Bruxism (Teeth Grinding)

The symptoms of bruxism include:

• Loud teeth grinding or clenching (that may awaken the sleep partner)
• Enamel erosion, exposing deeper layers of the tooth
• Fractured, chipped, flattened, or mobile teeth
• Heightened tooth pain and/or sensitivity
• Stiffness in the jaw muscles (difficulty in opening or closing the jaw completely)
• Soreness or pain in the jaw, neck, or face
• Sleep disruption
• Dull headaches originating in the temples
• Earache-like pain (not originating from the ear)

A combination of psychological, physical, and genetic factors has been associated with bruxism.

Possible causes:

• Anger, frustration, stress, anxiety, or tension may cause awake bruxism, which serves as a coping mechanism for activities involving deep concentration.
• Sleep-related chewing activities associated with arousals may cause sleep bruxism.

The following causative factors have been shown to increase the risk of bruxism:

• Stress: Increased levels of anger, frustration, and anxiety can cause the grinding of teeth.
• Age: While bruxism is common before and during early adolescence, it usually subsides by adulthood.
• Personality type: People who are competitive, aggressive, or hyperactive may be at an increased risk of developing bruxism.
• Family history: People with family members who have bruxism or a history of it may develop this condition.
• Medications and other substances: Some psychiatric medications, such as antidepressants, are associated with bruxism as a side effect. Consumption of caffeinated beverages or alcohol, recreational drug use, and smoking tobacco may also increase the risk.
• Other disorders: Some neurological disorders such as attention-deficit/hyperactivity disorder, epilepsy, and Parkinson's disease-related dementia, and sleep-related disorders such as sleep apnoea and night terrors have been associated with an increased risk of developing bruxism.

Bruxism is usually diagnosed during routine dental examinations based on the presence of the aforementioned signs, including tooth wear, jaw tenderness, or patient-reported grinding noises noticed by a bed partner.

Mild cases of bruxism in adults and in the majority of children may not require intervention. However, for cases of severe bruxism, dentists prescribe specific dental approaches, therapies/habits, and medications to prevent further tooth damage and provide relief from pain or discomfort:

• Dental approaches:
  • Mouth guards and splints: These devices, often prepared using hard or soft acrylic materials, are fit onto the upper or lower teeth; thus, they help separate the teeth and prevent the damage caused by tooth grinding/clenching.
  • Dental correction: When the bruxism is severe, i.e., wear and tear of the tooth has led to heightened sensitivity or difficulties in chewing/eating, the chewing surfaces may need to be reshaped for damage repair, followed by the insertion of dental crowns.
• Other approaches:
  • Management of anxiety and stress: Adopting strategies that promote relaxation, such as meditation, and/or guidance from a licensed therapist or counsellor, may be effective if the bruxism is a result of psychological stress or anxiety.
  • Behavioural changes: The dentist may recommend appropriate jaw posturing/alignment and mouth and jaw exercises as behavioural changes to suppress teeth grinding/clenching.
  • Biofeedback: If changing behaviours/habits is difficult, biofeedback, i.e., the use of monitoring procedures and equipment to teach patients how they can control muscle activity in the jaw, may be effective.
• Medications:
  • Botox injections
  • Muscle relaxants
  • Anti-anxiety or anti-stress medications

An appointment with a dentist should be scheduled if the patient experiences:

• Persistent tooth pain or sensitivity
• Chipped, loose, or fractured teeth
• Jaw pain, stiffness, or headaches
• Grinding noises noted by your sleep partner
• Sleep disturbances linked to jaw clenching

Although bruxism cannot always be prevented, adopting healthy lifestyle and stress-management strategies can reduce the risk or severity.

For management of bruxism, consult a:

• Dentist: for diagnosis, splints, and dental repair
• Sleep specialist: if associated with sleep disorders
• Psychologist/therapist: for stress and anxiety management