Teeth grinding, or bruxism is a repetitive clenching or rhythmic forceful grinding of the teeth. When you clench or grind your teeth, you tightly hold top and bottom teeth together, or slide your top and bottom teeth back and forth over each other. Teeth grinding causes tooth damage, pain in the jaw muscles and related problems. Most bruxism patients require mouth guards along with other treatments.
Teeth grinding effects and treatments
- Excessive tooth wear or attrition, particularly on the biting surface, exposes deeper layers of the tooth (dental pulp) and leaves the tooth vulnerable to decay. Another type of tooth wear, abfraction, causes notches to be formed around the neck of the tooth at the gum line.
Treatment: Attrition and abfraction can be resolved by restoring with tooth-coloured filling material – direct composite restorations or glass ionomer cement. A crown can be fitted over the entire tooth, where the erosion has led to a large-scale breakdown of the tooth, reconstructing the lost tooth structure. The decision to restore the dentition depends on the wants and needs of the patient, as well as on the severity of tooth surface loss
- Teeth grinding can fracture a filling. When a piece of a tooth’s chewing surface breaks off, often around a filling, it’s called a fractured cusp. The dentist can place a new filling or crown over the damaged tooth to protect it.
- Teeth grinding can lead to cracked teeth. Cracks can sometimes be repaired with filling material followed by crown placement. In severe cases, if the tooth splits vertically into two separate parts for instance, more radical treatment may be necessary. Some teeth, such as your back teeth, have more than one root. It may be possible to keep one of the roots, which will then be covered with a crown. Generally, when a root cannot be saved, the tooth will have to be removed.
- Trismus or restricted mouth opening can occur if the jaw muscles are seriously affected by bruxism.
Treatment: Along with jaw exercises to gently help improve mouth opening, pain medications such as non-steroidal anti-inflammatory drugs and muscle relaxants are used. Warm compresses may also be helpful. It is important to avoid large movements of the jaw, such as singing and wide yawning.
- Pain, clicking or tenderness of the temporomandibular joint, the joint connecting your lower jaw and skull.
Treatments: Choose soft foods and stay away from foods requiring repetitive chewing or the mouth to open wide. Massage the muscles of the neck, shoulders and face. Consciously relax your face and jaw muscles at intervals throughout the day. Heat and cold packs applied to the side of the face and temple for 10-minute intervals may reduce the intensity of the pain affecting the muscles and surrounding area of the jaw. Also, do not apply pressure with your hand against your jaw for an extended time period during sleep.
Dental treatments may be necessary as tooth decay, a missing tooth or misaligned bite may affect the bite.
Your doctor may prescribe non-steroidal anti-inflammatory drugs such as ibuprofen, muscle relaxants, anti-anxiety medications and in some cases anti-depressants. In extreme cases, muscle relaxants or botulism toxin (Botox) are injected to minimise spasms in overworked jaw muscles. The choice of medication depends on the intensity of the disorder and your medical history.
- Insomnia or not being able to sleep may be treated with medication. Consult your doctor.
- Bruxism can occur in patients with neurogenic abnormalities such as Parkinson’s disease, dystonia and Huntington’s disease. The medications prescribed for these conditions may cause teeth grinding as a side effect.
- Stress, anxiety or anger: If you grind your teeth because of stress, consult a professional counsellor or perform a relaxing routine before bed, such as exercises, meditation, deep breathing, massage, reading, and having a bath or listening to music.
Be aware of when you grind your teeth while awake, and try to break the habit by relaxing your jaw muscles. Practice repeatedly returning your mouth and jaw to a relaxed position.
As you can see, there are many solutions to this painful condition so make sure you ask your dentist for all your options.