Grinding and/or clenching of the teeth while asleep is a habit called bruxism. It can lead to excessive wear of the teeth enamel, causing permanent damage to the teeth. The jaw muscles and jaw joints can also become over- exerted and develop painful symptoms. Bruxism can happen while the person is awake (awake-bruxism) or during sleep (sleep-bruxism). Bruxism can become an issue when it leads to pain and dysfunction in the head and face region. Also, the grinding can lead to premature wear of the teeth and recurring damage of fillings, crowns etc.
What causes teeth grinding (bruxism)?
The causes of bruxism are varied and still being studied. They include physical and psychological factors such as:
- Physical conditions: illnesses associated with thyroid diseases, sleep and digestive disorders, cardiovascular diseases, nutritional deficiencies or dehydration
- Psychological stress- sensitivity to stress and anxiety
- Exogenous causes: nicotine, caffeine, alcohol, drugs and some medications.
What are the signs that indicate you are grinding (bruxing) your teeth?
The signs and symptoms of bruxism are:
- Teeth that ache or are more sensitive to heat and cold
- Chronic facial pain and tension headaches caused by over-exertion of the jaw muscles
- Stiffness in the jaw joint and associated muscles. The jaw joint may become affected and lead to clicking, locking of the jaw and even dislocation.
- Grinding noise that occurs as the teeth are ground together
- Flattened tooth surfaces with loss of the enamel layer which can make the teeth appear yellower
- The edges of the front teeth look chipped and jagged due to microfractures in the enamel
- Broken and chipped fillings
- Teeth that feel loose
Depending on the severity of the grinding, some patients might present with varying degrees of symptoms. A patient with a mild grinding habit may not have pain in the jaw joint but their teeth might show signs of excessive wear.
The damage caused by bruxism can take time to become obvious. However, by the time the changes become noticeable, the damage can already be quite extensive such as very worn down and broken teeth, that then require complex treatment to be fixed.
How can bruxism be treated?
There is currently no established treatment to cease someone’s bruxing habit.
If the bruxing habit is related to other health problems, such as sleep or digestive disturbances, these issues have to be treated first.
Stress- related causes of bruxism can be addressed through counselling, stress management and relaxation methods.
Muscle relaxant medications could also be prescribed to prevent over-activity of the jaw muscles.
Botulinum toxin (botox®) injections in the muscles of the jaw can help reduce overactivity of these muscles and reduce the bruxing habit.
Muscular facial pain, headaches and joint pain caused by the bruxing habit are treated with painkillers. Adjunct treatments such as physiotherapy can also be helpful.
Wearing a mouthguard or splint at night is recommended for bruxism to protect the teeth from wear and damage. The splint does not necessarily stop the wearer from grinding their teeth during sleep but protect teeth and fillings from the damaging effects of bruxism.
Some splints can incorporate pressure sensors that can detect when the wearer is grinding their teeth. The change in pressure during grinding triggers a vibrating mechanism that interrupts the grinding. This is called a biofeedback splint and has been shown to be effective in reducing bruxism and associated pain in the jaw muscles.
What are the long-term effects of bruxism?
The overexertion of the jaw muscles can lead to facial pain, headaches and disorders of the jaw joint.
Disorders of the jaw joint can lead to pain in the joint during jaw movement and even locking of the jaw. This might be accompanied by a clicking noise in the jaw joint.
Teeth can feel painful or more sensitive to cold and hot temperatures after prolonged episodes of bruxism.
Fillings and crowns can also chip or fracture and require regular repairing or replacing.
Teeth can become worn down with thinning of the enamel which then chips easily. Over time, the constant wear can lead to shortening of the teeth and a more aged appearance. Front teeth that have become shorter due to wear and chipping cause the appearance of a toothless smile. To fix front teeth that have been severely worn down due to bruxism, multiple crowns or veneers are usually necessary to restore their original appearance and improve the smile esthetics.
Bruxism can cause cracks to develop in the back teeth. If the crack is extensive and deep, it can cause the tooth to get infected. The tooth can become painful or an abscess might develop. In such cases, the tooth will require root canal treatment, followed by a crown. If the crack extends too far into the tooth, it might not be possible to save the tooth which then needs to be extracted.
How can we help with your bruxism issues?
At the Melbourne Smile Clinic, we are your dentist in Northcote when it comes to pain and dental issues due to bruxism.
A custom- made splint can be prescribed for night-time wear to prevent further damage to teeth.
We will also assess your teeth for existing damage and offer a range of solutions to repair and restore a healthy dentition. Worn down front teeth can be improved with resin buildups or ceramic veneers and crowns. In some cases, a full smile makeover might be necessary if all the front teeth have been damaged over time by the bruxing habit.
For more information, feel free to send us an enquiry or book your appointment for a consultation by calling us on 03 90784471