Bruxism

(Teeth Grinding)
  • Definition

    Bruxism is chronic, involuntary grinding or clenching of teeth. It usually occurs during sleep, but it may also occur while awake.
    Closed Jaw
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  • Causes

    The exact cause of bruxism is unknown, but it is believed to be related to:
    • Stress and anxiety
    • Abnormal alignment of the teeth or jaws
  • Risk Factors

    Risk factors that increase your chance of getting bruxism include:
    • Chronic stress or anxiety
    • Aggressive or competitive personality
    • Smoking tobacco or drinking caffeinated beverages
    • Abuse of drugs or alcohol (especially methamphetamines)
    • Post-traumatic stress disorder
    • Age: 40 or younger; especially common in women aged 27-40
    • Family member with bruxism
    • Facial or oral trauma
    • Use of psychiatric medications, especially antidepressants
    • Prior serious head injury
    • Complication resulting from a disorder, such as Huntington's disease or Parkinson's disease
  • Symptoms

    Symptoms may include:
    • Grinding sounds during sleep
    • Teeth that are sensitive to heat, cold, or brushing
    • Tense facial or jaw muscles
    • Teeth that are worn down, flattened, fractured or chipped
    • Hairline cracks or wearing of the enamel on some teeth
    • Sore teeth
    • Inflammation of the gums (gingivitis)
    • Headache, especially when waking in the morning
    • Damage to the inside of the cheek (from biting or chewing)
    • Temporomandibular joint disorder (TMD)
  • Diagnosis

    The doctor or dentist will ask about your symptoms and medical history. An examination of your teeth and jaw will be done. With bruxism, teeth will have flattened tips, excessive wear, thin enamel, or sensitivity. X-rays may be done to check for further damage to your teeth or the underlying bone.
  • Treatment

    Methods of treatment include:
    Behavioral or Cognitive Treatment
    This method focuses on changing behavior through various techniques, such as:
    Orthodontic Treatment
    Your dentist may recommend:
    • A protective mouth appliance, such as a night guard. It can absorb the pressure of constant night grinding.
    • Correction of misaligned teeth if your bruxism might be caused by this.
    Medication
    Medication is only recommended for short-term use. Medications may include:
    • Muscle relaxants before sleep
    • Mild sleeping aids
    • Injection of botulinum toxin (Botox) in severe cases if other treatment not working
    Bruxism that is not treated may result in gum damage, tooth loss, and jaw-related disorders.
  • Prevention

    The same methods used to treat bruxism can be used to prevent the condition.
    Avoid caffeine drinks in the evening
    Make sure to see your dentist regularly for check-ups
  • RESOURCES

    Academy of General Dentistry http://www.agd.org

    American Dental Association http://www.ada.org

    CANADIAN RESOURCES

    Canadian Dental Association http://www.cda-adc.ca

    The Canadian Dental Hygienists Association http://www.cdha.ca

    References

    Bruxism. University of Virginia Health System website. Available at: http://uvahealth.com/services/dentistry/conditions-treatments-1/11995/?searchterm=bruxism. Accessed January 22, 2013.

    Chang H. Botulism toxin: use in disorders of the temporomandibular joint. Dent Today. 2005;24:48,50-51.

    Tan EK, Jankovic J. Treating severe bruxism with botulinum toxin. J Am Dent Assoc. 2000;131:211-216.

    Teeth grinding. American Dental Association's Mouth Healthy website. Available at: http://www.mouthhealthy.org/en/az-topics/t/teeth-grinding.aspx. Accessed January 22, 2013. Bruxism/teeth grinding. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/bruxism/DS00337/DSECTION=causes. Accessed August 30, 2013.

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