Bruxism is a condition characterized by unconscious teeth grinding. This can occur during the day or at night while sleeping. When teeth grinding occurs during the day, it is known as awake or diurnal bruxism. Awake bruxism can be treated with biofeedback therapy, as the person grinding their teeth is fully conscious while bruxing and can actively address the teeth grinding. Grinding teeth at night, or sleep bruxism, presents a number of challenges for treatment.
One of the reasons grinding teeth at night can be hard to treat is because it is hard to catch in the first place. Some people are lucky enough to have their sleep bruxism witnessed by another person, in which case they know to begin treatment for bruxism. The sound of teeth grinding against each other can be enough to wake a sleeping partner.
Some signs of teeth grinding are straightforward and obvious, like damage to the teeth. Teeth grinding damage may be in the form of chipping, increased wear on chewing surfaces, or even looseness. Sometimes the damage can be enough to wear through the tough enamel that protects the softer tissues of individual teeth.
The bruxism symptoms that are less clear are the result of the nightly workout that the jaws are getting while teeth grinding. Pain or soreness in the neck, face, or even ears may be due to sleep bruxism. A dull headache in the temples may actually be because the muscles and tendons of the jaw are tired or damaged, or the temporo-mandibular joint (TMJ) of the jaw is being overworked. Considering all the other sources of headaches, it can be difficult to pin down sleep bruxism as the cause.
When someone is grinding their teeth at night, it is important to try to mitigate the damage. Adult teeth do not grow back, and the enamel coating of the tooth doesn’t regenerate if it is ground away. A dental splint or mouth guard for teeth grinding can protect teeth from being damaged while the sleep bruxism is treated.
One of the biggest teeth grinding causes is stress or anxiety. Relaxation strategies to deal with stress or anxiety can reduce the incidence of grinding teeth at night. Eliminating or reducing sources of stress may also help with both awake or sleep bruxism. If it is difficult or impractical to eliminate sources of stress or anxiety, anti-anxiety medications or antidepressants may help to provide relief.
Another approach is to reduce the tension in the jaw muscles. Muscle relaxant medication will reduce jaw muscle tension, but will also reduce tension in muscles throughout the body. In extreme cases the jaw muscles may be temporarily paralyzed with botulinum toxin in the form of Botox injections. This prevents them from contracting entirely, although the injections can be focused so that only part of the muscle is paralyzed.
One of the most straightforward signs of teeth grinding at night is if it is directly witnessed by a sleep partner or during a sleep study. Bruxism symptoms also include pain in the teeth, jaw, neck, face, or a dull headache. Other signs and symptoms of clenching teeth while asleep include damage to the teeth, insides of cheeks, or even an earache that is not the result of problems with the ear.
Sleep bruxism can be treated with a physical mouth guard or splint, and possibly with relaxation techniques. Awake bruxism can be treated with biofeedback therapy that aims to bring the grinding to the bruxer’s conscious attention. Both awake and sleep bruxism can be treated with muscle relaxants. In extreme cases of bruxism, Botox injections may be used to temporarily paralyze the jaw muscles to prevent them from contracting.
Yes, restless leg syndrome is a common condition that affects roughly 7 to 10 percent of people in the US. With the right type of restless leg syndrome treatment, it is easy to manage and live with this condition.
In cases of sleep bruxism, the sound can actually disrupt your or a partner’s sleep. Both daytime and nighttime bruxism can damage your teeth and jaws. The damage to teeth includes chipping, wearing, cracking or evening loosening of teeth. Enough tooth wear can occur that the underlying bone and nerves of the teeth are exposed. Damage to the jaws from bruxism can manifest as temporo-mandibular joint (TMJ) damage.
© 2021 American Sleep Association.