Bruxism


Bruxism is excessive teeth grinding and it may be done by a person subconsciously i.e. he is unaware of the activity he is doing. Teeth grinding or jaw clenching is normal to all, each one of us does this but excessive teeth grinding creates problems for the tooth and jaw. Symptoms of bruxism may range from mild to severe. Teeth grinding is more common among teenagers, but the problem sometimes goes away with age.

Bruxism can happen at any time of the day. It may also happen during sleep. Bruxism is commonly distinguished into two types depending on the time of the day it is happening. Although teeth grinding remains the same in both the cases, their causes, symptoms and treatments differ.

Awake Bruxism

The teeth grinding in this type happens during the day when the person is awake. In these, the person does this for various reasons unknown to him. Stress, anxiety, fear, etc. are the common reason for day bruxism. This may not need treatment if you notice it and stop it whenever you notice it.

Nocturnal Bruxism

Also known as sleep bruxism, in this type, teeth grinding happens during sleep. The unconscious part of our brain is responsible for this. There may be many central nervous disorders responsible for it and it may require proper diagnosis and treatment.

Bruxism: Causes

The cause of bruxism is unknown and several factors may be responsible for it. Awake bruxism causes can be different from that of nocturnal bruxism. Psychological factors are mainly responsible for awake bruxism whereas the central nervous system is responsible for nocturnal bruxism.

The following are the important causes of developing bruxism −

  • Awake bruxism is mainly due to stress, anxiety, or fear.

  • Sleep bruxism is associated with the central nervous system and its abnormalities.

  • Daytime stress can also lead to nocturnal bruxism.

  • Genetic factors are also a cause of bruxism. People with a positive family history are more inclined towards bruxism.

  • Drugs. Some of the drugs that are prescribed to a patient may induce bruxism.

  • Occlusal factors. Occlusal means the contact between the upper teeth and the lower teeth. Malocclusion is a misalignment between the upper and lower teeth structure. These factors are also a cause of bruxism.

  • Psychological disorder. Some of the underlying mental disorders can also cause bruxism.

  • Sleep disorder is also responsible for teeth grinding.

  • Smoking, addiction to drugs, and alcohol can also cause bruxism.

Bruxism: Symptoms

Bruxism patients are many times unaware of the symptoms. Teeth grinding is like any other subconscious activity like nail biting. It becomes serious when the grinding and clenching become excessive, and then only the patient inhibits the following symptoms −

  • Tapping or grinding noise during sleep. This is normally being caught by your parents or partner

  • Chick or lip biting can also be a symptom of bruxism

  • Headaches, pain in the jaw, earaches

  • Bad shape of the teeth i.e. flattening, fractured, etc.

  • Sensitivity in the teeth

  • Bad sleep

  • Difficulty chewing food

  • Chick gets sore

  • Gum pains

  • Locking of the jaw

  • Restriction in the opening of the jaw

  • Wearing of the teeth

  • Burning sensation in the tongue

Bruxism: Risk Factors

Several factors play an important role in the development of bruxism which includes −

  • Personality factors. A different person shows different personality attributes. Some are aggressive and they are more at risk.

  • Age. Children and younger people show the symptom of bruxism.

  • Disease. A patient already suffering from some ailments like depression, cancer, high blood pressure, sugar, etc. can experience bruxism.

  • Medicines. Some medicines increase the risk of oral diseases. You may ask your doctor to change the medicines prescribed.

  • Smoker. Smoking is bad for health and so for bruxism.

  • Mental disorder. Some disorder like stress, depression, and bipolar disorder increases the risk.

  • Genetics. According to much research people with a positive family history of bruxism are more at risk.

Bruxism: Diagnosis

Bruxism can do serious damage to your teeth, tongue, or even face. The jawline gets affected, which not makes it difficult to eat but also to speak. The look of the person becomes bad and they go into hiding. It is very important that you visit the doctor and he may use any of the diagnosis methods.

  • Physical examination. Your doctor may first physically examine you for abnormality in the tooth and jawline. He will then look into the severity of the damage done and will deal accordingly.

  • Questionnaire. He will ask you certain questions about the sleep pattern and other behavioral aspects and will refer you to a psychologist for any mental disorder.

  • Sleep tests. Bruxism is many times due to sleeping disorders like sleep apnea, and the same needs to be tested

  • X-rays. X-rays help the doctor to see the bone structure of the jaw and teeth structure. It also helps to assess the damage done.

  • Dental check-ups. Fractures, cavities, and alignment of the upper teeth and the lower teeth are checked.

  • Psychological test. Some of the cases of bruxism are due to personality disorder diseases, the confirmation of the same need.

Bruxism: Treatment

Bruxism is mostly seen in children and teens and it mainly goes away with age if caught early. The treatment is based on the severity of the symptoms. Your doctor may advise any of the following treatments.

  • Splints and dental guards. These guards are a very important non-medicinal way to restrict clenching or grinding of teeth and are very effective in sleep bruxism. This guard helps to guard teeth by holding them apart and preventing grinding.

  • Dental implants. The effect of bruxism can be very severe on teeth and it can affect the chewing of food. Sometimes, the teeth get so affected that it needs dental treatment. Crowning, dental ceramics, or another method of treatment may be used.

  • Medicines. Some of the medicines may be prescribed by the doctor for relaxing your muscles.

  • Injection. Botulinum neurotoxin shots can be given to bruxism patients if not treated by other conventional methods. This shot helps to partially paralyze the muscles and reduce the clenching activity.

  • Psychological treatment. This is also one of the methods used for treatment when the root cause of bruxism is found to be personality disorder diseases. Talk therapy, behavior change, and biofeedback are the different methods used in this treatment.

Bruxism: Prevention

Some of the measures that can help to prevent bruxism include −

  • Do not smoke or drink alcohol

  • Avoid spices

  • Avoid stress and do exercise regularly

  • Talk to your sleeping partner and explain your condition

  • Do not drink caffeinated drinks before sleep

  • Try to have some sleep exercise that helps to sleep more efficiently.

  • Yoga may be helpful

  • Maintain a healthy lifestyle

  • Good oral hygiene may help

  • Drink plenty of fluids

  • Be careful if you see any symptoms of bruxism and visit your doctor. Follow all the instructions carefully

If you are having other dental problems, make sure that it is treated.

Conclusion

Bruxism or teeth grinding or jaw clenching is the excessive grinding of the teeth which may happen during the day or sleep. The underlying reason for the same is not known to the patient and it can last for a lengthy period. It mostly occurs in children and teens and it goes away with age.

Bruxism can cause severe damage to the teeth and it can make eating food difficult. Proper diagnosis and prevention can help to reduce its impact. Yoga, oral hygiene, no smoking/ alcohol, etc. may help a lot.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha

MBBS MS [ OPHTHALMOLOGY ]

Updated on: 17-Apr-2023

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