Overview of Bruxism Management

Bruxism, a common condition, involves rhythmic tightening of the jaw muscles, often causing teeth grinding and thrusting of the lower jaw. Bruxism can be present during sleep or while awake, and different factors can contribute to each. Sleep bruxism is most common in children, affecting 15% to 40% of children and 8% to 10% of adults. Awake bruxism affects 22.1% to 31% of the population. The cause is likely a brain-controlled event related to sudden awakenings from sleep and the activation of the automatic nervous system.

Doctors usually classify bruxism as primary or secondary, depending on whether it’s associated with other medical conditions. In serious cases, bruxism can cause significant damage to teeth and dental work. This can lead to jaw pain in the morning, headaches near the temples, and limited movement of the jaw joint. Typically, the condition is diagnosed based on symptoms, but patients with bruxism need a thorough check-up to spot any possible sleep disorders or other related risk factors. Healthcare professionals use a multi-step treatment method that focuses on educating the patient, counseling, lifestyle adjustments, and the use of dental devices.

Anatomy and Physiology of Bruxism Management

Bruxism, or teeth grinding, can happen when you’re awake or asleep. At night, it is related to your sleep cycle, with certain brain and heart activities related to alertness playing a part in causing it. These activities usually occur eight to fourteen times per hour while you sleep, and just before they happened, the affected individuals may display increased heart rate, muscle activity in the jaw and throat area, and increased effort in breathing. Awake bruxism, on the other hand, typically happens when you’re stressed and more alert, which can also amplify heart activity. This usually includes repetitive or continuous teeth grinding. It’s not considered a movement disorder in healthy individuals.

There are several things that could potentially cause sleep bruxism. Having sleep apnea or anxiety are common risks. Your genes can play a part too; about half of people with teeth grinding report that someone in their family has it too. Certain sleep disorders — such as restless leg syndrome, periodic limb movement during sleep, sleep-related acid reflux, and certain forms of epilepsy — can increase the likelihood of bruxism. Many with sleep apnea also have bruxism. Some researchers even think that grinding your teeth in your sleep might actually help during times when you experience a sudden increase in alertness related to breathing.

Using certain medications, including amphetamines, antipsychotics, and certain antidepressants, can be linked to sleep bruxism. However, the research is not clear whether these substances make existing bruxism worse or cause it in the first place. Other conditions that can be linked to sleep bruxism include anxiety, Alzheimer’s disease, Huntington’s Disease, brain injury, Down syndrome, cerebral palsy, and ADHD. Bruxism can sometimes be linked to the use of stimulants used to treat ADHD. Drinking too much alcohol, consuming too much caffeine, using tobacco, and experiencing lots of stress can also contribute to bruxism.

The diagnosis of bruxism is mostly done based on your symptoms and a physical examination. Doctors may rely on what you or your sleep partner report about your bruxism habits, but they also need to examine you to get an idea of how severe your teeth grinding is and how often it happens. If you have other sleep disorders, they might also use polysomnography, a type of sleep study. They might also use EMG recordings, which measure muscle activity, to diagnose both awake and sleep bruxism. EMG can also identify brief and rhythmic muscle contractions, which are typically identified when at least 3 contractions lasting a short amount of time occur, with 2 or more intervals of no contractions.

The criteria for diagnosing sleep bruxism, according to the International Classification of Sleep Disorders, includes the following:

  • Repeated jaw muscle activity that causes teeth grinding or clenching during sleep.
  • One or more signs or symptoms like abnormal tooth wear, temporary morning jaw muscle pain or fatigue, or a headache in the temples.

Assessments that give personal information about muscle activity while awake can offer additional evidence of awake bruxism. International experts also suggest bruxism be categorized as possible, probable, and definite. A possible diagnosis relies only on self-reporting, while a probable diagnosis includes self-reporting and physical examination. A definite diagnosis includes self-reporting, physical exam, and sleep study, ideally with audio and video recordings.

Why do People Need Bruxism Management

Bruxism, or teeth grinding, especially when it comes and goes, is pretty common, especially in kids. Often, people don’t notice any issues, and they don’t need treatment. Usually, doctors only treat teeth grinding when it starts to cause problems for the mouth and teeth or when it happens alongside other conditions like sleep disorders or neurological problems.

So, what are some of these dental problems caused by teeth grinding that might need treatment? They could be:

  • Teeth getting worn down, causing a change in their shape or a flat look on the parts of your teeth that you use to chew
  • Teeth becoming overly sensitive
  • Teeth getting cracked or broken
  • Damaged dental restorations, crowns, or partial dentures
  • Dental implants failing
  • Chewing muscles getting larger than normal
  • Pain or stiffness in the jaw muscles
  • Difficulty in opening the mouth fully
  • Pain in the temporomandibular joint (the joint that connects your jaw to your skull)
  • Pain in front of the ears
  • Clicking sound and soreness in the jaw joint

There could also be non-dental problems like headaches due to stiffness and pain in the temporalis muscle (one of the chewing muscles in the head). Unpleasant loud noises made during sleep could also disturb a person’s sleep or the sleep of others. It’s these sorts of issues that might lead to a treatment plan for teeth grinding.

When a Person Should Avoid Bruxism Management

If a person has Obstructive Sleep Apnea, which is a condition that causes interruptions in breathing during sleep, they shouldn’t use a dental device known as an occlusal splint. This kind of device can actually make Obstructive Sleep Apnea worse.

If someone has both Obstructive Sleep Apnea and Sleep Bruxism (a condition where you grind or clench your teeth during sleep), and needs a way to protect their teeth, they should use something called a mandibular advancement device. This is a different kind of dental device.

On the other hand, these oral devices should be avoided by those with epilepsy, which is a nerve cell disorder causing frequent seizures. This is because, during a seizure, the device can become a foreign object in the airway, which could be dangerous. For more information about occlusal splints and mandibular advancement devices, look at the section of the article titled “Technique or Treatment”.

How is Bruxism Management performed

Treating teeth grinding, formally known as bruxism, aims to avoid further damage to your teeth while easing any symptoms you experience. The results of different treatments can vary quite a bit. Some believe that braces might help because of a possible link between bruxism and uneven teeth, but this isn’t a widely held belief and it’s not really backed up by scientific evidence.

Treating bruxism that occurs during sleep can involve a variety of different methods. These include providing advice and guidance, as well as treatments ranging from medication to devices that one wears in the mouth. It’s crucial to also manage any existing risk factors, particularly, obstructive sleep apnea, which can worsen the teeth grinding problem. Anyone suspected to have sleep apnea should undergo a formal sleep assessment and receive treatment if required. Treating sleep apnea alone may decrease the frequency of sleep bruxism incidents.

Counseling

Specialists often suggest counseling about good sleep habits, making lifestyle changes, and learning relaxation techniques as an initial step to control sleep bruxism. Promoting good sleep hygiene is usually safe. Some of the ways to maintain good sleep include avoiding alcohol, caffeine, and tobacco before bedtime. Lifestyle changes may also be advisable for obesity associated with sleep apnea.

Behavioral Interventions

Biofeedback is essentially a technique that involves positive feedback helping patients learn how to reduce tension. Other behavioral interventions and acupuncture may offer temporary relief from the discomfort and pain linked to bruxism.

Oral Devices

Bite guards covering upper or lower teeth, preferably made from hard acrylic resin, can be prepared by a dental clinician for protecting the teeth. Currently, we know that while these devices don’t decrease grinding frequency, they do manage tooth wear effectively and seem to decrease the discomfort felt in the jaw on waking. Some devices are made in the dental office or a lab and can be hard or soft. Hard ones are usually more effective as soft ones can actually increase clenching in some people.

Patients with sleep apnea as well as bruxism should use a mandibular advancement device, which can help reduce the motor activity related to teeth grinding by increasing the upper airway’s size.

Medications

In some severe cases, with limited response to other treatments, medications like clonazepam or clonidine may present beneficial effects, yet the supporting evidence is limited. Similarly, hormone therapies may offer some relief for women undergoing menopause, likely because of a decrease in the frequency of arousals related to hot flashes.

Other Potential Therapies

Injections of botulinum toxin A in certain muscles of the jaw have been shown to potentially improve severe bruxism. These injections decrease the strength of the muscles involved in grinding, but do not decrease the number of sleep bruxism incidents. There is also an electrical stimulation treatment, but more studies are needed to understand its long-term effects.

If awake bruxism is a problem, treating it may involve techniques such as habit alteration or behavioral therapy. This treatment could also involve the use of oral devices after ruling out any physical causes like certain medications or illnesses. It’s also recommended that patients with awake bruxism avoid nighttime consumption of caffeine, tobacco, and alcohol.

Possible Complications of Bruxism Management

Treating bruxism, or teeth grinding, can sometimes lead to what we call complications. These issues might look like teeth not aligning perfectly—something called malocclusion—or more cavities because it’s harder to clean your teeth properly. It can also cause problems in the jaw joint, known as temporomandibular disorders, or stains on the teeth.

Some of the devices used to treat this condition, called occlusal devices, only cover the front teeth. This can be a problem for children whose back teeth are still growing in. If a child with one of these devices starts growing new back teeth, it can result in a gap between their top and bottom front teeth when they bite down, even though the back teeth are touching. We call this an ‘anterior open bite’. If this happens, often the child will need extra orthodontic treatment. So it’s important that the devices and treatments are designed and used properly.

What Else Should I Know About Bruxism Management?

Sometimes, when the forces exerted during biting and chewing exceed what our bodies can handle, problems can arise with our teeth and mouths. These can include tooth wear, sensitivity, loose teeth, pain in the jaw or jaw muscles, headaches, gums pulling back from the teeth, and disrupted sleep. It can also make it difficult to create and place dental prosthetics.

Grinding our teeth during sleep, a condition known as bruxism, can also present challenges when creating and placing dental prosthetics. People who grind their teeth can experience migraines, neck pain, poor sleep, and feelings of depression.

Bruxism during sleep is quite common, affecting around 37% of preschool-aged children and over 40% of first graders. Research suggests that sleep bruxism in children is linked to increased health problems and behaviors such as anxiety, depression, withdrawal, and physical complaints. As these health problems increase, performance in mental and cognitive tasks decreases, suggesting that sleep bruxism may be a sign of current or potential health issues. This emphasizes the importance of early intervention when signs of sleep bruxism appear in children.

Frequently asked questions

1. What are the potential causes of my bruxism? 2. How severe is my bruxism and what are the potential risks or complications associated with it? 3. What treatment options are available for managing my bruxism? 4. Are there any lifestyle changes or habits that I should adopt to help alleviate my bruxism symptoms? 5. Are there any medications or oral devices that can be used to treat my bruxism?

Bruxism management can help alleviate the symptoms and potential complications of teeth grinding. It can help reduce tooth wear, jaw muscle pain, and headaches. By addressing the underlying causes, such as stress or sleep disorders, and using techniques like stress management, relaxation exercises, and dental appliances, bruxism management can improve your overall oral health and quality of life.

You would need Bruxism Management if you have Sleep Bruxism, which is a condition where you grind or clench your teeth during sleep. Bruxism Management helps protect your teeth and prevent any damage caused by teeth grinding or clenching.

You should not get Bruxism Management if you have Obstructive Sleep Apnea, as it can make the condition worse. Additionally, if you have epilepsy, you should avoid oral devices as they can become a foreign object in the airway during a seizure, which can be dangerous.

The text does not provide specific information about the recovery time for Bruxism Management.

To prepare for Bruxism Management, the patient should first seek a thorough check-up to identify any possible sleep disorders or related risk factors. They should also be prepared for a multi-step treatment method that includes education, counseling, lifestyle adjustments, and the use of dental devices. Additionally, the patient should be aware of the potential complications of bruxism, such as tooth damage and jaw pain, and be ready to discuss their symptoms and concerns with healthcare professionals.

The complications of Bruxism Management include malocclusion (teeth not aligning properly), increased risk of cavities, temporomandibular disorders (problems in the jaw joint), and stains on the teeth. Additionally, the use of occlusal devices, which are used to treat bruxism, can lead to an anterior open bite in children if the devices only cover the front teeth and the back teeth are still growing in. This may require additional orthodontic treatment.

Symptoms that require Bruxism Management include teeth getting worn down, teeth becoming overly sensitive, teeth getting cracked or broken, damaged dental restorations, crowns, or partial dentures, dental implants failing, chewing muscles getting larger than normal, pain or stiffness in the jaw muscles, difficulty in opening the mouth fully, pain in the temporomandibular joint, pain in front of the ears, clicking sound and soreness in the jaw joint, headaches due to stiffness and pain in the temporalis muscle, and unpleasant loud noises made during sleep.

There is no specific information provided in the given text about the safety of Bruxism Management in pregnancy. Therefore, it is recommended to consult with a healthcare professional or dentist for personalized advice and guidance regarding Bruxism Management during pregnancy.

Join our newsletter

Stay up to date with the latest news and promotions!

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

We care about your data in our privacy policy.