Bruxism (BRUK-siz-um) is a condition in which you grind, gnash or clench your teeth. If you have bruxism, you may unconsciously clench your teeth together during the day, or clench or grind them at night (sleep bruxism). Sleep bruxism is considered a sleep-related movement disorder.
Mild bruxism may not require treatment. However, in some people, bruxism can be frequent and severe enough to lead to jaw disorders, headaches, damaged teeth and other problems.
Because you may have sleep bruxism and be unaware of it until complications develop, it’s important to know the signs and symptoms of bruxism and to seek regular dental care.
Signs of Bruxism
Symptoms may include:
- Teeth grinding or clenching
- Teeth that are flattened, fractured, chipped or loose
- Worn tooth enamel, exposing deeper layers
- Increased tooth sensitivity
- Jaw or face pain or soreness
- Tired or tight jaw muscles
- Pain that feels like an earache
- Dull headache originating in the temples
- Damage from chewing on the inside of your cheek
- Indentations on your tongue
- Bleeding gums, receding gum line
- Loose teeth
- Periodontal pockets
See your doctor or dentist if:
- Your teeth are worn, damaged or sensitive
- You have pain in your jaw, face or ear
- Others complain that you make a grinding noise while you sleep
- You have a locked jaw that won’t open or close completely
If you notice that your child is grinding his or her teeth — or has other signs or symptoms of bruxism — be sure to mention it at your child’s next dental appointment.
What Causes Bruxism?
Doctors don’t completely understand what causes bruxism. Possible physical or psychological causes may include:
- Emotions, such as anxiety, stress, anger, frustration or tension
- Aggressive, competitive or hyperactive personality type
- Abnormal alignment of upper and lower teeth (malocclusion)
- Response to pain from an earache or teething (in children)
- An uncommon side effect of some psychiatric medications, such as phenothiazines or certain antidepressants
- A coping strategy or focusing habit
- Complication resulting from a disorder such as Huntington’s disease or Parkinson’s disease
These factors increase your risk of bruxism:
- Stress. Increased anxiety or stress can lead to teeth grinding. So can anger and frustration.
- Age. Bruxism is common in young children, but it usually goes away by the teen years.
- Personality type. Having a personality type that is aggressive, competitive or hyperactive can increase your risk of bruxism.
- Stimulating substances. Smoking tobacco, drinking caffeinated beverages or alcohol, or taking illegal drugs such as methamphetamines may increase the risk of bruxism.
Severe bruxism may lead to:
- Damage to your teeth, restorations, crowns or jaw
- Tension-type headaches
- Facial pain
- Disorders that occur in the temporomandibular joints (TMJs), located just in front of your ears, which may sound like clicking when you open and close your mouth
During regular dental exams, your dentist likely will check for signs of bruxism. If you have any signs, your dentist will look for changes in your teeth and mouth over the next several visits to see if the process is progressive and to determine whether you need treatment.
If your dentist suspects that you have bruxism, he or she will try to determine its cause by asking questions about your general dental health, medications, daily routines and sleep habits.
To evaluate the extent of bruxism, your dentist may check for:
- Tenderness in your jaw muscles
- Obvious dental abnormalities, such as broken or missing teeth or poor tooth alignment
- Damage to your teeth, the underlying bone and the inside of your cheeks, usually with the help of X-rays
- Strength of masseter muscles or jaw
If you or your child has bruxism, your doctor may suggest ways to preserve or improve your teeth. Although these methods may prevent or correct the wear to your teeth, they may not stop the bruxism:
- Splints and mouth guards. These are designed to keep teeth separated to avoid the damage caused by clenching and grinding. They can be constructed of hard acrylic or soft materials and fit over your upper or lower teeth.
- Dental correction. Correcting teeth that aren’t properly aligned may help if your bruxism seems to be related to dental problems. In severe cases — when tooth wear has led to sensitivity or the inability to chew properly — your dentist may need to reshape the chewing surfaces of your teeth or use crowns. In certain cases, your dentist may recommend braces or oral surgery.
Certain therapies may help relieve bruxism, such as:
- Stress management. If you grind your teeth because of stress, you may be able to prevent the problem with professional counseling or strategies that promote relaxation, such as exercise or meditation.
- Behavior therapy. Once you discover that you have bruxism, you may be able to change the behavior by practicing proper mouth and jaw position. Ask your dentist to show you the best position for your mouth and jaw.
In general, medications aren’t very effective for treatment of bruxism, and more research is needed to determine their effectiveness. Examples of medications that may be used for bruxism include:
- Muscle relaxants. In some cases, your doctor may suggest taking a muscle relaxant before bedtime, for a short period of time.
- OnabotulinumtoxinA (Botox) injections. Botox injections may help some people with severe bruxism who don’t respond to other treatments.
If you develop bruxism as a side effect of a medication, your doctor may change your medication or prescribe a different one.
These self-care steps may prevent or help treat bruxism:
- Reduce stress. Listening to music, taking a warm bath or exercising can help you relax and may reduce your risk of developing bruxism.
- Avoid stimulating substances in the evening. Avoid stimulants. Don’t drink caffeinated coffee or caffeinated tea after dinner, and avoid alcohol and smoking during the evening, as they may worsen bruxism.
- Practice good sleep habits. Getting a good night’s sleep, which may include treatment for sleep problems, may help reduce bruxism.
- Schedule regular dental exams. Dental exams are the best way to identify bruxism. Your dentist can spot signs of bruxism in your mouth and jaw with regular visits and exams.