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Definition

Bruxism is chronic, involuntary grinding or clenching of teeth. It usually occurs during sleep, but it may also occur while awake.

Closed Jaw

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Causes

The exact cause of bruxism is unknown, but it is believed to be related to:

  • Stress and anxiety
  • Abnormal alignment of the teeth or jaws
Risk Factors

Risk factors that increase your chance of getting bruxism include:

  • Chronic stress or anxiety
  • Aggressive or competitive personality
  • Smoking tobacco or drinking caffeinated beverages
  • Abuse of drugs or alcohol (especially methamphetamines)
  • Post-traumatic stress disorder
  • Age: 40 or younger; especially common in women aged 27-40
  • Family member with bruxism
  • Facial or oral trauma
  • Use of psychiatric medications, especially antidepressants
  • Prior serious head injury
  • Complication resulting from a disorder, such as Huntington's disease or Parkinson's disease
Symptoms

Symptoms may include:

  • Grinding sounds during sleep
  • Teeth that are sensitive to heat, cold, or brushing
  • Tense facial or jaw muscles
  • Teeth that are worn down, flattened, fractured or chipped
  • Hairline cracks or wearing of the enamel on some teeth
  • Sore teeth
  • Inflammation of the gums (gingivitis)
  • Headache, especially when waking in the morning
  • Damage to the inside of the cheek (from biting or chewing)
  • Temporomandibular joint disorder (TMD)
Diagnosis

The doctor or dentist will ask about your symptoms and medical history. An examination of your teeth and jaw will be done. With bruxism, teeth will have flattened tips, excessive wear, thin enamel, or sensitivity. X-rays may be done to check for further damage to your teeth or the underlying bone.

Treatment

Methods of treatment include:

Behavioral or Cognitive Treatment

This method focuses on changing behavior through various techniques, such as:

Orthodontic Treatment

Your dentist may recommend:

  • A protective mouth appliance, such as a night guard. It can absorb the pressure of constant night grinding.
  • Correction of misaligned teeth if your bruxism might be caused by this.
Medication

Medication is only recommended for short-term use. Medications may include:

  • Muscle relaxants before sleep
  • Mild sleeping aids
  • Injection of botulinum toxin (Botox) in severe cases if other treatment not working

Bruxism that is not treated may result in gum damage, tooth loss, and jaw-related disorders.

Prevention

The same methods used to treat bruxism can be used to prevent the condition.

Avoid caffeine drinks in the evening

Make sure to see your dentist regularly for check-ups

RESOURCES:

Academy of General Dentistry
http://www.agd.org

American Dental Association
http://www.ada.org

CANADIAN RESOURCES:

Canadian Dental Association
http://www.cda-adc.ca

The Canadian Dental Hygienists Association
http://www.cdha.ca

References:

Bruxism. University of Virginia Health System website. Available at: http://uvahealth.com/services/dentistry/conditions-treatments-1/11995/?searchterm=bruxism. Accessed January 22, 2013.

Chang H. Botulism toxin: use in disorders of the temporomandibular joint. Dent Today. 2005;24:48,50-51.

Tan EK, Jankovic J. Treating severe bruxism with botulinum toxin. J Am Dent Assoc. 2000;131:211-216.

Teeth grinding. American Dental Association's Mouth Healthy website. Available at: http://www.mouthhealthy.org/en/az-topics/t/teeth-grinding.aspx. Accessed January 22, 2013.

Bruxism/teeth grinding. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/bruxism/DS00337/DSECTION=causes. Accessed August 30, 2013.



Last reviewed September 2013 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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