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- Causes of Bruxism
- Symptoms of Bruxism
- Problems Caused by
Bruxism
- Treatment of Bruxism
If you wake up with dull headaches or vise-like pain, you
may be one of many people who grind their teeth at night. Many people are
unaware they even have the disorder (called bruxism) because it often
occurs at night during sleep. Your dentist can usually detect the telltale signs
of wear on your teeth.
More research is needed to determine the exact cause of bruxism,
but it is thought that both emotional and physical factors are involved. Some of
the contributing factors may be stress or sleep disorders, an abnormal bite or
crooked or missing teeth.
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 | Tooth wear, fractures of the teeth and fillings,
especially on the front teeth |
| Grinding noise noticed by a sleeping partner |
| Facial muscle pain and fatigue |
| Locking, cracking, and clicking of the jaws |
| Headaches |
| Tooth mobility |
| Sensitive teeth |
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Bruxism can either directly or indirectly cause many problems.
Grinding can cause teeth to become painful or loose. Patients can literally
grind away parts of their teeth, leaving them with worn surfaces or fractured
enamel.
- Wearing of teeth.
Wear occurs from the movement of the teeth harshly against one another.
Although all teeth may show this type wear, it is especially noticeable when
a person has front teeth that appear having the same length - as if they
were filed down.
- Breaking of teeth.
As teeth wear, the edges of front teeth and the cusps or corners of back
teeth will begin to show microfractures or cracks. These cracks can not be
seen on x-rays. It takes magnified vision and/or an intraoral magnified
image to diagnose them. Where this becomes especially important, is that
teeth with these type of fractures will either eventually chip, break a
corner, or yet require root canal therapy. The reason for root canal therapy
is that the fracture begins on the surface of the tooth and eventually
deepens until the crack enters the area of the nerve.
- Sensitive teeth.
Usually a generalized soreness and/or a cold sensitivity..
- Receeding gums and/or teeth with gum line “notches”.
Most people have been told or assume that receeding gums occur because of
age, using a hard bristle brush or the occurence of gum (periodontal)
disease. In fact none of these reasons are correct in a majority of the
cases. These are referred to as abrasion areas. When teeth grind hard
against each other year after year, they flex at the gum line and the
enamel (which ends thinly at the gum line) microfractures away. The end
result is an area at the gum line that you can catch your fingernail in
and may get extremely sensitive to touch and/or cold.
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Exposed root surface and advanced abrasion
areas.
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- Loose teeth
Teeth loosen because of the "rocking" back forth that occurs. The
best analogy is the example of getting a fence post out of the ground by
rocking it back and forth.
- Periodontal pockets (loss of supporting bone around the teeth).
Sometimes instead of the tooth getting loose, there may be a generalized
horizontal loss of supporting bone and/or localized areas of bone loss.
- Bony ridges (tori)
Instead of losing bone support - some people actually form
"extra" bone to support the teeth (this appears as bony ridges
that can be seen and felt on the jaw bones as a smooth raised area
about at the level of the roots.
Lower jaw showing extra bone in the
"floor" of the mouth by the tongue.
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Cheeks pulled back and the ridge along
and above the upper back teeth.
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Cheek irritation - A ridge or
line of fibrosed (toughened) tissue on the inside of the cheek that
corresponds to where the teeth come together. Sometimes a person will
actually bite themselves along this line (especially in the most posterior
molar area).
- Sore muscles (especially in the cheek and temple area) When these
two muscles are overused. They may get sore - just like when you over
exercise, your other muscles get sore.
 
10. Headaches (especially upon waking in the same
muscle areas mentioned above).
Instead of soreness, the
muscle aches will appear as a headache.
11. TMJ problems (jaw joint pain / soreness / etc
The jaw joint may be over
loaded and resulting problems occur.
These
signs take time (usually decades of years) to show themselves.
Does everyone show every problem? No they
don't, we are all very different. Some of us will exhibit none of these
problems (thank your genetic code for that), some of us will exhibit severe
problems (curse your genetic code for that). So any combination, or NO
problems may exist for any one person.
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There are a number of ways to treat bruxism. Your dentist will
determine which single treatment or combination of treatments is right for you.
When stress is the major cause of bruxism, people need to find ways to relax.
People who have difficulty handling stress may need to seek counseling or the
dentist may prescribe muscle relaxants to relax jaw muscles. To help alleviate
muscle pain, physical therapy may be needed.
Nightgaurds
It would be logical to think that an acrylic nightguard is simply a piece of
plastic used to cover and prevent the teeth from coming together while sleeping
at night. This is true - BUT - most importantly, when in place it
provides a correct bite so that muscles will relax and problems in a persons
bite will not trigger the bruxing action. Making
and delivering nightguards correctly is very important. A point needs
to be made that tooth wear still slowly occurs when using a nightguard. The
reason for this is that a person (especially severe bruxers) will clench and
very slightly grind during the day time when their guard is not being worn.
A nightguard is NOT a solution, rather a method of greatly
decreasing the damage caused by bruxing. It is possible to alter a bite so
that a guard may not be needed - the method varies from case to case.
- The following tips can be helpful to prevent grinding:
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| To help break the habit, place reminders around the
house, or try repeating phrases that help you relax. |
| To help relax clenching muscles, apply a warm wash
cloth to the side of your face. |
| To relieve stress, cut down on caffeine, take warm
baths and ease up on yourself. |
Because it is thought that an abnormal bite may predispose a
person to grinding, treatment may involve removing the "high spots" of
a tooth. Another treatment involves wearing a plastic mouth guard at night to
prevent tooth grinding. A bite plate is a removable plastic device which
prevents teeth from coming together. In some cases , such as with an
overbite, it may eventually improve the bite. A method used to treat the damage
caused by more serious cases of grinding involves reshaping or reconstruction of
the biting surfaces with crowns or inlays.
Grinding is a common occurrence among many people at some time
or another. If you develop facial pain, fatigue or other problems, treatment may
be needed. Talk with your dentist if you suspect that you are grinding your
teeth. We will help relieve you from the daily grind of bruxism.
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