February 3, 2010

Bruxism – Teeth Grinding and Clenching

Most people grind, clench, or gnash their teeth at some point in their lives. While well within the range of normal, in some cases these may be signs of a concern known as bruxism.

While we do not fully know the causes of bruxism, it rarely leads to serious problems. Bruxism may take place while asleep or awake. It is often so mild that treatment is not called for.

In more severe forms, though, bruxism may lead to problems that are more serious. These include tension headaches, facial pain or distortion, problems with the jaw or temporomandibular joints (TMJs), hearing loss, loss of teeth, and injury to dental restorations.

Bruxism Causes

When bruxism occurs during sleep, it may be due to lost or crooked teeth or an abnormal bite. Young children often experience bruxism. This may be due to teething pain or earaches. In most cases, it goes away as the teen years draw near. There are some things, though, that may raise your level of risk.

Stress, anger, and frustration may lead one to clench the jaw or grind the teeth. The same is true of hyperactive or aggressive tendencies. The use of stimulants, such as nicotine, alcohol, or caffeine, may raise one’s risk as well.

Bruxism is not just linked to youth, stress, or over stimulation, though. It can be linked to abnormal tooth alignment. It has also been linked with disorders such as Parkinson’s or Huntington’s disease. Less often, it has been linked as a side effect to meds.

Bruxism Symptoms

Some symptoms of bruxism include:

  • Chipped, flattened, loose or fractured teeth, damaged tooth enamel or recessed gums
  • Damage inside the cheek or on the tongue
  • Pain of the face or neck, such as headaches or migraines, sensitive teeth, earaches (or ringing in the ears), and sore, tired, tight, or painful jaw muscles
  • Stress, anxiety, tension, depression, insomnia or eating disorders

Most people who have bruxism do not know it. This is because the symptoms often occur while asleep. Bruxism can be loud enough to wake others, though, so it is often a parent or sleep partner who first notices it.


Dentists check for signs of bruxism during dental exams. If they note any concerns, such as wear and tear, they will monitor the need for treatment.

To help find out the cause of the grinding and clenching, a dentist may ask about general health and sleep habits as well as any meds being taken. In some cases, dentists refer people with bruxism to specialists to help find out and address any hidden causes.

Bruxism Treatment

If bruxism is caught early, it can be reduced or stopped by finding and treating the related factors. If it becomes habitual, behavior modification may be called for.

In the worst cases, chronic bruxism can leave people with only stumps where full, healthy teeth had been. If allowed to reach an advanced stage, dental restorations or reconstructive treatments may be called for. Examples include root canals, implants, bridges, crowns and partial or complete dentures. Note, though, that these steps may not deal with the real cause.

In the worst cases, the options for treatment also include therapies and meds. To help stop any more harm to the teeth or to restorations, a dentist may prescribe the use of a mouth guard or splint, a type of protective device.

Biofeedback can help those with bruxism learn to control clenching and grinding. Because stress is often found to be a factor, learning to relax can help address the symptoms and reduce the risks.