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Grinding Teeth

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Bruxism is clenching or grinding your teeth. Most people are not even aware that they are doing this.

Some people grind their teeth only during sleep. This is called "nocturnal bruxism" or "sleep-related bruxism." Others grind or clench their teeth during the daytime as well. This is thought to be related to stress or anxiety. Stress can occur for many reasons, including sad and painful events such as the death of a loved one or the loss of a job. It can also occur from joyous events such as a new job or the birth of a baby.

Bruxism can have a variety of causes. Some experts view bruxism as nothing more than a habit. It also can be a result of the body's reaction when the teeth do not line up or come together properly. Bruxism also can be a symptom of certain rare diseases of the nerves and muscles in the face. In rare cases, bruxism may be a side effect of some medicines that treat depression. These include Prozac (fluoxetine), Zoloft (sertraline) and Paxil (paroxetine).

People with severe bruxism can break dental fillings or damage their teeth. Rubbing the teeth together can cause the outer layers of enamel to wear away, exposing dentin. This can result in tooth sensitivity. Severe bruxism also has been blamed for:

Symptoms

You may be a bruxer if you experience any of the following:

Diagnosis

If you experience any of these signs and symptoms, see your dentist. He or she can determine if you are a bruxer and how best to treat it.

Your dentist will ask about your general dental health, what sources of stress you have in your life, and what medicines you take. If you share your bedroom, the dentist also may want to talk to that person. The dentist will ask about your sleep habits, especially about any unusual grinding sounds heard during the night.

Your dentist will examine you, paying special attention to the muscles in and around your jaw. The dentist also will look at your teeth for evidence of grinding. During this examination, your dentist will check for tenderness in your jaw muscles and the jaw joint. He or she also will look for broken teeth, missing teeth and poor tooth alignment.

A more detailed exam may follow if your dentist suspects that your bruxism is related to dental problems. In addition to checking your "bite," (how your upper and lower teeth come together) the dentist will examine your teeth and gums for damage caused by bruxism. Your dentist might also take X-rays of your teeth and jaws.

About 30% of children grind or clench their teeth. The rate is highest in children under age 5. If your child grinds or clenches his or her teeth, discuss the problem with your family dentist. Most children eventually outgrow bruxism and suffer no permanent damage to their teeth.

Expected Duration

Of all children who brux between the ages of 3 and 10, more than half will stop on their own by age 13.

In teenagers and adults, how long bruxism lasts depends on its cause. For example, bruxism can last for many years if it is related to stress that doesn't go away. However, if bruxism is being caused by a dental problem, it should stop when the teeth are repaired and realigned. Often this occurs within a few dental visits.

Prevention

If your bruxism is related to stress, professional counselling may help. You also can try strategies to help you relax. It may help to cut down on stimulants such as tobacco and caffeine.

In both children and adults, tooth damage related to bruxism can be prevented. The usual method is to wear a night bite plate or a bite splint (a dental appliance worn at night to stop teeth grinding). Wearing a bite splint also can help relieve pressure on facial muscles and the jaw joint. Hot compresses on facial muscles may help relieve some of the muscle pain and tightness that bruxism can cause.

Treatment

The treatment of bruxism varies depending on its cause:

When to Call a Professional

Call your physician or dentist if you have symptoms of bruxism, or if you are told that you grind your teeth while you sleep.

See your dentist right away if you break a tooth, lose a filling, or notice that your teeth are becoming loose.

Prognosis

Even without special treatment, more than half of young children with bruxism stop grinding their teeth by age 13.

Meanwhile, your dentist can fit your child with a night bite plate to prevent excessive tooth wear. This device is effective in almost all children who use it as directed.

In teenagers and adults, the outlook is excellent if bruxism is treated properly and in a timely manner.

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