What is Bruxism?

Bruxism is a common and usually unrecognized routine that occurs in both children and adults.  It is the technical term for grinding and clenching that can lead to worn, crumbling teeth, chronic headaches and constant jaw pain.  The challenge for both dentists and patients is to recognize the habit before irreversible damage occurs.  Despite showing many symptoms, such as awakening with tired jaws and headaches, or flattened teeth and tooth pain, many patients are unaware that they ever do it.  There are different causes of bruxing, but a majority of the time it is simply a reaction to stress.  Some people get an ulcer - others grind their teeth!

Most of the damage from clenching and grinding occurs while we sleep.  If you have ever heard someone grind their teeth at night, it is a terrible sound.  Ask them to make the same noise while they are awake and they can’t because it hurts.  People can generate up to five times the amount of force between their teeth while they sleep than they could normally do during the day.  Considering the average person can generate 150-250 pounds per square inch of force during the day, it is a huge force at night.

Can bruxism cause harm?
People who have otherwise healthy teeth and gums can clench so often and so hard that over time their teeth break, wear or become sensitive.  They may experience jaw pain, tense muscles and headaches along with the damage to their teeth.

What are the signs?
When a person has bruxism, the tips of the teeth look flat.  The upper and lower teeth have worn areas that fit together like a puzzle.  Teeth are worn down so much that the outer layer of enamel is rubbed off, exposing the second layer of tooth structure called dentin.  When exposed, dentin may become sensitive.  Often bruxers develop abfractions (notches) at the gum line as a result of the force.  They may also experience pain in their temporomandibular joint which can manifest itself as popping and clicking.  In many instances, patients will develop indentations on the side of their tongue or white lines along their cheeks at the level of the teeth as other signs of clenching.

Stress and certain personality types are major factor in bruxism.  Nervous tension, stress, anger, pain and frustration can trigger bruxing.  You wouldn’t believe the amount of students I see with jaw pain around the stressful time of finals!  People who are aggressive, competitive and hurried also may be at a greater risk for grinding their teeth.

What can be done about it?
During regular dental visits, the dentist should automatically checks for physical signs of bruxism.  If the dentist notices signs of bruxism, the severity of the condition will determine what is to be done.  The condition may be observed over several visits to be sure the problem is ongoing before recommending and starting therapy.

The objective of therapy is protecting the teeth and jaw joints while helping the bruxer to change behavior.  Many patients believe their teeth should be together at all times, but a relaxed mouth will have the tongue positioned slightly upward, the lips will be together and the teeth will be apart.  Just advising a patient of this may be enough to change their behavior and relieve discomfort.  However, in many situations the dentist will recommend a plastic mouth appliance, such as a bite splint or night guard that's worn to correctly position the jaws and absorb the force of biting.  In order to function properly, the appliance must be precisely adjusted to the ideal position for your jaws and bite and may require several visits.  The appliance can prevent future damage to the teeth and often helps change the patient's destructive behavior.

I am fortunate and found out fairly early that I grind my teeth at night.  Because of this, I have chosen to wear a bite splint to minimize future damage.  If you think you might have a concern with bruxism, don’t hesitate to talk with your dentist.  It may save you lot of “headaches” down the line.