Teeth grinding, also known as “bruxism”, is a parafunctional habit. It involves involuntary grinding and clenching of teeth with no functional purpose. Examples of parafunctional habits:
- Checks, lips, and tongue biting.
- Teeth grinding and clenching.
- Tongue thrust (against teeth or palate).
- Chewing an object such as fingernails or pencils.
In normal, the lower jaw is usually located in the rest position. Jaw muscles are relaxed and teeth of upper and lower jaw don’t touch each other. The distance between the upper and lower teeth is 2 – 4 millimeters. Teeth contact occurs during chewing. In teeth grinding, the upper and lower teeth are in contact with no functional purpose. Teeth and tooth-supporting tissues are exposed to continuous loads which may cause tooth damage.
People who suffer from teeth grinding often don’t notice it. Because it occurs unconsciously. Also, it occurs mainly during sleep (nocturnal bruxism). Frequent teeth grinding can cause some complications such as a headache, tooth damage, and TMJ disorders. So, it is important to visit your dentist to treat the cause and prevent the complications.
Teeth Grinding in Baby and Children
Usually, teeth grinding in the baby is not a cause for concern. About half of the babies begin to grind their teeth at the age of ten months and it usually disappears with the loss of primary teeth. In contrast, when it frequently occurs in school children, it may be an indication of stress especially if it associated with nail biting and pencil chewing. The parents should talk to the doctor to reduce the stress level of the child. Also, a customized mouthguard should be worn at night to prevent tooth damage and other complications.
Causes of Teeth Grinding
Experts don’t completely understand what causes teeth grinding. They believe that several factors (physical, psychological, and genetic factors) are involved in the formation of this parafunctional habit. These factors include:
- Stress, anxiety, anger, and frustration: daily stress is usually the most common cause.
- Dental problems: some dental problems may trigger bruxism such as:
- Periodontal diseases.
- Ill-fitting dentures.
- Improper tooth fillings.
- TMJ disorders.
- Some drinks: the consumption of alcohol or caffeine-containing beverages (coffee, black tea, coke, or energy drinks) can promote teeth grinding because of substances that affect the central nervous system (CNS).
- Sleep problems: such as snoring, sleep talking, and sleep apnea can trigger this parafunctional habit. The nocturnal teeth grinding is considered a form of sleep disorders.
- Some medical conditions: it can be associated with some medical problems such as:
- Some neurological diseases such as Parkinson’s syndrome and Huntington’s disease.
- Sleep-related disorders such as sleep apnea and snoring.
- Night terrors.
- Some medications: it can be a side effect of psychiatric and antidepressant medications, for example, Prozac (fluoxetine), Zoloft (sertraline), and Paxil (paroxetine).
Teeth Grinding Risk Factors
These factors can increase the risk of teeth grinding:
- Age: teeth grinding is common among children. About half of the babies begin to grind their teeth at the age of ten months and it usually disappears with the loss of primary teeth.
- Type of personality: an aggressive, competitive, or hyperactive personality may increase the risk of this parafunctional habit.
- Stimulating substances: tobacco smoking or alcohol and caffeinated beverages drinking can increase the risk of bruxism.
- Sleep problems: sleep apnea, snoring, and sleep talking are the most common triggers.
Symptoms of Teeth Grinding
Teeth grinding can cause unpleasant symptoms. Especially, if it occurs for a long period. Most people grind their teeth during sleep. So, the symptoms become noticeable in the next morning. Signs and symptoms of bruxism may include:
- The sound of teeth grinding during sleep may disturb the sleep of who you share your room with.
- Fractured, chipped, or loose teeth.
- Tooth wear caused by tooth-to-tooth contact.
- A toothache, earache, and headache.
- Tooth sensitivity.
- Ringing in the ear (Tinnitus)
- Facial muscles tension and pain.
- Pain and tension in the neck and shoulder area.
- Temporomandibular joint (TMJ) pain.
- Clicking or popping of the temporomandibular joint when you open or close your mouth.
Even a slight teeth grinding can cause changes in teeth surfaces (so-called dental attrition, a type of tooth wear caused by tooth-to-tooth contact). If you grind your teeth for a long period of time, your teeth may become sensitive, painful, or even loose. Also, it can cause problems with the temporomandibular joint. During teeth grinding, the force that acts on the temporomandibular joint are huge. Long-lasting grinding can lead to:
- Clicking sound during mouth opening and closing.
- Limited movement or locking of the jaw.
Complications of Teeth Grinding
For many patients, teeth grinding is a very serious condition that can cause very serious consequences. Once the cause is known, it should be treated immediately. Otherwise, it can cause pain, teeth damage, and other complications such as:
- Tooth wear: it is the most common complication of bruxism. Tooth wear can lead to tooth sensitivity to heat and cold.
- Cracked, chipped, or fractured tooth: the pressure generated by bruxism is equivalent to six times the maximum pressure of normal bite.
- Gum recession: the pressure generated by bruxism can affect the tooth-supporting structures, causing gum recession, gum pocket, and even tooth loss.
- Headache and tinnitus: teeth grinding can cause tinnitus, ringing in the ear (hiss or roaring sound).
- Jaw and facial pain: because of the overuse of muscles.
- TMJ disorder: it is characterized by pain of jaw muscles, restricted jaw movement, and clicking or popping of the temporomandibular joint when you open or close your mouth.
Diagnosis of Teeth Grinding
People who suffer from teeth grinding may be unaware of this parafunctional habit because it often occurs during sleep. The dentist will check for signs and symptoms of bruxism:
- Tooth wear caused by tooth-to-tooth contact (dental attrition).
- Broken, cracked, or chipped teeth.
- Broken restorations.
- Tooth sensitivity.
- Clicking or popping of the TMJ when you open or close your mouth.
- Pain in the TMJ and jaw muscles.
- Muscle tension in the neck and shoulder area.
The existence of these visible changes usually means that teeth grinding is already in an advanced stage. So, you should visit your dentist to prevent tooth damage and the development of TMJ disorders.
Treatment of Teeth Grinding
The treatment varies depending on the underlying cause. it includes a professionally made night guard, dental treatments, and medications to relieve symptoms and prevent tooth damage.
- Splints and mouthguards: they are a specially manufactured prosthesis, adapted to the arch to protect teeth. They are constructed from hard or soft acrylic material.
- Dental treatment: in some cases, teeth grinding is caused by malocclusion, periodontal disease, gum recession, improper tooth restoration, and ill-fitting denture. So, visiting the dentist is important for:
- The correction of teeth alignment by braces or oral surgery.
- The treatment of periodontal disease.
- The reconstruction of tooth restorations and ill-fitting denture.
- In severe cases, teeth grinding can cause dental attrition (tooth wear) and teeth may become sensitive and painful. So, the dentist may recommend dental crowns.
- Stress and anxiety management: stress plays an important role in teeth grinding. So, relaxation techniques such as autogenic training and meditation can reduce the stress level. In addition to physical therapy exercises, massaging jaw muscles, and heat treatments can help to relax jaw muscles and relieve discomfort.
- Muscle relaxants and stress medications: they can be used for the treatment of teeth grinding but they are not very effective (more research is needed). In severe cases, botox injections may help people who don’t respond to other treatments.
- A side effect of some medications: if you develop bruxism as a side effect of some medications such as psychiatric and antidepressant medications, you should visit your physician to change your prescription or prescribe a different one.
- A side effect of some medical conditions: also, if bruxism is associated with some medical conditions such as sleep related disorders, you should visit your physician.
Prevention of Teeth Grinding
You can prevent teeth grinding by following this instruction:
- Manage stress: the main trigger of bruxism is stress. Of course, stress can’t be avoided entirely. But relaxation techniques like autogenic training or yoga can help you to better handle stressful situations. Sports such as running, swimming, and boxing are an excellent way to free yourself from tension and stress.
- Avoid parafunctional habits: avoid chewing fingernails, pens, and gum because they can promote teeth grinding.
- Avoid tobacco and drinks that contain alcohol and caffeine: drinks such as coffee, soda, and energy drinks stimulate the nervous system and can promote teeth grinding.
- Eat food rich in calcium and magnesium: calcium and magnesium are important minerals for the health of nervous system and muscles function. You can find magnesium in great leafy vegetables. Any deficiency in these minerals can cause muscle spasm and tension.
- Manage your medications: if you develop teeth grinding as a side effect of some medications, visit your physician to change the medication or the dosage.