Clenching or teeth grinding is a condition characterised by involuntary grinding or clenching during sleep. Clenching or teeth grinding leads to tooth damage, jaw pain, and headaches. The condition is multifactorial and influenced by physical, psychological, and genetic factors, and it requires a comprehensive approach to diagnosis and treatment.
The symptoms of bruxism include jaw or face soreness in the morning, pain when chewing, opening the mouth, or talking, and dull headaches around the temples. Additional symptoms include ringing in the ears, earaches, and teeth that become flatter, shorter, or chipped due to prolonged grinding. Grinding sounds are audible to a sleep partner.
Treatments for bruxism aim to reduce symptoms, prevent tooth damage, and address the underlying causes. Common treatments include custom mouthguards provided by dentists to protect the teeth and reduce muscle strain, stress reduction techniques such as meditation and exercise, lifestyle changes like reducing caffeine and alcohol intake, and medications such as muscle relaxers. Botulinum toxin injections relax the jaw muscles in severe cases.
The causes of bruxism are varied and involve a combination of physical, psychological, and genetic factors. Sleep-related bruxism is linked to sleep disorders, misaligned bites, jaw positions, and psychological stress. Other contributing factors include age, family history, personality type, and the use of certain substances like caffeine, nicotine, and alcohol. Bruxism is linked to other health conditions such as ADHD, Parkinson's disease, epilepsy, dementia, gastroesophageal reflux disorder (GERD), and sleep apnea.
Several conditions are similar to bruxism in that they involve repetitive unconscious behaviours that result in physical damage. It includes trichotillomania (compulsive hair pulling), alopecia areata (stress-induced hair loss), hair twirling or pulling, traction alopecia (hair loss due to tension from hairstyles), and trichoteiromania (compulsive scalp rubbing or scratching). These conditions highlight the complex relationship between psychological stress and physical manifestations.
Research on bruxism covers various aspects, including its aetiology, assessment, and treatment approaches. Significant studies include “Bruxism: a summary of current knowledge on aetiology, assessment” investigating the correlation between sleep bruxism and apnea, “Dental practitioner approaches to bruxism: Preliminary findings from the national dental practice-based research network” focusing on how dentists assess and treat bruxism, “Publication Performance and Trends in Bruxism Research: A Bibliometric Analysis” evaluating research trends, and “On Defining Bruxism” aiming to establish a clear definition for accurate diagnosis and clinical research. Researchers involved in these tests are experts in dental practice and orofacial research.
What are the Types of Clenching or Grinding Your Teeth?
The types of clenching or grinding your teeth are listed below.
- Awake Bruxism (Diurnal Bruxism): The condition happens in the waking hours and is associated with stress, anxiety, or concentration. Individuals are aware they are clenching their teeth.
- Sleep Bruxism (Nocturnal Bruxism): Occurs during sleep and is more harmful due to stronger grinding forces. A bed partner or dentist identifies it.
- Primary Bruxism: Bruxism occurs independently, without being associated with other medical conditions or medications.
- Secondary Bruxism: Bruxism is related to other conditions, such as psychiatric disorders and sleep disorders, like sleep apnea, or as a side effect of certain medications, like antidepressants.
- Teeth Grinding: The act of moving the jaw in a way that grinds the teeth against each other, causing noticeable noise and significant wear on the teeth.
- Teeth Clenching: The act of tightly clamping the teeth together without lateral movement, causing muscle fatigue, jaw pain, and potential damage to the teeth and temporomandibular joints (TMJs).
What are the Symptoms of Clenching or Grinding Your Teeth?
The symptoms of clenching or grinding your teeth are listed below.
- Jaw or Face Soreness or Pain: Pain or soreness in the jaw or facial muscles is most noticeable upon waking in the morning.
- Pain When Chewing, Opening the Mouth, or Talking: Discomfort or pain experienced during tasks such as chewing, opening the mouth, or talking.
- Dull Headaches: Frequent headaches around the temples, feel dull and persistent.
- Ringing in the Ears and Earaches: Sensations of ear ringing (tinnitus) or experiencing ear pain without an apparent infection.
- Teeth Damage: Observable physical changes in the teeth, such as becoming flatter, shorter, or chipped due to continuous grinding.
- Grinding Sounds: Audible grinding noises that a bed partner hears while they are sleeping.
What are the Causes Clenching or Grinding Your Teeth?
The causes of clenching or grinding your teeth are listed below.
- Combination of Factors: There is no single known cause of tooth grinding. Physical, psychological, and hereditary components all play a role.
- Sleep-Related Bruxism: Bruxism is caused by sleep disorders, sleep-related chewing motions, misaligned bites, certain jaw positions, changes from dental work or injury, or psychological stress.
- Predisposing Factors: Certain factors make individuals more prone to bruxism, such as age (common in children), family history, personality type (high-strung, hyperactive, aggressive), and use of certain medications, nicotine, alcohol, or caffeine.
- Secondary to Other Conditions: Bruxism occurs secondary to other physical or mental health conditions, such as attention-deficit/hyperactivity disorder (ADHD), Parkinson's disease, epilepsy, dementia, gastroesophageal reflux disorder (GERD), and sleep problems like sleep apnea.
What are the Treatments for Clenching or Grinding Your Teeth?
The treatments for clenching or grinding your teeth are listed below.
- Mouth Guards: A dentist makes a custom mouth guard to protect teeth and position the jaw in a more favourable position to reduce TMJ muscle strain. The appliance is worn when one is most likely to grind teeth.
- Stress Reduction Techniques: Managing stress through meditation, exercise, and cognitive behavioural therapy reduces bruxism symptoms.
- Lifestyle Changes: Reducing or eliminating caffeine and alcohol intake and quitting smoking help decrease teeth grinding and improve sleep quality.
- Medications: Taking a muscle relaxer before bedtime reduces or prevents teeth grinding, though the approach is recommended temporarily.
- Botulinum Toxin Injections: Healthcare providers recommend Botox® injections to temporarily relax jaw muscles and reduce pain. Repeat treatments are needed every three to four months.
Can Clenching or Grinding Your Teeth Be Treated At Home?
Yes, bruxism can be treated at home with various lifestyle and self-care steps, although severe cases require professional treatment. Engaging in relaxing activities such as listening to music, taking a warm bath, or exercising helps reduce the risk of developing bruxism. Avoiding stimulating substances in the evening helps, as these exacerbate the condition. Practising good sleep habits, including maintaining a regular sleep schedule and addressing any sleep problems, is crucial. Having a sleep partner monitor for grinding or clicking sounds during sleep provides valuable information for the dentist or doctor.
Regular dental check-ups are essential for identifying signs of bruxism early. Dentists detect evidence of grinding and clenching during routine exams, enabling early intervention. Mild cases of bruxism are helped by these home remedies, but severe or long-lasting cases need to be treated by a professional. These include custom mouthguards, medications, or botulinum toxin injections. Combining home care with professional guidance offers the best approach to managing and treating bruxism effectively.
What are the Researches about Clenching or Grinding Your Teeth?
The research about clenching or grinding your teeth (bruxism) has explored various aspects of the condition, including its aetiology, assessment, and treatment approaches. The studies involve researchers, dental practitioners, and orofacial specialists who contribute valuable knowledge to understanding and managing bruxism. The research highlights the multifactorial nature of bruxism, involving physiological and psychological factors, and underscores the importance of comprehensive approaches to diagnosis and treatment. Experts work together and do more research to develop better ways to deal with the problems that bruxism causes, ultimately leading to better patient care and quality of life.
Research on bruxism has explored various aspects of the condition, including its aetiology, assessment, and treatment approaches. “Bruxism: a summary of current knowledge on aetiology assessment” investigated the correlation between sleep bruxism (SB)-related masseter muscle activity (MMA) and apnea, aiming to understand the relationship between muscle activity during bruxism and sleep disturbances. “Dental practitioner approaches to bruxism: Preliminary findings from the national dental practice-based research network” focused on the approaches dental practitioners take to assess and treat bruxism in their practices, providing insights into current clinical practices and their effectiveness. Additionally, a bibliometric analysis titled “Publication Performance and Trends in Bruxism Research: A Bibliometric Analysis” evaluated the trends and performance in bruxism research, highlighting the evolution of scientific literature in the field. A study named “On Defining Bruxism” aimed to define bruxism for accurate diagnosis and reliable clinical research, which is crucial for standardising treatment protocols and improving patient outcomes.
What are the Differences between Grinding Teeth and Cracked Tooth?
The difference between grinding teeth (bruxism) and cracked tooth syndrome (CTS) is that they are distinct dental problems with different causes and treatments but are sometimes interconnected. Bruxism involves involuntary clenching or grinding of the teeth during sleep and is caused by factors such as stress, anxiety, sleep disorders, malocclusion, and certain medications. CTS is characterised by a physical crack in the tooth resulting from trauma, biting on hard objects, large dental fillings, sudden temperature changes, or bruxism. The mechanisms differ, with bruxism involving muscle contractions and CTS involving structural damage to the tooth.
The treatments for these conditions reflect their distinct causes. Bruxism is managed with mouthguards or splints to protect the teeth, stress management techniques, medications like muscle relaxants, dental corrections for misaligned teeth, and behavioural therapy to change grinding habits. CTS treatments focus on repairing the tooth structure and include bonding, crowns, root canal therapy, or extraction in severe cases. Regular monitoring by a dentist is crucial for the two conditions to prevent further damage and manage symptoms effectively.
Bruxism and cracked tooth syndrome share several similarities. Bruxism and CTS cause significant pain and discomfort when chewing or biting and increase sensitivity to temperature changes. Jaw pain is a common symptom of grinding and cracked teeth due to the strain on the jaw muscles and joints. Preventive measures such as regular dental check-ups, using mouthguards, and avoiding hard foods help manage and prevent the progression of bruxism and CTS. Understanding these similarities and differences is essential for effective diagnosis and treatment.
Dentist Dr. Dt. Erdem CETIN
He started his professional career in a private practice in Antalya in 2005 and served there until 2012. Between 2012 and 2016, he continued his work as a partner at the institution named KlinikAntalya. In 2016, he founded Myra Dental Centre Turkey and continues his professional activities there. Additionally, he has strengthened his expertise in the field with his membership in the International Congress of Oral Implantology (ICOI).
