What Is Bruxism (nocturnal tooth grinding)?

Sleep Bruxism, also known as nocturnal tooth grinding, is a medical condition in which you clench or grind your teeth while sleeping. Teeth clenching is when you hold your top and bottom teeth together tightly, and teeth grinding is when you repeatedly slide your top teeth over your bottom teeth. Unconscious teeth grinding when awake is known as awake bruxism.

Considered a sleep-related movement disorder, sleep bruxism is often associated with other sleep disorders such as sleep apnea (gaps in breathing) and snoring. Sleep bruxism is a common disorder, with one survey estimating that 8% of all adults grind their teeth during sleep, and as many as a third of children grind their teeth. Occasional bruxism may not be detrimental, but regular teeth grinding can result in dental and other oral problems as well as facial pain, jaw disorders, earaches, and headaches.

Symptoms

Because sleep bruxism happens at night, most people are unaware of it until complications develop. Some symptoms of sleep bruxism are:

• Teeth clenching or grinding that wake your sleep partner.
• Flattened, chipped, cracked, or loose teeth.
• Worn tooth enamel.
• Increased tooth sensitivity or dental pain.
• Sore jaw muscles.
• Neck or facial pain or soreness.
• Earache.
• Depression.
• Eating disorders.
• A dull headache originating in the temples.
• Lacerations of the inside of your cheek or tongue (from biting yourself).
• Poor quality of sleep.

If you notice any of these symptoms, see your doctor or dentist.

Risk factors and causes

While researchers don’t fully understand the causes of sleep bruxism, it may be due to a number of factors. They include:

• Stress, anger, and frustration.
• Age – Bruxism often occurs in young children who are teething or getting their adult teeth. This usually goes away after their adult teeth have come in.
• Aggressive or competitive personality type.
• Use of certain medications such as antidepressants and amphetamines.
• Use of certain substances such as tobacco, caffeine, alcohol, and recreational drugs.
• Heredity – Bruxism often runs in families.
• Teeth alignment.
• Posture.
• Diet.
• Sleep apnea and snoring.
• Fatigue.
• Parkinson’s disease, dementia, gastroesophageal reflux disorder, epilepsy, sleep apnea and other disorders.

Awake bruxism may be caused by anxiety or stress, and it may be a coping strategy.

How is sleep bruxism diagnosed?

Because sleep bruxism occurs while we sleep, it is difficult to know if it is a problem. It is usually diagnosed after a sleep partner complains, or if we are experiencing symptoms. Once you see your dentist, she will evaluate your teeth and jaw to look for signs of sleep bruxism (such as loose or cracked teeth) or temporomandibular joint (TMJ) disorder. If one of your symptoms is an earache, you may be referred to an otolaryngologist to rule out an ear infection.

Some things you can do

If you are having dental issues, make sure you see your dentist or doctor right away. For low-grade symptoms, there are some things you can do to alleviate discomfort.

• Apply a cold pack or moist heat to relieve sore jaw muscles.
• Avoid hard foods like nuts and hard candy.
• Avoid chewing gum.
• Stay hydrated.
• Learn some stretching exercises for the jaw to help restore their normal range of movement.
• Massage your neck, shoulders, and face.
• Learn how to relax your facial and jaw muscles. Do this periodically during the day.
• Learn some relaxation techniques. Do these during the day and immediately before bed.

If you find that you are grinding your teeth, you can stop bruxism by:

• Avoiding alcohol and caffeine.
• Avoiding chewing gum.
• Not chewing on pens or pencils.
• If you find yourself clenching your teeth, stop and position the tip of your tongue between your teeth. This helps your jaw muscles relax.
• Relaxing your jaw before you go to bed by using a warm compress on your cheeks.
• Use a bruxism mouthpiece during sleep

Conclusion
While occasional sleep bruxism may not be harmful, chronic sleep bruxism can cause discomfort. Left untreated, this can result in the need for major dental work.  It can also result in TMJ.  If you are experiencing any of the symptoms above (or are becoming more severe), see your doctor or dentist as soon as possible.

Sleep bruxism often occurs with other sleep disorders such as sleep apnea. If your bruxism appears to be related to a major sleep issue, you may be referred to a sleep medicine specialist. Evidence suggests that treating sleep apnea often reduces sleep bruxism. If your sleep bruxism is stress or anxiety related, you may be referred to a therapist.