Bruxism, a medical term used for tooth grinding or teeth clenching, is one might that unintentionally does from time to time. Although this phenomenon can happen at any time during the day, most people suffering from bruxism, grind their teeth at night in their sleep.
Moreover, its severity leads to the abovementioned discomforts. A large number of people affected with bruxism grind their teeth during their sleep at the night. This continuous grinding can eventually remove critical portions of healthy enamel from the chewing surfaces of the teeth and may cause facial pain, Although a mild form of bruxism will not threaten or trouble a person, if it escalates it could lead to jaw disorders, headaches, damaged teeth and other oral problems.
Awake bruxism: This occurs during the daytime when you are awake. It is mostly associated with stress, anger, emotional issues, or concentration. It does not require treatment, and stress management can help reduce the frequency of this type of bruxism.
Sleep Bruxism: This type of bruxism occurs during sleep hours. As you are unaware of yourself clenching or grinding your teeth during the sleeping hours, it can lead to it being undetected. However, because of this constant clenching action, you may suffer from jaw pain, teeth problems, and headaches.[1]
Symptoms
The bruxism-related signs and symptoms are so subtle that it usually goes unnoticed during the initial periods. People usually are not diagnosed with bruxism until it is too late because they do not realize that they have the habit. Many times, one learns about this habit from a loved one who hears the grinding sound at the night. Though one might not find out the grinding and clenching habit on his own, there are signs that can point out to it:
Morning headaches: During severe fits of bruxism, one may wake up in the morning with a headache. The muscles that are stressed because of constant grinding and clenching during the night set the stage for migraine headaches, tension-type headaches, sinus headaches, allergy headaches and premenstrual headaches.
Jaw pain: The constant grinding and clenching can give rise to tooth and jaw pain with a distressing feeling on the face. Tensed muscles and excessive wear and tear of the teeth because of bruxism causes jaw pain.
Other oral problems: Continuous forceful biting in sleep may cause the jaws to move out of proper balance. It can cause stress fractures in the teeth. Moreover, this may damage the temporomandibular joint that helps the lower jaw to join with one side of the head. It can lead to hearing loss or change the face’s shape. Even with the mild form of the condition, if it persists longer, can result in chipped, broken or reduced teeth. With time, it can loosen teeth from the cavity and can present with a receding gum line.
Tooth sensitivity: People who have otherwise healthy teeth and gums clench so often and so hard that their teeth become sensitive with time.
Distressing behaviour: For many whose, symptoms of night grinding go unnoticed can bite fingernails, and pencils or chew the insides of their cheeks during the daytime.
Causes And Risk Factors
Causes
Experts believe that increased stress and anxiety are related to bruxism. The genetic transmission of bruxism is seen in 20% of the population. Emotional or physical stress, which is a source of nocturnal teeth grinding, may be used as a tension-relieving method. This has been seen in the medical literature. Individuals who have temporary bruxism may exhibit stress-related symptoms such as tossing and turning in their sleep, excessive perspiration, or other symptoms not related to bruxism.
Risk Factors
Remember that the causes of bruxism vary from person to person. Different people have different triggers. Some common triggers that can set off an episode of nocturnal grinding are listed below:
Daytime stress
Eyestrain
Sinus infections
Exertion
Caffeine withdrawal
Weather-related changes
Adjusting to new eyeglasses
Constant use of headbands
Hormonal changes
The spectrum of stress and anxiety is large and what would give rise to a habit of bruxism in one might not be significant for the other. Usually, bruxism affects people with some underlying nervous tension or disturbance. Anger, pain and frustration can trigger a bout of clenching and grind in the night. Moreover, people who are aggressive, competitive and hurried in nature can be at a greater risk of bruxism.
Prevention
To prevent bruxism, you can take up the following steps.
Avoiding alcohol, cigarettes, and drugs as these can lead to worsening of your night bruxism symptoms.
Avoid chewing on pens, pencils or other non-food items
Avoid the daily chewing of gum.
Avoid caffeine in foods or drinks or limit the quantity. Caffeinated drinks and foods include chocolates, coffee, and colas.
Making regular appointments with your dentist can help identify the problem and accordingly treat it.
Treat any dental problems that you may have to avoid bruxism such as missing or misaligned teeth.[1]
Diagnosis
Usually, a physical examination and a history of your symptoms should suffice for your doctor to diagnose you with bruxism. People usually are not diagnosed with bruxism until it is too late.
So, if you notice any of the abovementioned symptoms or see changes in your teeth structure for no certain reason, it makes sense to visit your dentist and get verified. In certain cases, your doctor may advise a sleep test for you called polysomnography, which is performed at a sleep centre. This test will confirm your bruxism diagnosis.[1]
Treatment
Bruxism can be treated and verified in the following manner:
Learning to relax: The aim is to help the bruxer or the person suffering from bruxism change his behaviour by helping him learn to properly rest the tongue, teeth and lips.
When someone becomes aware of their problem, simply advising them to rest their tongue upward with teeth apart and lips shut may be enough to change their behaviour and relieve the discomfort.
Using a night guard: A night guard is a plastic mouth appliance that is worn on the arches of the teeth to absorb the force of biting and grinding because of bruxism in sleep. It forms a barrier between the top and bottom teeth to stop the grinding of these two arches. The night guard receives the occlusal wear rather than the teeth.
This appliance can prevent future damage to teeth and helps change the patient’s destructive behaviour and relieve the tension-related headache.
Drugs: Bruxism is treated with drugs only when relaxation methods and device wearing have failed. Medications such as anti-anxiety, pain-relieving, muscle relaxants, sedatives, and anti-inflammatory drugs may be prescribed.[2]
Exercising regularly: Regular exercises can help you relieve stress and muscle tension from the overall body, which protects you from night grinding of teeth.
Observe a peaceful sleep routine: Create a calm atmosphere for yourself before your bedtime. Relax and unwind at least prior to an hour of going to bed. You can read a book and soothe yourself and avoid eating before going to bed.
Soothe your jaws: If your jaw aches in the morning, moisten a terry-cloth tissue in warm water, squeeze it and apply to an aching jaw till you feel better. This will help to calm down the pain.
Keep up with your dental visits: Regular dental visits are important as the dentist inevitably checks for the physical signs of bruxism. In case you or your dentist notice signs of bruxism, it needs to be observed over several visits before confirming that you are suffering from bruxism. Once your diagnosis is confirmed, your dentist can recommend the required treatment.
Take sessions in stress management: Therapies for stress management; relaxation therapy and meditation help manage stress and hence help to control nighttime teeth grinding. It is important to know all signs and symptoms of bruxism at regular intervals to accordingly treat the core cause.
Prognosis And Complications
Prognosis
The prognosis for bruxism is good if you stick with your treatment plan. Children may outgrow bruxism by adolescence; however, in certain cases, despite treatment many bruxism conditions reoccur.[1,2]
Complications
Complications such as fractures of your teeth, headaches, pain, and temporomandibular disorders (TMJ syndrome) can occur. In TMJ, the muscles of your jaw and joints can cause problems that will inhibit your chewing and limit your jaw movement. It may lead to loss and wearing down of teeth, and other complications may include cosmetic changes involving a change in how you look and your overall facial profile. [1,3]
References
1. Bruxism. Cleveland Clinic. Available at:
https://my.clevelandclinic.org/health/diseases/10955-teeth-grinding-bruxism.(https://my.clevelandclinic.org/health/diseases/10955-teeth-grinding-bruxism)
2. Bruxism Management. NCBI. Available at:
https://www.ncbi.nlm.nih.gov/books/NBK482466/. Accessed on July 11, 2021.
(https://www.ncbi.nlm.nih.gov/books/NBK482466/)
3. Teeth Grinding- Causes, Treatment, and Consequences. Cedars Sinai.
Available at: https://www.cedars-sinai.org/blog/teeth-grinding.html.
(https://www.cedars-sinai.org/blog/teeth-grinding.html)
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