Bruxism: Causes, symptoms and treatment

Bruxism, or tooth grinding, is a very common problem that many people suffer from daily.

The UK Bruxism Association suggests that teeth grinding effects as much as 8-10% of the population, mostly in the 25–44-year age bracket. However, it can affect children too.

Whilst many associate bruxism with grinding teeth at night, it can occur during the day too.  Daytime bruxism is associated with stress and night-time bruxism with disorders that disrupt the normal sleeping pattern.

Bruxism is a complex condition and is yet to be fully understood.  However, it is believed that a combination of physical, psychological and genetic factors have a role to play.

The main causes of bruxism are:

• Stress and anxiety: Emotional and physical stress can cause bruxism and is a contributing factor in around 70% of cases, in particular job-related stress.  Anger and frustration also increase the risk of daytime tooth grinding.
• Lifestyle: The use of psychoactive substances such as tobacco, caffeine, recreational drugs and alcohol are associated with an increased chance of bruxism.

• Medication:  Some medication used to reduce stress and anxiety, such as SSRI (selective serotonin reuptake inhibitor) anti-depressants like fluoxetine, paroxetine, and sertraline, can cause an increased incidence of bruxism.

• Disorders: Bruxism can also be associated with some mental health and medical disorders, like gastroesophageal reflux disorder (GERD), epilepsy, night terrors, Parkinson’s disease, dementia, epilepsy, and sleep-related disorders such as sleep apnoea, and attention-deficit/hyperactivity disorder (ADHD).
• Age: Tooth grinding is particularly common in children.  This may be due to the discomfort of erupting permanent teeth, but the reasons are not fully understood. Most children will grow out of this habit.

• Occlusal interference:  Teeth or fillings that sit higher than the rest of the dentition can cause tooth grinding as you subconsciously try to “wear” it down for increased comfort.  If occlusal interference is the cause, once the offending filling has been dealt with the grinding will stop.

Why are we so interested in bruxism?  Well, those who suffer from it or have suffered in the past, can tell you the problems that it can cause.  The list below is by no means exhaustive, but gives an idea of some of the issues associated with bruxism:

• Facial pain
• Headaches
• Earache
• Pain and stiffness in the jaw joint (temporomandibular joint) and surrounding muscles which can lead to temporomandibular disorder (TMD)
• Disrupted sleep
• Worn-down teeth (which can lead to increased sensitivity and even tooth loss)
• Broken teeth, fillings or orthodontic brackets

So, what treatments are available for people who grind their teeth?

1) Mouth guards, like those made to protect teeth when playing vigorous sports, help to even out the pressure across your jaw, reduce pain and create a barrier between your upper and lower teeth.  This helps to reduce the physical damage to teeth and fillings and reduce grinding noises.  A custom-made mouthguard is the best option and can be made for you by your orthodontist or dentist.

2) A mouth splint serves the same purpose as a mouth guard but is made from harder plastic and fits precisely over your upper or lower teeth.  As the material is stronger it lasts longer, which is useful for those with a long-term tooth grinding habit.

3) Stress management techniques such as yoga, deep breathing and massage are helpful in combatting stress, which is one of the main contributing factors in bruxism.  You may also benefit from cognitive behavioural therapy (CBT), your GP will be able to guide you.

4) Your doctor may prescribe non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to help relieve pain or swelling around your jaw caused by grinding.  They may also suggest a muscle-relaxant before bed to help relieve your symptoms.

5) Your medication may need to be reviewed if these are exacerbating the bruxism.  Your doctor will be able to advise you whether suitable alternatives are available, never stop taking medication prescribed for you without consulting your doctor.

6) Lifestyle changes such as reducing your alcohol and caffeine intake as well as avoiding recreational drugs, such as ecstasy and cocaine, will help with reducing tooth grinding.

7) A dental check-up will help identify and resolve problems that have occurred because of grinding, such as broken teeth or sensitivity. Your dentist will also be able to suggests how to reduce further damage to the teeth in the future.

If you are a tooth-grinder and need some advice, get in touch on 01923 836334 or info@orthodontics-london.co.uk.