Bruxism – Clenching Teeth or Grinding Teeth

Clenching and grinding of the teeth is called bruxism. It can be caused by a number of factors and many people are unaware of doing it. Using your teeth in this way is called parafunction as it is using your teeth in ways for which they are not designed. Unfortunately it can be difficult to know if you do grind your teeth, as it is something that tends to be done subconsciously. Many people in fact grind in their sleep only, so it is often only when someone sees or hears them grinding that they become aware of it.

What causes teeth grinding?

Bruxism is a sleep disorder, more than a dental disorder. A pattern, or cycle, is created in the brain with the muscular movements of grinding. This then gets repeated over and over as a habit. There are many risk factors which trigger grinding, but the exact cause or reason is not known with certainty.

What are the risk factors of grinding?

It used to be thought that stress was the leading factor of grinding. There has been a link with many stressful life events, including bereavement, moving house, divorce and exams. Remember stress does not have to be mental stress, and there can be stress put on your body from chronic pain or acute pain, poor immune system, diet and other factors. There is more and more evidence that breathing problems are as important, if not more so. Given the increase in risk for other diseases with sleep apnoea and reduced airway, if you suspect that airway problems may be triggering bruxism, it is important to raise it with your doctor or dentist. Malocclusions and changes to your bite can cause bruxism, so if you have a restoration, such as a filling or crown, that feels high to your bite, it is best to return to the dentist before a grinding habit develops. Disturbed sleep patterns are a risk, so those with shift work or poor sleep patterns are at risk. Some personality types are more at risk: competitive, anxious, aggressive or hyperactive personalities are at increased risk of grinding.

How do I know if I grind my teeth?

Often you will be unaware of the grinding movement, but you can monitor for other symptoms. The symptoms are related to overuse of the teeth, joint and muscles. The teeth can be tender or achey generally, particularly morning times. The face can feel tight as the muscles are tense. This can present as tension headaches, often called stress headaches. There can be neck pain and/or shoulder pain. The joint can have pinpoint pain and it can be sore to open or close. Occasionally it can be hard to open or close, which is called trismus or lock jaw. There can be clicking of the jaw joint. Many of these symptoms are not specific to grinding and it is a full history taking all of these into consideration that leads to a bruxism diagnosis.

For some, their grinding can be harmless. Most people will be grindng at some stage in their life. The problem arises if it becomes a habit. Those that use mild force but do it a lot of the time get lot of damage. Those that do it for a short period, but with a lot of force can also do a lot of damage.

How will my dentist know I grind my teeth?

Your dentist will check your teeth for flat wear facets. These occur where your teeth rub against each other. In normal chewing and talking, our teeth don’t touch, but stop about a millimeter short of each other. In grinding, the teeth are in contact and the rubbing action wears them down equally. This is called attrition. There can also be cracking of your teeth and fillings. Chips can occur, leading to roughness at the edge of your teeth due to flexure. Once the damage is there, it stays for life, so once you start grinding, it is important to address it soon, so as to prevent worsening and minimise the damage throughout life. If they suspect bruxism, they will talk to you about any symptoms you are experiencing and examine the muscle and the joint. They may take

Is there any treatment for grinding?

Wearing an occlusal splint protects the teeth from further damage. Similar to a sports mouthguard, it is custom made and moulded to your teeth. Properly constructed, it guides your tooth movements to prevent your teeth touching and to take the strain off your muscles and jaw. It should help to hold your jaw in a comfortable position to prevent jaw problems. It may stop you from grinding, but it may not. Some people need to wear it for a short period, some people need to wear it for life.

Is there anything I can do to stop grinding?

If there is a trigger that causes you to grind, addressing it can help you to stop grinding. Sometimes, however, once the habit is formed, even if the trigger is removed, you can continue to grind. Some people will grind on and off throughout life, whereas for some it is just transient. For those that grind daytime, creating new habits can help. The first step is identifying when you clench or grind. There are many daytime triggers: anger, stress, concentration, physical exertion, heightened emotion, worry. Then at these times, trying to stop the habit occurring, such as getting up at work for a glass of water, or taking a 10 second time out can help. Sometimes a negative feedback, such as gently pinching the back of your wrist can help.

How much does a splint cost?

A standard flat plane occlusal comfort splint is $500. Sometimes a softer splint is more suitable which is $300. Sometimes a specialised splint is required which can be up to $650. The item number for your health fund is 965. Your dentist will give you a quote for the splint that is most suitable for you or discuss options if many are suitable.