Bruxism

Definition

Bruxism is the habit of clenching and grinding the teeth. It most often occurs at night during sleep, but it may also occur during the day. It is an unconscious behavior, perhaps performed to release anxiety, aggression, or anger.

Description

Bruxism is one of the oldest disorders known, and approximately one in four adults experiences it. Most people are not aware of it before their teeth have been damaged.


Causes and symptoms

While bruxism is typically associated with stress, it may also be triggered by abnormal occlusion (the way the upper and lower teeth fit together), or crooked or missing teeth.

Symptoms of bruxism include: dull headaches; sore and tired facial muscles; earaches; sensitive teeth; and locking, popping, and clicking of the jaw.

During a dental examination, a dentist may recognize damage resulting from bruxism, including enamel loss from the chewing surfaces of teeth, flattened tooth surfaces, loosened teeth, and fractured teeth and fillings. Left untreated, bruxism may lead to tooth loss and jaw dysfunction.



Diagnosis

Medical and dental histories and examinations are necessary to differentiate bruxism from other conditions thatmay cause similar pain, such as ear infections, dental infections, and temporomandibular joint (TMJ) dysfunction. However, uncommonly worn-down teeth strongly suggest a diagnosis of bruxism.

Treatment

To prevent further damage to the teeth, bruxismis treated by placing a removable, custom-fitted plastic appliance called a night guard between the upper and lower teeth. Although the clenching and grinding behavior may continue, the teeth wear away the plastic instead of each other.

In some cases, abnormal occlusionmay be adjusted and high spots removed so that the teeth fit together in a more comfortable position. Missing teeth may be replaced and crooked teeth may be straightened with orthodontic treatment to eliminate possible underlying causes of bruxism. In cases where jaw muscles are very tight, a dentist may prescribe muscle relaxants.

Alternative treatment

Stress management and behavior modification techniques may be useful to break the habit of clenching and teeth grinding. Tight jaw muscles may be relaxed by applying warm compresses to the sides of the face. Herbal muscle relaxants also can be helpful. Massage therapy and deep tissue realignment, including rolfing, can assist in releasing the clenching pattern. This is a more permanent alternative treatment for bruxism.

Prognosis

Bruxism may cause permanent damage to teeth and chronic jaw pain unless properly diagnosed and promptly treated. The behavior may be eliminated if its underlying causes are found and addressed.

Prevention

Increased awareness in patients prone to anxiety, aggression, or anger may prevent the habit of bruxism from developing.