Around 10% of people grind their teeth at night, and most of them are unaware that they are doing it. While a seemingly harmless activity, bruxism can actually damage teeth and cause poor sleep among other problems.

If you ever find yourself grinding your teeth or tightly clenching your jaw, read on to find out what could be causing it and what you can do about it.

What is Bruxism?

Bruxism is a condition in which you excessively grind, gnash, or clench your teeth. You may unconsciously do it when you’re awake or you may do it during sleep.

Symptoms of Bruxism

Teeth grinding is a seemingly harmless activity that can cause bigger problems in the longer run. And most people don’t even realize that they have been doing this. But if you have been doing this, eventually, your body will tell you.

Bruxism can cause symptoms like:

• Face, neck, and shoulder pain
• Muscle pain in the jaw area, which can cause Temporomandibular Disorder (TMJ)
• Worn-down teeth, broken teeth, or teeth that have started to flatten at the bottom edge (It is important to note that this can cause increased sensitivity and cause teeth and fillings to fail)
• Swelling
• A clicking noise when you open or close your mouth
• Headache
• Earache
• Disturbed sleep

It can be long before you figure out that you grind your teeth at night, so it’s important to look out for any warning signs to get ahead of the problem.

Causes of Teeth Grinding

While it’s not clear exactly what makes people grind their teeth, there can be a few things to blame:

• Stress and anxiety
• Sleep problems like snoring and sleep apnea.
• Certain medicines, like antidepressants that are SSRIs.
• Smoking, drinking alcohol, drinking coffee, and taking drugs like ecstasy and cocaine.

Types of Bruxism

Bruxism is generally categorized into two main types: Awake Bruxism and Sleep Bruxism, each with its own set of triggers and management techniques.

1. Awake Bruxism

Awake bruxism occurs during waking hours, often unconsciously. It is typically linked to emotional or psychological triggers such as stress, anxiety, or even intense concentration.

Triggers

• Stress: Many people grind or clench their teeth when they are stressed or anxious. The tension often builds up in the jaw, leading to bruxism.
• Concentration: Some individuals grind their teeth when they are deep in thought or concentrating on a specific task, especially if they are working in a high-pressure environment.

Management

• Stress Management: Reducing stress through relaxation techniques like meditation, yoga, or breathing exercises can help reduce episodes of awake bruxism.
• Behavioral Awareness: Cognitive Behavioral Therapy (CBT) or behavior modification techniques can help individuals become more aware of their jaw clenching habits, and teach them how to stop this unconscious behavior.
• Physical Therapy: Jaw exercises and massages can relieve tension in the jaw and help prevent clenching.

2. Sleep Bruxism

Sleep bruxism, on the other hand, occurs during sleep and is often harder to detect. Since it happens involuntarily, most people aren’t aware of it until a partner notices the grinding sounds, or a dentist spots the signs of damage.

Triggers:

• Sleep Disorders: Sleep apnea and other sleep disorders are commonly associated with sleep bruxism. These conditions can cause disruptions in breathing, leading the body to respond with teeth grinding as a way to clear the airway.
• Medication: Certain medications, especially selective serotonin reuptake inhibitors (SSRIs) used to treat depression, have been linked to increased episodes of sleep bruxism.
• Other Factors: Smoking, alcohol consumption, and caffeine intake, particularly close to bedtime, can trigger or worsen sleep bruxism.

Management:

• Mouth Guards: Wearing a custom-made night guard or splint can protect the teeth from grinding damage during sleep.
• Addressing Sleep Disorders: Treating underlying sleep disorders such as sleep apnea can significantly reduce or eliminate sleep bruxism.
• Medication Adjustment: If the grinding is linked to medication, consulting with a doctor about switching or adjusting the dosage may help alleviate the symptoms.

Risk Factors for Bruxism

There are a few things that make you more inclined to grind your teeth:

1. Family history: If anyone in your family grinds their teeth, chances are that you do it too.
2. Stress and anxiety: When we are anxious, we may unconsciously clench our teeth.
3. Sleep disorders: With disorders like sleep apnea, you stop breathing multiple times in your sleep. This can happen if your tongue is blocking your airway. Grinding teeth may be your body’s way of clearing the airway and letting you breathe again.
4. Unhealthy lifestyle: If you indulge in smoking, drinking, or even drinking too much coffee, it can cause bruxism.
5. Bite misalignment: If you have a misaligned bite or crooked teeth, you may develop TMJ syndrome and experience pressure or pain on your jaw joints. The spasms that result from that can take the form of teeth grinding.
6. Medication: Certain medicines like antidepressants can also trigger bruxism.
7. Other medical and mental health problems: A number of mental health problems can make you more prone to developing bruxism, like Parkinson’s disease, epilepsy, ADHD, dementia, night terrors, and gastroesophageal reflux disorder.

Grinding Teeth in Your Sleep?

The cause is unique for each individual, but there can be physical, psychological, or genetic factors involved. During the day, this can be triggered by stress, anxiety, tension, or concentration. This is called Awake Bruxism. At night, the reasons can be hyperactivity, sleep apnea, acid reflux, or even a side effect of certain medicines. This is called Sleep Bruxism. Additionally, this can also be caused by missing teeth, crooked teeth, or even an abnormal bite.

How is Bruxism Treated?

Mild bruxism may not need to be treated, but if it is frequent and so severe that it is causing headaches, damaging teeth, and leading to jaw disorders and other problems, then you will need to seek treatment as soon as you can. If you grind your teeth, here’s what you can do to stop:

1. You can wear a night guard to sleep; it will protect your teeth if you try to grind them in sleep. Your dentist will create them so they fit precisely over your upper or lower teeth.
2. If a certain medication is causing bruxism for you, your doctor may advise you to change the medication.
3. If stress is making you grind your teeth, you can benefit immensely from counseling, psychotherapy, and behavior modification techniques.
4. If the culprit is sleep apnea, you can consult with a sleep specialist to work on the apnea and help you sleep better.
5. You can try to reduce your stress by doing breathing exercises, listening to music, and exercising every day.
6. Improving your quality of sleep by sticking to a sleep schedule and creating a dark, quiet, and cool environment can stop you from grinding your teeth.
7. You will also need to eliminate or cut back on smoking, drinking, or drinking too much caffeine.
8. Other options include botox injections to paralyze the jaw muscles used during teeth grinding, although this is not approved by the FDA.

Long-Term Effects of Untreated Bruxism

Bruxism, especially when left untreated, can lead to serious complications over time. Even if the grinding occurs unconsciously or during sleep, the physical effects can be damaging.

1. Tooth Fractures: Constant grinding can weaken the tooth structure, making them more prone to cracks and fractures. Teeth can break or chip, leading to the need for costly dental repairs like crowns or even tooth extraction.
2. Loss of Tooth Enamel: The repetitive grinding and clenching wears away the protective enamel on your teeth. As the enamel thins, teeth become more vulnerable to cavities, decay, and sensitivity. The loss of enamel is irreversible and can lead to the need for dental treatments such as fillings, veneers, or crowns.
3. Chronic Headaches: The tension and muscle strain caused by constant grinding can lead to frequent tension headaches or migraines. These headaches often occur upon waking and can affect daily life and productivity.
4. Jaw Disorders: Bruxism can cause or exacerbate Temporomandibular Joint (TMJ) Disorder, a painful condition affecting the jaw joint and muscles that control jaw movement. TMJ disorders can lead to jaw pain, stiffness, clicking or popping sounds, and difficulty opening or closing the mouth.
5. Tooth Loss: Severe and prolonged grinding can cause such significant damage to teeth that they may become loose or even fall out. In such cases, the affected individual may require dental implants, bridges, or dentures to restore function and aesthetics.

By recognizing and treating bruxism early on, you can avoid these potential long-term effects and ensure better dental and overall health.