication is only recommended for short-term use. Medications may include:
- Muscle relaxants
- Mild sleeping aids
- Injection of botulinum toxin (Botox) in severe cases
- Novel medications, such as clonidine, are being explored as alternative treatments for some patients.
Bruxism that is not treated may result in gum damage, loss of natural teeth, and jaw-related disorders.
RESOURCES:
Academy of General Dentistry
http://www.agd.org
American Dental Association
http://www.ada.org
CANADIAN RESOURCES:
Canadian Dental Association
http://www.cda-adc.ca/
The Canadian Dental Hygienists Association
http://www.cdha.ca/
References:
Academy of General Dentistry website. Available at: http://www.agd.org .
Chang H. Botulism toxin: use in disorders of the temporomandibular joint. Dent Today . 2005;24:48,50-1; quiz 51.
Huynh N, Lavigne GJ, Lanfranchi PA, Montplaisir JY, de Champlain J. The effect of two sympatholytic medications—propranolol and clonidine—on sleep bruxism: experimental randomized controlled studies. Sleep . 2006;29:307-316.
Orofacial Pain Research Center at UKCD website. Available at: http://www.mc.uky.edu/COHR/orofacial_pain.htm .
Tan EK, Jankovic J. Treating severe bruxism with botulinum toxin. J Am Dent Assoc . 2000;131:211-216.
Last reviewed November 2008 by Laura Morris-Olson, DMD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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