What is clenching of teeth or “Bruxism” ?
Bruxism is excessive, involuntary or habitual grinding or jaw clenching. It is not related to normal activities like eating or talking. Most people grind their teeth and are unaware of it. However, when grinding teeth becomes habitual, it causes damage to the teeth and other oral health complications.
Why do people grind teeth?
The exact cause of bruxism is not known. But stress, genetics, medications and malocclusions can contribute to teeth grinding. Habitual grinding of teeth can damage your teeth. Research has shown that children of people who grind teeth are more likely to have the habit than the children of people who don’t have the habit.
What are the types of Bruxism?
There are two main types of bruxism
One that occurs during sleep ( nocturnal bruxism )
On during wakefulness ( awake bruxism )
The tooth damage is the same in both the types. The symptoms of sleep bruxism is worst on waking up and improves over the day. With awake bruxism there may not be any symptoms on waking, but worsens over the day. Sleep bruxism affects men, women and children.
How will you know if you grind teeth?
Most people who grind may not be aware of it. Grinding affects the teeth, chewing muscles, TMJ and your gums. Bruxism can show some signs and symptoms which can indicate the habit.
- Excessive tooth wear. The wearing of teeth occurs most on the chewing surface. This is called ‘Attrition’. Sometimes a notch type of defect is seen near the gum line of your tooth. This is called ‘Abfraction’.
- Tooth fractures. This includes failure of crowns and bridges and cosmetic restorations of the front teeth.
- Hypersensitive teeth. Sensitivity to hot and cold foods increases because of the wearing of the protective enamel and dentin of your tooth.
- Infection of the gums and possibly loose teeth
- Trismus or limited mouth opening.
- Fatigue of the chewing muscles especially during chewing or other jaw movements.
- Clicking of the TMJ and/ or TMJ pain
- Headaches particularly in the temples.
- Your family members can tell you about the ‘grinding’ or ‘tapping’ sound you make in your sleep.
What can you do to stop grinding of teeth?
- Treatment for grinding involves restoring the damaged teeth and also preventing further damage to the teeth and the related oral structures. Your dentist will fabricate a night guard for bruxism. A night guard ( occlusal splints or Dental guard ) is a thin, clear plastic appliance. This is essentially worn in sleep bruxism. A mouth guard only acts to reduce the damage to your teeth and does not treat the condition.
- Some medications like antidepressants have been tried for the treatment of bruxism.
- Botulinum toxin has been used to inject into the chewing muscles. The toxin causes partial paralysis of the muscles and reduces the ability of the muscles to forcefully clench and grind the jaw. The treatment involves 5-6 injections and the effect may last for upto 3 months.
- ‘Occlusal rehabilitation’ has been tried by some dentists with little results. This involves various specialities in dentistry and is a complex procedure. However, there is not much evidence available for the success of this procedure.
You can however follow these tips to avoid grinding
- Relaxation techniques of yoga and breathing exercises.
- Stress management.
- Behvioural modification.
- Habit reversal.
- Cutting back on the consumption of alcohol and smoking.
- Avoid foods and beverages that contain caffeine, cola and chocolates.
- Avoid chewing on objects like pens and pencils.
- Avoid continuous chewing on the gum.
Is tooth grinding common in children?
Children are reported to brux as commonly as the adults. About 14-20% of the children grind teeth. Generally, your child will grind teeth during the eruption of teeth. This can happen in two stages——-One during the coming out of milk/baby teeth and then during the coming out of the adult teeth.
Bruxism in children can be due to improper aligned teeth or other medical conditions such as worm infestation, allergies, endocrine disorders. Psychological factors like anxiety and stress can also be the cause. Sleep bruxism is more common in children. Teeth grinding can cause headaches, jaw pain and the wearing out of the teeth.
You can help reduce the grinding habit in your child with the following tips
- Help your child relax especially during bed time.
- Keep you child well hydrated. A dehydrated child tends to clench teeth.
- Massage the muscles of the face and try applying packs to the areas in front of the ear.
- Take your child to the dentist for an assessment. If your dentist feels that your child is a bruxer, then he may prescribe temporary crowns or a night guard.
- Bruxism in pre school children is common and no intervention is required.