Teeth grinding and clenching

The tendency to grind teeth has generally been linked to tense and unhappy circumstances. In 1931 the term bruxing was introduced to designate the gnashing and grinding of the teeth during sleep.

Most often patients are not even aware that they are grinding their teeth, since bruxing is performed on a subconscious reflex-controlled level. Bruxism is caused by the activation of reflex chewing activity; it is not a learned habit. Most patients only recognise the habit once it is brought to their attention by their sleeping partner or dentist. Children as young as two years have been shown to grind their teeth during sleep.

Diagnosis

Diagnosing bruxing is not very easy, and apart from a spouse or roommate hearing audible grinding sounds, it is sometimes only a dentist who can make the diagnosis. The effects of bruxing may be quite advanced before patients are even aware that they are grinding their teeth. Damaged (abraded) teeth are usually brought to the patient's attention by their dentist during a routine dental examination.

If enough enamel has been worn away by bruxing, the softer dentine will be exposed and the damage will accelerate. This can lead to dental decay and tooth fracture, and in some people, gum recession. Early intervention by a dentist is advisable.

It is also important to note that bruxism can easily ruin prosthetic dental work.

Symptoms

Grinding of teeth has been associated with frequent headaches, sore joints of the jaw, sore and stiff jaw muscles, a tired feeling in the jaws in the morning and locking of the jaws. Pain in the neck, throat, shoulders and face are also frequent complaints.

Bruxing also results in various dental problems. These include excessive wear of the teeth resulting in aesthetically unacceptable shortening of the length of the teeth, sharp edges, wearing down of the enamel on top of the teeth, as well as fractured teeth, fillings or crowns.

Eventually, bruxing shortens and blunts the teeth being ground, and may lead to myofacial muscle pain and headaches. In severe, chronic cases, bruxism can lead to arthritis of the temporomandibular (TMJ) joints.

Other symptoms that may signal teeth grinding:

  • Sore or sensitive teeth
  • Inflamed gums
  • Damage to the inside of the cheeks
  • Hairline cracks in tooth enamel

Causes

The causes of bruxism are not clear. It is thought that daytime bruxism may be caused by the abnormal alignment of upper and lower teeth (malocclusion), though this hasn't been confirmed in research studies. Sleep bruxism may be related to changes that occur during sleep cycles in some patients, but this is still being researched.

In adults, psychological factors that appear to be associated with bruxism, include:

  • Anxiety, stress or tension
  • Suppressed anger or frustration
  • An aggressive or hyperactive personality type

It has been thought that children brux because the top and bottom teeth don't fit together comfortably as they are erupting.  Others believe that children may brux due to tension, anger, or as a response to pain from an earache or teething. Most children appear to outgrow bruxism before they get their adult teeth.

Bruxism can also be due to a complication of other disorders, such as Huntington's disease or Parkinson's disease, and it can also be an uncommon side effect of some psychiatric medications, including certain antidepressants.

Treatment

If you suspect you are grinding your teeth, speak to your dentist. Treatment methods include:

  • Behaviour modification
  • Relaxation techniques
  • Orthodontic devices such as mouth guards or "bite plates"
  • Muscle relaxants
  • Mild sleeping aids

Read more:

- Bad breath

- Cavities

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