What is bruxism?
Bruxism is the medical term for teeth grinding or clenching that occurs unconsciously. It can either occur during the night (sleep bruxism) or during the day (awake bruxism).
Bruxism is not a rare problem: 10 to 30% of adults grind or clench their teeth, with more than half of them doing so during their sleep. If you suffer from sleep bruxism there is a high chance that you are not aware of it. Therefore, it is important to know the signs and symptoms and to seek regular dental advice.
Could grinding be causing you pain?
Teeth grinding and clenching can be responsible for a wide array of painful symptoms and health problems. Indeed, you may be surprised to find out that many of the chronic pain-related symptoms that affect your quality of life have their root in your teeth grinding, which you may not even be aware of.
Damage to your teeth and wearing down costly dental work are just the beginning. Many grinders suffer from poor, disturbed sleep (as do their partners). The increased muscle tension caused by grinding and clenching also often leads to facial pain, tension type headaches and other painful symptoms. These problems can seriously impact your quality of life.
Over 90% of patients who suffer from bruxism report multiple secondary symptoms & consequences:*
The vicious circle of sleep bruxism
In fact, people suffering from severe sleep bruxism often get caught in a vicious circle of pain and tension as well as disturbed sleep, leading to continuously increased levels of stress and fatigue, which goes on to further fuel their grinding or clenching during the night. This vicious circle can trap you in your habit of sleep bruxism and go on to erode your sense of wellbeing.
What are the causes of bruxism?
The cause of bruxism is not yet fully understood. Stress and its related emotions like anxiety and anger are strongly linked to bruxism. Genetic disposition may also increase the likelihood of grinding and clenching your teeth. In addition, certain drugs, smoking, alcohol and sleeping disorders also increase the risk of bruxism.
Splints, also known as mouthguards, are the traditional treatment of choice offered by dentists. They are designed to keep teeth apart to protect them from the frictional damage that grinding and clenching can occasion. Their effect on the pain-related symptoms of bruxism, such as headaches, orofacial pain, and muscle tension however has been shown to be limited. Some patients find them uncomfortable to wear during the night, leading to low compliance.
Physiotherapy is an important part of bruxism treatment. It focuses on the pain-related secondary symptoms of bruxism by addressing the muscle tension. Ideally it is accompanied by regular at home exercises. While there is a clear benefit of physiotherapy the pain relief may be only temporary as physiotherapy on its own usually does not address the root of the problem.
As bruxism is often linked to stress, cognitive behavioral therapy, including stress management and psychotherapy, are sometimes recommended. By addressing the underlying cause of bruxism, this approach can be an effective solution to put an end to unconscious grinding behavior. Additional relaxation exercises can also be used to practice and assimilate proper mouth and jaw positioning. Though these methods can be quite effective, they do take time and patient commitment to achieve positive results.
In some cases, your doctor may suggest taking a muscle relaxant before going to bed. In rare cases, Botox injections may also help people with more severe cases of bruxism who don't respond to other treatments. This approach is however not normally recommended due to the potential side effects of medication.
Biofeedback devices are designed to help you break your grinding habit by making you aware of it and teaching you to control muscle activity in your jaw. Most first-generation biofeedback devices monitor jaw muscles and send an automatic alert – usually an acoustic signal or vibration – when you start grinding so that you can consciously act upon it. This conscious learning effect involves at least an initial phase of waking up or sleep disturbance.
Contingent Electrical Stimulation (CES)
CES is a new-generation approach to biofeedback. A mild contingent impulse stimulates a conditioned reflex in the jaw muscles as soon as it detects tension, inhibiting grinding and clenching. This happens while you sleep, without you noticing a thing and without compromising the quality of your sleep. Over time, the unhealthy habit of grinding or clenching is progressively reduced. By addressing bruxism at the source, it can provide relief from the associated secondary symptoms.