Bruxism(Teeth grinding and clenching)

Teeth grinding (bruxism) is involuntary clenching, grinding and gnashing of the teeth. It is thought that about half of the population bruxes from time to time, while around five per cent are habitual and forceful tooth grinders. It generally happens during sleep, but some people experience it when they are awake.

Bruxism can be a physical expression of stress; for example, susceptible people may tend to grind their teeth when they are angry, concentrating hard on a particular task or feeling anxious.

Generally, the person doesn’t realise that they grind their teeth in their sleep. The spouse or partner who shares their bed (and hears the grinding noises at night) is often the first to notice the problem.

Signs and symptoms
The signs and symptoms of bruxism include:

* Audible grinding sounds while the person is asleep
* Headache, jaw joint and/or ear pain
* Aching teeth, particularly upon waking
* Aching and/or stiffness of the face and temples upon waking
* Aching or stiffness in the jaws while chewing, particularly during breakfast
* Clenching the jaw when angry, anxious or concentrating
* Temperature-sensitive teeth
* Cracked or chipped tooth enamel
* Tooth indentations on the tongue
* Raised tissue on the cheek mucosa caused by cheek biting (linea alba)
* Mobile teeth.

Complications of bruxism
Teeth grinding can cause a range of dental problems, which may include:

* Cracked tooth enamel
* Excessive wear and tear on the teeth
* Broken teeth or restorations
* Strain on the joints and soft tissue of the jaw joint (temporo-mandibular joint)
* Temporo-mandibular disorder
* Tooth loss (rarely)
* Enlargement of the jaw muscles (rarely).

A range of causes
Some of the many factors believed to trigger bruxism in susceptible people include:

* Emotional stress, such as anger or anxiety
* Mental concentration
* Physical effort or stress, such as illness, nutritional deficiency or dehydration
* Incorrect tooth alignment, including fillings that are too ‘high’
* Drug misuse (particularly amphetamines)
* Eruption of teeth (babies and children).

Diagnosis
If you suspect you may grind your teeth, see your dentist as soon as possible. Your dentist will inspect your teeth and may take x-rays to gauge the severity of the problem and the damage done to teeth and bone.

Dental treatment
You should consult your dental professional for their recommended course of treatment. Dental treatment options include:

* Repair of tooth damage
* Adjustment of fillings that may be too high and interfering with the bite (not adjustment of teeth)
* Mouth appliances to be worn at night (bite splints), so that you grind the device and not your teeth. However, in most cases, these appliances will only provide relief from the associated symptoms and will not stop you from grinding your teeth.

Other treatments
Other treatments that may help to manage teeth grinding include:

* Stress management therapy
* Relaxation techniques
* Cognitive behaviour therapy
* Regular exercise
* Muscle relaxant medication.

Where to get help

* Your dentist
* Dental specialist
* Psychologist, to help with stress management
* Dental Health Services Victoria Hotline Tel. 1300 360 054 – for information about public dental services

Things to remember

* Teeth grinding (bruxism) is involuntary clenching, grinding and gnashing of the teeth that usually happens during sleep.
* Causes can include stress, concentration, incorrect tooth alignment and drug misuse.
* Treatments include bite splints (to be worn at night), repair of tooth damage, muscle relaxant medication and stress management therapy.