Bruxism is the medical term for tooth clenching and/or tooth grinding. The most obvious sign of bruxism is when the actual grinding is observed by another person. Someone who grinds their teeth may report bruxism symptoms, such as fatigue or pain in the jaw, a dull headache, or pain or sensitivity in their teeth.
It is worth noting that in medicine, the term “sign” is used to indicate something that can be observed by either the patient or others. A “symptom,” however, is the subjective experience of the patient.1 For example, chipped or damaged teeth are a sign of bruxism, while a patient reporting that their jaw muscles ache is a bruxism symptom.
When bruxism occurs during waking hours, it is known as diurnal bruxism, or awake bruxism.2 This often happens without the person who is grinding their teeth being aware of the fact that they are doing so. Others may observe that they are grinding their teeth, or they may become aware of the fact and stop, only to become absorbed in a task and begin grinding their teeth again.
When a bruxer grinds their teeth during sleeping hours, it is termed nocturnal bruxism, or sleep bruxism,3 and this may be harder to spot. Grinding teeth at night might be noticed if the nocturnal bruxer shares their bed or sleeping quarters with another person. The bruxism may be so severe that it produces enough noise to wake the other person, one of the telltale signs of teeth grinding. However, if the bruxism is not directly witnessed, there are a number of other tells that point towards bruxism.
Masseter hypertrophy, or enlarged jaw muscles from extensive flexing of the jaws, can indicate bruxism. Chipped or excessively worn teeth, and even chewed soft tissues in the mouth, like the cheeks or tongue, are also signs of bruxism.4
While the signs and symptoms of bruxism are problematic on their own, bruxism is often associated with other conditions. Sleep apnea, where you stop breathing temporarily while sleeping, is closely linked to bruxism5. If you are experiencing or reporting bruxism symptoms, this can point to the potentially more severe issues associated with sleep apnea. If you are experiencing bruxism symptoms, it might be a good idea to determine whether you show any signs of sleep apnea.
Due to the damage that teeth grinding can cause to teeth, dental implants, and the soft tissues of the mouth, treatment for bruxism might include protective measures. A hard mouth guard for teeth grinding, also called an occlusal splint6, not only protects teeth from grinding against each other, but actually reduces bruxism.
Vitamin D deficiency has been associated with a higher incidence of bruxism7. However, this does not prove that the deficiency causes tooth grinding. Vitamin D deficiency has also been associated with anxiety and sleep disorders, which are comorbid with bruxism.
Studies have found that bruxism is closely associated with anxiety. In fact, it has been found that people that report bruxism symptoms are over two times as likely to also report having anxiety.8 Self-reported frequent bruxers were found to be two and a half times as likely to report severe stress as mild or non-bruxers. This suggests there is a close linkage between anxiety and bruxism.
Bruxism may be treated in a variety of ways. If the bruxer began grinding their teeth as a side effect of a medication or substance, cessation or avoidance of the chemical may be sufficient to stop bruxism. Sleep hygiene measures such as avoidance of coffee, alcohol, nicotine, and even heavy meals before bed can help. Some prescription medications have been found to relieve bruxism9.
Bruxism is an unconscious activity, like breathing, tapping your leg, or snoring. How many people have you met that deny that they snore, only to start snoring the moment they nod off? Or have you ever been absorbed in a task or activity and had another person ask that you stop tapping your leg? Suddenly you become of aware of the fact that you were doing so the entire time. It is the same with grinding your teeth.
© 2021 American Sleep Association.