Bruxism

Definition

Bruxism is the habit of grinding the teeth together, typically at night.

Although the grating noise may be annoying for a spouse or sibling, teeth grinding is not something to become worried about.

Description

Contrary to popular belief, chronic teeth grinding will rarely wear down the teeth, nor does bruxism have a link to temporomandibular disorder (TMJ).

Bruxism is thought to be transmitted genetically and occurs in about 20 percent of people.

There is some evidence that emotional or physical stress can lead to nocturnal teeth grinding, which may be a way to relieve tension. People who exhibit temporary bruxism also toss and turn in their sleep, perspire heavily, and exhibit other symptoms typical of stress that are not specifically related to bruxism.

Early detection of this condition can prevent consequences such as headaches, muscle pain, temporomandibular joint dysfunction and permanent tooth damage.

Diagnosis

For the detection of bruxism, some experts recommend the use of a simple 60-second screening examination that involves a number of screening questions. These are:

• Do you clench or grind your teeth, or has anyone told you that you do?

• Do you ever have headaches or pain in your neck or shoulders.

• Do you have a clicking jaw?

• Do your teeth or jaws ever feel tired when you wake up?

• Do you have sensitive teeth?

• Do you have, or have you ever had, pain in your jaw or in the sides of your face in the area of your ears?

• On which side of the mouth do you chew?

Treatment

While the symptoms of bruxism in adults can be treated, the condition usually cannot be cured. Treatment focuses on relieving acute symptoms and limiting permanent sequelae. Treatment should be provided jointly by the patient's family physician and dentist.

Because bruxism may have a number of causes, a variety of treatments can be used. The success of treatment is determined by symptoms resolution and improved mandibular range of motion.

Treatment approaches include biofeedback exercises, massed negative practice, change in sleep positioning, drug therapy, psychotherapy, hypnotherapy, occlusal orthotics, and stress reduction and coping techniques.

Stress must be considered as a causative factor in bruxism. A thorough evaluation of financial, marital and familial relationships should be made. Counseling in these areas can lead to an awareness of stressful situations, and long-term management should be directed at helping the patient make comprehensive changes in lifestyle.

Stress reduction can be achieved by a number of techniques such as visual imagery and autosuggestion, aversive conditioning (such as awakening the patient during episodes of teeth grinding), massed negative practice (the patient voluntarily clenches the teeth for 5 seconds and then relaxes the jaw for 5 seconds), pharmacologic therapy to suppress REM sleep, changes in sleep position (lying supine with neck and knee support allows the lower jaw to rest), and a soft food diet.

Questions to Ask Your Doctor

Is this related to a sleep disturbance?

What are the consequences of continual grinding of the teeth?

What can be done to prevent or minimize teeth grinding?

Is it essentially stress-related?

Would psychological counseling help?

Is a change in sleep position called for?

Are any changes in diet necessary?