Teeth Clenching & Bruxism
Bruxism is when you clench (tightly hold your top and bottom teeth together) or grind (slide your teeth back and forth over each other) your teeth.
People can clench and grind without being aware of it during both the day and night, although sleep-related bruxism is often the bigger problem because it is harder to control.
The cause of bruxism is not completely agreed upon, but daily stress is seen as the most common trigger for many. In some cases, people clench their teeth and never feel any symptoms. Whether or not bruxism causes pain and other problems may be a complicated mix of factors:
- How much stress you are under
- How long and tightly you clench and grind
- Whether your teeth are misaligned
- Your posture
- Your ability to relax
- Your diet
- Your sleeping habits
- Each person is different
Clenching the teeth puts pressure on the muscles, tissue, and other structures around your jaw. The symptoms can cause temporomandibular joint problems (TMJ).
Grinding can wear down your teeth. Grinding can be noisy enough at night to bother sleeping partners.
- Anxiety, stress, and tension
- Earache (due in part because the structures of the temporomandibular joint are very close to the ear canal, and because you can feel pain in a different location than its source; this is called referred pain.)
- Eating disorders
- Hot, cold, or sweet sensitivity in the teeth
- Sore or painful jaw
Exams and Tests
An examination can rule out other disorders that may cause similar jaw pain or ear pain, including:
- Dental disorders
- Ear disorders such as ear infections
- Problems with the temporomandibular joint (TMJ)
- You may have a history of significant stress and tension
The goals of treatment are to reduce pain, prevent permanent damage to the teeth, and reduce clenching as much as possible. To help relieve pain, there are many self-care steps you can take at home. For example:
- Apply ice or a wet heat source to jaw muscles. Either can have a beneficial effect
- Avoid eating hard foods like nuts, candy, and steak
- Drink plenty of water every day
- Get plenty of sleep
- Learn physical therapy stretching exercises to help restore a normal balance to the action of the muscles and joints on each side of the head.
- Massage the muscles of the neck, shoulders, and face, Search carefully for small, painful, nodules called trigger points that can cause pain.
- Relax your face and jaw muscles throughout the day. The goal is to make facial relaxation a habit.
- Try to reduce your daily stress and learn relaxation techniques.
To prevent damage to the teeth, night guards or appliances have been used since the 1930’s to treat teeth grinding, clenching, and TMJ disorders. An appliance may help protect the teeth from the pressure of clenching and grinding.
An appliance may help reduce the clenching and grinding symptoms but some people find the symptoms go away as long as they use the splint, but pain returns when they stop or the splint loses effectiveness over time.
As a next phase after splint therapy, adjustment of the bite pattern may help some people. Surgery should be considered as a last resort. Finally, there have been many approaches to try to help people unlearn their clenching behaviours. These are more successful for daytime clenching, since nighttime clenching cannot be consciously stopped.
In some people, just relaxing and modifying daytime behaviour is enough to reduce nighttime bruxism. Methods to directly modify nighttime clenching have not been well studied, They include biofeedback devices, self-hypnosis, and other alternative therapies.
Bruxism or teeth clenching affects sufferers in many ways.
Some of the adverse effects are short-term and disappear when the teeth grinding or teeth clenching ceases. Others sadly, are long-term or even permanent. So it is important you understand now how to stop teeth clenching and stop teeth grinding if you notice any of the following symptoms.
Short-Term Effects of Bruxism (Teeth Clenching or Teeth Grinding at Night)
- Headache- Bruxism sufferers are three times more likely to suffer from headaches.
- Facial myalgia (aching jaw & facial muscles)
- Tightness/Stiffness of the shoulders
- Limitation of the mouth opening
- Sleep disruption
- Sleep disruption of bed partner due to noise
- Excess tooth mobility
- Inflamed & receding gums
Long-Term Effects of Bruxism
Temporomandibular Joint Disorder (sometimes called TMJD or just TMJ) tooth wear and breakage.
All bruxing appliances in essence are designed to prevent inadvertent tooth movement and to reduce the grinding noise and protect the teeth from premature wear without substantial adverse effects. Occlusal appliances may also reduce muscle activity associated with sleep bruxism but it must be acknowledged that these devices are only a control and will not cure the condition.
Bruxism is not a dangerous disorder, However, it can cause permanent damage to teeth and uncomfortable jaw pain, headaches, or ear pain. Possible complications include:
- Eating disorders
- Increased dental or TMJ problems
- Nightly grinding can awaken roommates and sleeping partners.
When to Contact a Medical Professional
There is no recognized specialty in dentistry. See a dentist immediately if you are having trouble eating or opening your mouth. Keep in mind that a wide variety of possible conditions can cause TMJ symptoms, from arthritis to whiplash injuries. Therefore, see your dentist for a full evaluation if self-care measures do not help within several weeks.
Grinding and clenching does not fall clearly into one medical discipline. For a massage-based approach, look for a massage therapist trained in trigger point therapy, neuromuscular therapy, or clinical massage.