Night bruxism is so common that many people don’t even realise they’re suffering from it until a partner, or someone else who’s witnessed them sleep, points it out. In fact, it is estimated that up to 10-15% of adults and children respectively, grind their teeth at night on a regular basis. However, not everyone who suffers from bruxism experiences side effects; usually those who present with complaints suffer are dealing with a severe case of teeth grinding.
This is the result of protracted jaw contraction and pressure that’s exerted on the teeth during sleep. Without early intervention, teeth grinding can eventually lead to an array of both short and long-term health consequences. Many symptoms are also not strictly dental, so it’s not uncommon for patients to seek medical attention from their GP to identify other possible medical conditions causing the problem.
In terms of the short-term effects of teeth grinding, patients often complain of frequent headaches or migraines. Studies have shown that people who grind their teeth are three times more likely to experience regular headaches than those who do not. Typically, these will occur first thing in the morning upon waking, and are usually located in the temporal region of the brain.
The medical explanation for these headaches is that they result from the build-up of lactic acid in the jaw muscles due to prolonged jaw contraction. The lactic acid irritates the nerves and triggers pain in the surrounding area. People who have pre-existing migraine problems would, in most cases, find bruxism-induced headaches even more severe.
Some patients also present with morning facial and jaw muscle pain that lingers throughout the day. In some cases, the pain might cause discomfort and difficulty moving the jaw – specifically opening and closing the mouth. Facial pain often occurs simultaneously with the aforementioned headaches.
GPs sometimes misdiagnose the muscle pain as idiopathic facial pain. Muscle fatigue and the build-up of lactic acid is the usual medical explanation for that facial pain, as with the headaches. Over a prolonged period of time, those who grind their teeth might begin noticing structural change in the face, such as a more prominent jawline and an increase in how toned their cheek muscles are. While this may not be a problem for men, some women find it concerning.
Another consequence of frequent teeth grinding is that over time it weakens the tooth enamel, one of the strongest substances in the body. The force exerted when teeth grind together is also capable of cracking the teeth, after which a crown will be required.
Teeth should, in theory, last a lifetime thanks to the protection provided by the enamel. Everyday chewing and eating does not normally wear them out, but night bruxism can significantly lower their durability. This is because the pressure exerted by clenching and grinding may be up to 40 times stronger than the normal chewing action.
Studies show that the brain does nothing to suppress such pressure during sleep. As a result, most night bruxism sufferers end up with both weakened gums and teeth, leading to acceleration in tooth decay.
Sufferers regularly complain of tooth sensitivity, especially when eating or drinking cold substances. Some common signs of severe bruxism include the shortening of incisors, cracking of enamel, enamel loss at gum level, broken cusps of molar teeth, gum recession, bony exostosis, and damage to dental restorations. This damage can be extremely painful, not to mention costly to repair.
Fortunately in most cases, the symptoms of bruxism are reversible. But sometimes, temporomandibular joint (TMJ) problems may lead to permanent damage, which is why early intervention is crucial. Temporomandibular disorder has a spectrum of symptoms, some of which overlap with the symptoms mentioned above.
These include joint clicking, popping noises or pain, limited facial and jaw range of movement, deviation of mouth opening, headache, neck and shoulder stiffness, tinnitus (ear buzzing), hearing loss, pain in the orbital region of the eye, difficulty concentrating, dizziness and a tingling sensation in the arm. It is, therefore, vital that a correct diagnosis is made based not only on symptoms, but also on the history behind those complaints.
Incorrect dental occlusion can lead to inflammation when the position of the teeth is not aligned with that of the jawbone. The jawbone can either be positioned too far forward, backwards or in some cases may deviate laterally. If the jawbone is positioned too far backwards, it can easily become inflamed, particularly in those who suffer from bruxism or who have pre-existing dental problems.
TMJ noises, usually a clicking or popping sound, indicate that the joint movements are not smooth. At first these sounds may be unaccompanied by symptoms, but in the long run, TMJ disc displacement can cause jaw stiffness and lead to the jaw locking in the displaced position. So it’s important to be aware of these early signs and seek for treatment before the damage becomes irreversible.
While healthcare professionals are still finding ways to cure bruxism and attempting to identify the cause of the problem, there are many methods of treatment available now. The most economic approach recommended by dentists is wearing a night guard, which can minimise muscle tension and protect the teeth. There are other methods of managing bruxism including pharmacological treatment, psychological therapy, medical devices or lifestyle changes.
Most importantly, sufferers must pay close attention to the severity of their symptoms. A worsening pattern should sound the alarm for a dental check-up. To conclude, early intervention is key in preventing long-term damage caused by bruxism, which not only affects quality of life, but may also lower the sufferer’s self-esteem.