The medical term for grinding, gnashing or
clenching your teeth is "bruxism". The condition affects both children
and adults. Some people with bruxism unconsciously clench their teeth
together during the day, often when they feel anxious or
tense. This is different from tooth grinding or clenching
that occurs at night, which is called sleep bruxism. Most
children who are grind teeth do so at night, while adults do
so
either during the daytime or nighttime.
Bruxism may be mild and may not even require treatment.
However, it can be frequent and severe enough to lead to jaw
disorders, headaches, damaged teeth and other problems.
Often, people with sleep bruxism usually aren't
aware of the habit, so they aren't diagnosed with the
condition until complications occur. That's why it's
important to know the signs and symptoms and get regular dental care.
Signs and symptoms
Signs and symptoms of bruxism include:
- Teeth grinding
or clenching
- Teeth that are worn down, flattened or chipped
- Worn tooth enamel, exposing the inside of your tooth
- Increased tooth sensitivity
- Jaw pain or tightness in your jaw muscles
- Earache — due
to severe jaw muscle contractions,
not a problem with your ear
- Headache
- Chronic facial pain
- Chewed tissue on the inside of your cheek
Many doctors don't completely understand the causes of bruxism.
For daytime bruxism, it has been thought that abnormal
alignment of upper and lower teeth (malocclusion) may
contribute to the problem, though this hasn't been confirmed
in research studies. Sleep bruxism is believed to be related
to changes that occur during sleep cycles in some
individuals, and this is an area of current research.
In adults... psychological factors seem to be associated
with bruxism, including:
Anxiety, stress or tension
Suppressed anger or frustration
Aggressive, competitive or hyperactive personality
type
In children... tooth grinding may be related to growth and
development of the jaws and teeth. Some researchers think
children grind because their top and bottom teeth don't fit
together comfortably as they are erupting. Others believe
that children grind their teeth because of tension, anger,
or as a response to pain from an ear ache or teething. While bruxism has been reported to occur in up to 30% of
children (often in children under the age of 5) most
children outgrow bruxism before they get their adult teeth.
Medical advice
Bruxism often goes unnoticed. See your doctor or dentist
if you have worn teeth or pain in your jaw, face or ear.
Also consult your doctor or dentist if your partner
complains that you make a grinding noise while you sleep. If you notice that your child is grinding his or her
teeth, or has other signs or symptoms of this condition, be sure to mention it at your child's next dentist
appointment.
Screening and diagnosis
Your dentist likely will
check for physical signs of bruxism during regular
dental exams, such as unusual wear
and tear on your teeth, broken dental restorations and tooth
sensitivity. Continued breakdown of dental restorations,
loss of crowns and fracture of teeth are frequent problems
associated with the tooth grinding and clenching associated
with bruxism. If you have any of these 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. You may also be asked
to return for additional exams.
If your dentist suspects that you have bruxism, he/she
will try to determine the cause by asking questions about
your stress level, your general dental health, your daily
medications, and whether you routinely drink alcohol or
caffeinated beverages, especially at night. If you share
your bedroom, your dentist may also ask your partner about your sleep habits, especially about any
unusual grinding sounds heard during the night.
Dentists will
examine your mouth and jaw, checking for tenderness in your
jaw muscles and any obvious dental abnormalities, such as
broken or missing teeth or poor tooth alignment. Your
dentist will also inspect your teeth, the underlying bone
and the inside of your cheeks for damage caused by bruxism.
He or she may take a series of X-rays of your mouth and jaw.
A dental exam may detect other disorders that can
cause similar jaw or ear pain, such as temporomandibular
joint disorders or other dental disorders. If your dentist
suspects that you have an ear infection (otitis media), he
or she will probably refer you to your primary care provider
for further examination and treatment. If your dentist
suspects a significant psychological component to your teeth
grinding or a sleep-related disorder, you may be referred to
a therapist, counselor or sleep specialist.
Treatment Methods
Often times, no
treatment is necessary. Many children will
outgrow bruxism without special treatment, and many adults
don't grind their teeth badly enough to require therapy. However, if the
problem is severe, treatment options include:
Stress management.
If you grind your teeth because of stress, you may be able
to prevent the problem with professional counseling oractivities that promote relaxation, such as exercise and
meditation. If your child grinds his or her teeth because
of tension or fear, it may help your child to talk about
his or her fears just before bed or to relax with a warm
bath or a favorite book.
Dental approaches.
If you or your child has bruxism, your doctor may suggest
a mouth guard or protective dental appliance (splint) to
prevent damage to the teeth. Your dentist can make a
custom mouth guard to fit your mouth. Over-the-counter
mouth guards are available and they're less expensive than
custom guards, but they generally don't fit well and can
dislodge.
If your bruxism seems to be
associated with dental problems, your dentist may also
correct misaligned teeth. In severe cases, when tooth
wear has led to sensitivity or the inability to chew
properly, your dentist may need to use overlays or crowns
to entirely reshape the chewing surfaces of your teeth.
Reconstructive treatment can be quite extensive and though
it will correct the wear, it may not stop the bruxism.
Behavior therapy.
Once you discover that you have bruxism, you may be able
to change the behavior by practicing proper mouth and jaw
position. Concentrate on resting your tongue upward with
your teeth apart and your lips closed. This should keep
your teeth from grinding and your jaw from clenching. If
you're having a hard time changing your habits, you may
benefit from biofeedback, a form of complementary and
alternative medicine that uses special monitoring
procedures and equipment to teach you to control
involuntary body responses.
In a biofeedback
session, a therapist applies electrical sensors to
different parts of your body. These sensors monitor your
body's physiological responses to stress — such as teeth
grinding — and then feed the information back to you via
auditory and visual cues. These cues may take the form of
a beeping sound or a flashing light. With this feedback,
you'll start to associate teeth grinding or clenching with
stress and learn to change your behavior. You may also be
given a portable biofeedback device that you use at home.
Your therapist will explain how it works.
Medications. In
general, medications aren't very effective for treatment
of bruxism. In some cases, your doctor may suggest taking
a muscle relaxant before bedtime. If you develop bruxism
as a side effect of an antidepressant medication, your
doctor may change your medication or prescribe another
medication to counteract your bruxism. Also, botulinum toxin (Botox)
injections may help some people with severe bruxism that
hasn't responded to other treatments.
Source: Marketdata Enterprises, Inc. research, Wikipedia
