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Bruxism (Teeth Grinding): Symptoms, Causes, & Remedies

Millions of Americans suffer from bruxism. However, what many people don’t realize is that teeth grinding isn’t all about stress — it’s frequently a symptom of a sleep disorder. What is bruxism? Bruxism is a condition in which people grind, clench, or gnash their teeth. It is also known as teeth grinding, or simply “grinding”. Bruxism is a dental health epidemic, even if it’s not contagious. The 2 types of bruxism are:

  1. Daytime grinding/awake bruxism — Awake bruxism is frequently stress-related. Jaw clenching is common in people who experience chronic stress and anxiety.

  2. Nighttime grinding/sleep bruxism — Sleep bruxism is typically airway health-related. It is usually caused by sleep apnea or another type of disordered sleep breathing (like UARS). Your brain signals teeth grinding to restart breathing as a response to an apneic episode, when you stop breathing because your airway is obstructed.

How many people have bruxism? Experts estimate 12-31% of adults suffer from sleep bruxism, most of whom are unaware of their medical condition. Much more alarming: As many as 50% of children may experience nighttime grinding. This is your one-stop article for everything you need to know about teeth grinding, known in the dentistry community as bruxism, including the long-term complications of untreated bruxism.

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Bruxism Symptoms

Symptoms of bruxism (teeth grinding) include:

  • Aching jaw muscles
  • Neck soreness
  • Facial pain
  • Earache
  • Jaw pain (temporomandibular joint disorder, also known as TMD or TMJ)
  • Headaches
  • Tooth damage
  • Tooth sensitivity
  • Damage to dental restorations

Bruxism with mercury (amalgam) fillings is especially dangerous. Grinding your teeth with mercury fillings will almost certainly increase your exposure to toxic mercury.

Some mouth movement is normal during sleep. More than half of people make chewing-like motions, known as “rhythmic masticatory muscle activities”. However, those suffering from sleep bruxism experience these mouth movements more often and more forcefully.

Can you reverse damage from teeth grinding? Cosmetic dental procedures may help reverse damage from teeth grinding. Chronic bruxism may result in broken, chipped, cracked, or worn down teeth.

Cosmetic dentistry can artificially restore your smile, but there is no natural cure to reverse the damage from teeth grinding.

Bruxism Diagnosis

To diagnose bruxism, a doctor may:

  • Review your symptoms
  • Ask about your medical history
  • Ask about your sleeping habits
  • Find out what medications you’re on
  • Check for soreness in jaw muscles
  • Check for tooth damage
  • Check for underlying bone damage, with x-rays

Bruxism causes similar symptoms to temporomandibular joint (TMJ) disorder, so your doctor may diagnose you with TMD when you thought you had bruxism. I discuss this in more detail below, as bruxism can actually cause TMD.

During your biannual visits to the dentist, your dentist will probably check for signs of bruxism. A sleep medicine dentist should discuss these signs with you and encourage you to get a sleep study to determine the underlying cause of grinding.

Bruxism causes similar symptoms to temporomandibular joint (TMJ) disorder, so your doctor may diagnose you with TMD when you thought you had bruxism. I discuss this in more detail below, as bruxism can actually cause TMD.

During your biannual visits to the dentist, your dentist will probably check for signs of bruxism. A sleep medicine dentist should discuss these signs with you and encourage you to get a sleep study to determine the underlying cause of grinding.

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Causes of Teeth Grinding

What causes bruxism? The known or suggested causes of bruxism are:

  • Sleep apnea
  • Stress
  • Anxiety
  • Depression
  • Abnormal bite
  • Genetics
  • Crooked teeth
  • Vitamin deficiencies
  • Certain medications (such as SSRIs, nicotine, anti-anxiety meds, and antipsychotics)
  • Parasites What deficiency causes teeth grinding? Nutritional deficiencies in vitamin B5, calcium, and/or magnesium may cause teeth grinding. Supplementing these three nutrients can improve bruxism in some cases.

Risk factors for bruxism do not include your gender. Unlike most medical conditions, bruxism affects men and women relatively equally.

Below, I briefly broke down the causes of bruxism into awake bruxism and nighttime bruxism, since they are really very different in their origin.

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What Causes Awake Bruxism?

Stress and anxiety are the most common causes of awake bruxism.

How do you stop awake bruxism? To stop awake bruxism, begin with reducing stress and other mental health problems, such as anxiety and depression.

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What Causes Sleep Bruxism?

The underlying cause of bruxism at night is usually a sleep disorder, like sleep apnea. If you grind at night, it’s probably your body telling you to grind your teeth so you can wake up long enough to start breathing again.

Sleep apnea can be caused by poor airway health — when your tongue is too big for your oral cavity and obstructs the upper airway.

Many teeth grinders find success by safely and painlessly increasing the space behind their teeth with the DNA oral appliance. This appliance is used to expand the palate and allow space for the tongue in the mouth so it won’t obstruct the airway.

Parasites may also cause sleep bruxism. Multiple studies link parasites (sometimes called “digestive parasites” or “worms”) to nighttime grinding.

Teeth Grinding Treatments

You must treat bruxism by treating the underlying cause of your bruxism. Therefore, many of these treatments are for sleep apnea (the main cause of sleep bruxism) and chronic stress (the main cause of awake bruxism).

There are 6 teeth grinding treatment options:

  • Relaxation techniques: The best treatment option for awake bruxism is relaxation techniques. Meditation, yoga, prayer, guided imagery, spending time outdoors — stress relief and relaxation should be your first-line defense against teeth grinding during the day.

  • Daytime-Nighttime Appliance: Also called DNA oral appliance, this FDA-regulated treatment option naturally, safely, gradually, and painlessly “stretches” the arches of your teeth. This allows more room for your tongue to occupy in the mouth so it doesn’t block your airway. A tongue without proper airway space is an underlying cause of sleep apnea that often causes sleep bruxism. Patients also report their smile is improved after using the DNA oral appliance!

  • Night guard: The American Dental Association (ADA) suggests using night guards to protect your teeth from damage due to grinding. These oral appliances are called occlusal splints, since they’re a specific type of mouthguard used to prevent damage from grinding. However, night guards come with side effects that may actually worsen symptoms of sleep apnea, since you’re not addressing the underlying cause. I do not recommend night guards for bruxism.

  • Oral appliances: Other oral appliances may manage symptoms of sleep apnea, such as bruxism. These devices do not treat the underlying cause of sleep apnea but reposition the airway for easier breathing. Mandibular advancement devices (MAD) or tongue retention devices (TRD) can help manage sleep apnea symptoms, such as grinding. Some of these oral appliances may trigger a sore jaw or worsen temporomandibular disorders.

  • CPAP/APAP/BiPAP: CPAP, APAP, or BiPAP therapy is the first line treatment for sleep apnea, which is often the underlying cause of sleep bruxism. CPAP stands for “continuous positive airway pressure”, APAP stands for “automatic positive airway pressure”, and BiPAP stands for “bilevel positive airway pressure”. I would not suggest these therapies as a lifetime solution for bruxism/sleep apnea because they can be very uncomfortable and may weaken the muscles of the throat after long-term use. These machines also do not address the underlying cause of sleep apnea: your tongue is too big for your oral cavity.

  • Mouth taping: This newer treatment method for sleep apnea helps retrain you to breathe through your nose. It doesn’t prevent you from mouth breathing (which isn’t great for your oral health), but instead encourages nasal breathing. You can mouth tape during the day or during sleep.

Many conventional doctors use muscle relaxants, antidepressants, or botox to “treat” bruxism. These treatment options typically address symptoms, instead of the root cause.

How do I stop grinding my teeth? If you experience daytime grinding, you can stop grinding your teeth by reducing your daily stress levels. If you experience nighttime grinding, you can stop grinding by treating the underlying cause of sleep apnea, which is likely the underlying cause of bruxism.

Can bruxism go away? For some individuals, bruxism is temporary. Bruxism may go away on its own if it is caused by temporary stressors in your life. While teeth grinding may resolve on its own, it is wise to seek treatment to avoid long-term complications.

How do you treat bruxism pain? To treat bruxism pain, talk to your doctor about appropriate natural and over-the-counter remedies for you. He or she may suggest pain relief techniques such as medications or even acupuncture.

How do I stop grinding my teeth in my sleep naturally? Here are 6 tips to stop grinding your teeth naturally:

  • 1. Exercise to reduce stress levels (daytime grinding)

  • 2. Practice mindfulness to retrain your jaw clenching habits (daytime grinding)

  • 3. Use massage as a stress-relief technique (daytime grinding)

  • 4. Avoid alcohol to improve sleep apnea (nighttime grinding)

  • 5. Steer clear of caffeine in the P.M. hours (nighttime grinding)

  • 6. Take a warm bath before bed, which may relax throat muscles (nighttime grinding)

Teeth Grinding in Children

Almost half of children experience teeth grinding. Almost 40% grind their teeth once a week. This can easily lead to long-term complications even into adulthood. How many kids do you think understand what teeth grinding is? Answer: approximately none of them will be able to identify their symptoms or seek help in correcting this serious medical condition. Bruxism in children may lead to:

  • Mouth breathing
  • Snoring
  • Drooling
  • Lack of sleep
  • Fewer social skills

A child’s teeth may fall victim to grinding without the child or parent even realizing it. Look out for the sneaky symptoms of childhood bruxism.

Note: Sleep apnea (which can cause bruxism) and ADHD exhibit similar symptoms. Researchers estimate up to half of children diagnosed with ADHD were misdiagnosed and actually suffered from sleep apnea.

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Long-Term Complications of Untreated Grinding

Complications of bruxism depend on the individual’s severity of the grinding/clenching, dental health, overall health, and even diet.

The long-term complications of teeth grinding are:

  • Significant tooth damage
  • Chronic jaw pain
  • Popping, clicking noises in your jaw
  • Premature loss of tooth enamel
  • Tooth loss
  • Irreversible gum recession
  • Migraine headaches
  • Decreased quality of life for your bed partner
  • Temporomandibular joint disorder (TMD)
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Conditions Associated with Grinding

The following medical conditions are associated with grinding. Experts don’t yet know whether bruxism causes them, or the other way around, or if they’re both symptoms of another underlying cause.

What are the medical conditions associated with teeth grinding?

  1. Gastroesophageal reflux disease (GERD)

  2. Behavioral problems in children

  3. Depression

  4. Sleep-disordered breathing

  5. Kidney disease

How Common is Bruxism?

According to studies I’ve mentioned above, bruxism is more common than you probably think.

  • Up to 31% of adults suffer from awake bruxism
  • Up to 16% of adults suffer from sleep bruxism
  • Up to 49.6% of children experience bruxism

Most bruxism sufferers don’t know that they grind their teeth.

I implore people to pay attention to bruxism symptoms when they wake up. Having a random headache and jaw pain is not just “sleeping weird” — it’s a symptom that you should discuss with your dentist and/or primary care physician.

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How to Prevent Teeth Grinding

You can prevent teeth grinding by determining if you are at risk for an underlying cause of your bruxism. Nighttime grinding usually means sleep apnea, and daytime grinding usually means stress/anxiety. If you are at risk, find out how to avoid the root cause. If you need help diagnosing, treating, or preventing bruxism, Rejuvenation Dentistry has a long, successful record of helping patients who grind their teeth — especially those whom the conventional healthcare system has failed.

Did you know? A landmark 2006 study on 145,000 patients found up to a 21% reduction in healthcare costs associated with major diseases when oral health is improved. Click here today to set up your appointment with us. At Rejuvenation Dentistry, we empower our patients to take control of their overall health, especially bruxism, airway health problems, and obstructive sleep apnea.

Sources

Dr. Gerry Curatola is a renowned biologic restorative dentist with more than 40 years of clinical practice experience.

He studied neuroscience at Colgate University and attended dental school at the New York University (NYU) College of Dentistry where he now serves as Adjunct Clinical Associate Professor in the Department of Cariology and Comprehensive Care.

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