Bruxing/Clenching

BRUXING / CLENCHING

Bruxing is a term used to describe the action of clenching or grinding your teeth. Bruxism can occur during sleep (sleep bruxism) or during the day (awake bruxism).Sleep bruxism usually occurs during REM sleep and periods of light sleep.

Bruxing or grinding occurs when the lower jaw contracts and moves side to side. This action leaves distinct wear patterns on the teeth that can usually be observed in a clinical exam. Clenching on the other hand, occurs when the jaw braces against the opposing teeth with no side to side movement. Clenchers are more likely to report aching discomfort in their jaws with little wear noted on clinical exams.

Grinding is more likely related to a central nervous system disturbances in neurotransmitters production and transmission and is thought to be tied to sleep disturbances. The individual grinding may be unaware of the condition and bed partners or parents are usually the first ones to hear the sound. Evening grinders usually wake in the morning with sore jaws that usually dissipates as the day progresses.

Clenching is usually seen during the day (awake bruxing). It is commonly associated with stress. The person is likely to be symptom free during the morning but begins to feel worse as the day progresses. Clenching is thought to be semi-voluntary and is often associated with nail biting, cheek biting and tongue thrusting.

Some medications, such as muscle relaxants, may also prove beneficial for treating the habit of bruxing. If bruxing is a result of any medicines, then these may need to be changed.

Psychotherapy and meditation to reduce stress can be helpful. There are some studies that find reduction in the consumption of caffeine and alcohol can help reduce bruxing.

Symptoms of Bruxing:

Teeth grinding or clenching, which may be loud enough to wake up your sleep partner
Teeth that are flattened, fractured, chipped or loose
Increased tooth pain or sensitivity
Worn tooth enamel, exposing deeper layers of your tooth
Fatigued or tight jaw muscles, or a locked jaw that won't open or close completely
Cervical pain or soreness
Pain that feels like an earache, though it's actually not a problem with your ear
Dull headache radiating from the temples
Damage from chewing on the inside of your cheek
Sleep fragmentation

Causes

Researchers aren’t completely sure what causes bruxism, but it could be due to a combination of physical, psychological and genetic factors.

Awake bruxism may be due to emotions such as anxiety, stress, anger, frustration or tension. Or it may be a coping strategy or a habit during deep concentration.

Sleep bruxism may be a sleep-related chewing activity associated with arousals during sleep.

Risk factors

Stress
Age
Personality type
Medications and other substances.
Genetics

Bruxism can be associated with some mental health and medical disorders, such as Parkinson's disease, dementia, gastroesophageal reflux disorder (GERD), epilepsy, night terrors, sleep-related disorders such as sleep apnea, and attention-deficit/hyperactivity disorder (ADHD).

Complications

Bruxism usually doesn't cause serious complications ,but severe bruxism may lead to:

Damage to your teeth, restorations, crowns or jaw
Tension-type headaches
Severe facial or jaw pain
TMJ disorders

Treatment

Treatment focuses on minimizing the impact on the teeth as well as repairing any damage that may have occurred. Oral appliances like splints and dental orthotics can minimize the potential damage to the teeth. These bruxing appliances can protect the teeth but don’t eliminate the bruxing.

Timothy C. Adams, DDS, D.ACSDD has extensive training in bite management, TMJ, Occlusion, Sleep, and Neuromuscular dentistry which will provide a comprehensive evaluation and treatment to this condition. His expertise and technologies used provides patients with optimal results. Schedule an appointment to discuss treatment options.