Bruxism is a condition in which you grind, gnash or clench your teeth.
If you have bruxism, you may unconsciously clench your teeth when you’re awake (awake bruxism) or clench or grind them during sleep (sleep bruxism).
Sleep bruxism is considered a sleep-related movement disorder. People who clench or grind their teeth (brux) during sleep are more likely to have other sleep disorders, such as snoring and pauses in breathing (sleep apnoea).
Bruxism has various degrees of severity and may be due to several factors, in order to treat the bruxism successfully it is important to identify the contributing factors first. Bruxism may mildly affect many patients and at times not even require any form of treatment. However, it can be recurrent and severe enough to cause jaw disorders, inflict damage to teeth, induce headaches and cause a variety of other complications. Patients may be victim to sleep bruxism and be unaware of it until complications arise, it is therefore important to be acquainted with the signs and symptoms of bruxism and to seek regular dental care.
Symptoms of bruxism may include:
- Abraded teeth or restorations, teeth that begin to look flattened and shorter over time.
- Exposed dentine which may cause sensitivity.
- Fractured or cracked teeth or restorations.
- The most significant is the gritting, grinding sound that is so loud it can wake the person sleeping next to you.
- Jaw pain, pain in the ear or eye area and/or pain in the muscles of mastication making it difficulty, even painful to open the mouth, especially in the morning.
- To a lesser extent, patients may suffer from a dull morning headache, cheek trauma, inflamed gums and tongue indentations.
Bruxism may have multiple contributing factors. Most common contributing factor is stress and anxiety. Having a personality type that’s aggressive, competitive or hyperactive can increase your risk of bruxism. Bruxism may be an uncommon side effect of some psychiatric medications, such as certain antidepressants. Smoking tobacco, the use recreational drugs, drinking highly caffeinated beverages or alcohol may increase the risk of bruxism. Bruxism may also be associated with certain medical and mental health disorders such as epilepsy, Parkinson’s disease, dementia, gastroesophageal reflux disorder (GERD), night terrors, attention-deficit/hyperactivity disorder (ADHD) and sleep-related disorders such as sleep apnoea.
There has been a strong association with bruxism and psychosocial factors. Hence interventions such as relaxation techniques, stress management, behavioural modification and habit reversal have been adopted as a non-drug treatment for bruxism.
Use of medication provides some relief for bruxism. A combination of anti-inflammatory drugs and a muscle relaxant helps to relieve the pain and tension within the muscles of mastication.
Even though no studies have been proven successful regarding ‘sleep hygiene’ many people have found that by avoiding stimulants such as tea, coffee, cigarettes for several hours before bed and maintaining a regular sleep schedule promotes better sleep. Better sleep means that more time is spent in the deeper sleep stages and less arousal occurs since bruxism mostly happens during lighter sleep stages.
The most common treatment would be the use of the occlusal splints which are typically worn every night during sleep on a long-term basis. These are small plastic mouth guards. They have been proven most successful as it protects teeth from premature wear, reduces muscle strain as well as the noise from grinding of teeth. Treatment goals of wearing splints include preventing damage to the temporomandibular joint by constraining the bruxing patterns, minimizing the gradual changes of teeth position by stabilizing the occlusion of teeth, preventing tooth damage and examining the markings on the splint surface to reveal the extent and pattern of bruxism.
Use of laser pain therapy and BOTOX
In severe cases where no relief is found using escalation therapy with medication and occlusal splints, laser pain therapy and BOTOX is an option for longer lasting pain relief.
Botulinum toxin or Botox is a biological toxin that results in muscle paralysis by inhibition of acetylcholine release at neuromuscular junctions. Botox injections are used in bruxism to paralyze the muscles of mastication and lessen their ability to forcefully clench and grind the jaw, whilst aiming to retain enough muscular function to enable normal activities such as talking and eating.