Teeth Grinding/Clenching
What is Teeth Grinding (Bruxism) and Clenching?
Teeth grinding (bruxism) and clenching are conditions that cause a patient to repeatedly gnash or clamp their teeth together without being aware they are doing it. Bruxism and clenching may occur while the patient is awake or during sleep.
Bruxism and clenching are actually quite common; Athens dentist Dr. Phillip Durden frequently sees patients with dental problems related to teeth grinding and clenching in his dental practice at Winterville Dental.
While the cause is not always clear, teeth grinding and clenching while awake may be an unconscious physical reaction to stress or anxiety.
Nocturnal bruxism and clenching may be associated with snoring or a sleep breathing disorder (obstructive sleep apnea, hypopnea or upper airway resistance syndrome).
Alcohol use before bedtime, being overweight and some medical conditions (such as gastroesophageal reflux disease) may also contribute to sleep bruxism and clenching.
Some patients grind their teeth so loudly during sleep that the grating and squeaking sounds of gnawing teeth wake up their bed partner.
Bruxism and clenching can also occur in young children and teens due to anxiety, sleep breathing or other health issues.
Bruxism and Dental Health
If you grind or clench your teeth, your dentist may have told you that your teeth show signs of unusual wear or fracture. Bruxism and clenching can contribute to a number of dental problems, including toothaches, gum disease, jaw bone loss and broken or failing dental restorations (crowns, bridges or dental implants).
Common signs and symptoms of bruxism and clenching include:
- Jaw soreness or frequent dull headaches
- Difficulty opening or closing mouth or jaw joint noises (clicking, popping)
- Poor, restless sleep
- Dental pain and gum recession
- Noisy teeth grinding while awake or asleep
- Face or ear pain
- Biting cheeks or tongue
The Bruxism/Clenching Connection to Snoring and Sleep Disorders
Studies continue to suggest that patients that grind or clench their teeth during sleep have a higher occurrence of snoring or sleep breathing disorders, such as obstructive sleep apnea (OSA), hypopnea or upper airway resistance syndrome (UARS). The frequency of airway obstruction during sleep (full or partial obstruction) with tightening and shifting of the jaw in the effort to breathe may be linked to teeth grinding and clenching.
TMJ Disorders and Bruxism/Clenching
Temporomandibular Joint (TMJ) Disorders can be the result or the cause of bruxism and clenching. These two joints (located on either side of the jaw) give us the ability to move the jaw up/down and side to side for talking or chewing.
TMJ pain and symptoms occur when the tissues and facial muscles that support the jaw become inflamed or damaged. This can occur due to a medical condition such as arthritis, skeletal issues or a jaw injury, or, from the strain and stress on the jaw muscles from teeth grinding and clenching.
TMJ disorders share common symptoms with bruxism and clenching, including jaw pain, headaches and facial pain. Learn more about TMJ Disorders.
What is the recommended Treatment for Bruxism and Clenching?
Based on the underlying cause, treatment for bruxism and clenching generally involves a combination of lifestyle and health changes, medications, dental care, oral appliance therapy or physician referral:
Lifestyle and Health changes
Stress and anxiety are considered to be a leading risk factor for patients that grind or clench their teeth while they are awake, and can be a contributing cause for sleep bruxism/clenching. Reducing stress levels is always health-smart; relaxation exercises, meditation or yoga and a healthy diet with plenty of exercise can also help in managing bruxism/clenching.
Patients that have extra weight can sometimes improve their bruxism/clenching by losing a few pounds, especially in the case of sleep disordered breathing. Loss of excess weight helps relieve pressure on the back, neck and airway, making it easier to breathe while the body is relaxed during sleep. Learn more about obstructive sleep apnea.
Alcohol, caffeinated beverages and smoking can make sleep less restful, contributing to bruxism and clenching during sleep. Quitting smoking and reducing caffeine and alcohol intake before bedtime may help decrease sleep bruxism and clenching.
Sedatives and certain medications can increase the risk of bruxism; ask your doctor about possible links between any medications you are taking with bruxism/clenching. You may be able to adjust when you take your medicine to help reduce teeth grinding and clenching.
Oral Appliance Therapy
Patients that grind or clench their teeth can often prevent pain and symptoms by wearing a bite guard (or nightguard) during sleep. A nightguard (also called a mouthguard or bite splint) looks like a plastic orthodontic retainer; it is made of hard acrylic and fits snugly over all of the teeth in the arch (upper or lower).
Athens dentist Dr. Phillip Durden designs a bruxism nightguard to serve as a buffer between the upper and lower teeth; instead of gnashing together, the teeth just glide across the plastic barrier. The bite guard also helps to distribute the opposing forces of the teeth evenly, minimizing the tension placed on the jaw joints.
Dental Bite Adjustment
For most patients, when the mouth is at rest, the teeth fit together comfortably. In some cases, however, when teeth are out of alignment, damaged/missing, rotated or are poorly shaped, the upper and lower teeth do not fit together normally. While each patient is different, a misaligned bite may contribute to bruxism/clenching or make the condition worse.
Dr. Durden may recommend replacement of old dental work, orthodontic treatment or minor tooth height/shape adjustments to minimize interferences between teeth and help the bite relax in a comfortable position.
Medication
Treatment of bruxism and clenching may include temporary medication for relief of jaw muscle pain in conjunction with oral appliance therapy. Your doctor may also prescribe medication for anxiety if you are clenching and grinding your teeth as a reaction to stress.
Physician Referral for Sleep Study or Medical Illness
In addition to TMJ disorders and obstructive sleep apnea, clenching and bruxism may be related to other health issues, such as gastroesophageal reflux disorder (GERD), attention-deficit/hyperactivity disorder (ADHD) and some forms of dementia.
Dr. Durden or your doctor may recommend that you or your child see a specialist to rule out medical issues that may be contributing to bruxism and clenching.
Dental Sleep Medicine of Athens
Dr. Phillip Durden consults with patients with bruxism/clenching symptoms to recommend treatment and further evaluation by medical professionals as needed.
If you have questions about teeth grinding/bruxism or clenching, please Contact Dental Sleep Medicine of Athens to schedule a New Patient appointment with Dr. Durden.