Definition

Bruxism (BRUK-siz-um) is a condition in which you grind, gnash or clench your teeth. If you have bruxism, you may unconsciously clench your teeth together during the day, or clench or grind them at night (sleep bruxism). Sleep bruxism is considered a sleep-related movement disorder. People who clench or grind their teeth (brux) during sleep are more likely to have other sleep disorders, such as snoring and pauses in breathing (sleep apnea). Mild bruxism may not require treatment. However, in some people, bruxism can be frequent and severe enough to lead to jaw disorders, headaches, damaged teeth and other problems. Because you may have sleep bruxism and be unaware of it until complications develop, it's important to know the signs and symptoms of bruxism and to seek regular dental care.

What is teeth grinding?

Bruxism or Teeth Grinding is a condition in which you grind, gnash or clench your teeth. If you have bruxism, you may unconsciously clench your teeth together during the day, or clench or grind them at night (sleep bruxism).

Different sounds:

1: Very clear long repeating grinding sound.

The jaw muscles are very active and the sound is very clear and present (mixed episodes), toothwear is often very visible in the mouth.

2: Clear short repeating grinding sounds

The jaw muscles are active during a period of your sleep, not contracting all the time but in short episodes (phasic episodes)

Symptoms

Signs and symptoms of bruxism may include:

• Teeth grinding or clenching, which may be loud enough to awaken your sleep partner
• Teeth that are flattened, fractured, chipped or loose
• Worn tooth enamel, exposing deeper layers of your tooth
• Increased tooth sensitivity
• Jaw or face pain or soreness
• Tired or tight jaw muscles
• Pain that feels like an earache, though it's actually not a problem with your ear
• Dull headache originating in the temples
• Damage from chewing on the inside of your cheek
• Indentations on your tongue

When to see a doctor

See your doctor or dentist if:

• Your teeth are worn, damaged or sensitive
• You have pain in your jaw, face or ear
• Others complain that you make a grinding noise while you sleep
• You have a locked jaw that won't open or close completely
• If you notice that your child is grinding his or her teeth — or has other signs or symptoms of bruxism — be sure to mention it at your child's next dental appointment.

Causes

Doctors don't completely understand what causes bruxism. Possible physical or psychological causes may include:

• Emotions, such as anxiety, stress, anger, frustration or tension
• Aggressive, competitive or hyperactive personality type
• Abnormal alignment of upper and lower teeth (malocclusion)
• Other sleep problems, such as sleep apnea
• Response to pain from an earache or teething (in children)
• Stomach acid reflux into the esophagus
• An uncommon side effect of some psychiatric medications, such as phenothiazines or certain antidepressants
• A coping strategy or focusing habit
• Complication resulting from a disorder such as Huntington's disease or Parkinson's disease

Risk factors

These factors increase your risk of bruxism:

• Stress. Increased anxiety or stress can lead to teeth grinding. So can anger and frustration.
• Age. Bruxism is common in young children, but it usually goes away by the teen years.
• Personality type. Having a personality type that is aggressive, competitive or hyperactive can increase your risk of bruxism.
• Stimulating substances. Smoking tobacco, drinking caffeinated beverages or alcohol, or taking illegal drugs such as methamphetamine or Ecstasy may increase the risk of bruxism.

Complications

In most cases, bruxism doesn't cause serious complications. But severe bruxism may lead to:

• Damage to your teeth, restorations, crowns or jaw
• Tension-type headaches
• Facial pain
• Disorders that occur in the temporomandibular joints (TMJs), located just in front of your ears, which may sound like clicking when you open and close your mouth

Tests and diagnosis

During regular dental exams, your dentist likely will check for signs of bruxism. If you have any 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. If your dentist suspects that you have bruxism, he or she will try to determine its cause by asking questions about your general dental health, medications, daily routines and sleep habits. To evaluate the extent of bruxism, your dentist may check for:

• Tenderness in your jaw muscles
• Obvious dental abnormalities, such as broken or missing teeth or poor tooth alignment
• Damage to your teeth, the underlying bone and the inside of your cheeks, usually with the help of X-rays

A dental exam may detect other disorders that can cause similar jaw or ear pain, such as temporomandibular joint (TMJ) disorders, other dental problems or an ear infection. 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. A sleep specialist may conduct more tests, such as assessment for sleep apnea, video monitoring and measuring how often your jaw muscles tighten while you sleep.

Treatments

In many cases, treatment isn't necessary. Many kids outgrow bruxism without treatment, and many adults don't grind or clench their teeth badly enough to require therapy. However, if the problem is severe, treatment options include certain dental approaches, therapies and medications. Talk to your doctor about what may work best for you.

Lifestyle and remedies

These self-care steps may prevent or help treat bruxism:

• Reduce stress. Listening to music, taking a warm bath or exercising can help you relax and may reduce your risk of developing bruxism.
• Avoid stimulating substances in the evening. Don't drink caffeinated coffee or caffeinated tea after dinner, and avoid alcohol and smoking during the evening, as they may worsen bruxism.
• Practice good sleep habits. Getting a good night's sleep, which may include treatment for sleep problems, may help reduce bruxism.
• Talk to your sleep partner. If you have a sleeping partner, ask him or her to be aware of any grinding or clicking sounds that you might make while sleeping so that you can report this to your doctor.
• Schedule regular dental exams. Dental exams are the best way to identify bruxism. Your dentist can spot signs of bruxism in your mouth and jaw with regular visits and exams.