What is it?

Bruxism does not consist only of teeth grinding; it may also involve clenching the teeth when we are concentrated or irritated, or habits such as biting the tongue or keeping the jaw fixed and rigid in the same position (in other words, bruxism can also occur without dental contact).

Bruxism is classified according to when it occurs: awake bruxism, when the person is awake, and sleep bruxism, when the person is asleep. However, bruxism is usually mixed, meaning that people who clench or grind their teeth at night almost always do so during the day as well.

Teeth grinding can seriously impair sleep quality, cause headaches, and lead to fractures in teeth, implants and crowns. It may also cause severe pain in the chewing muscles, intense ear pain and, in more serious and untreated cases, jaw locking, as well as tension in the muscles of the head, back and neck.

It is important to remember that bruxism is a habit and, as such, most people may not realise they do it. Often, individuals present a series of symptoms and signs without being aware that they are related to bruxism.

What are the symptoms?

There are several signs that may indicate bruxism, and not all of them are located in the mouth. Some professionals specialise exclusively in this area, such as dentists who work with temporomandibular disorders, orofacial pain or occlusion. You should consult one of these professionals if you notice:

• Grinding or clenching the teeth forcefully

• Tongue and cheek marks or bites

• Worn or fractured teeth, tooth mobility and sensitivity, gum sores

• Fillings, crowns or implants frequently becoming loose

• Teeth shifting or misaligning in adulthood

• Pain or discomfort in the facial muscles

• Headaches

• Temporomandibular joint dysfunction (clicking, pain, difficulty opening the mouth or limited movement)

• Snoring or sleep apnoea

What are the causes?

In most cases, teeth grinding is caused by:

• Anxiety, tension and sensitivity to stress

• Neurological disorders (e.g. Parkinson’s disease, epilepsy)

• Sleep disorders (snoring and sleep apnoea)

• Gastro-oesophageal reflux

• Medications (such as certain antidepressants)

• Excessive coffee consumption

How is it diagnosed?

Teeth grinding produces a characteristic sound, and often the person who sleeps in the same room as the individual with bruxism is the one who raises the alarm – but this is only one type of bruxism. Bruxism can be “silent”, which is believed to be the most prevalent and most damaging form, progressing over time without the person being aware of it.

Clinical diagnosis of bruxism is made by a doctor, based on the patient’s history (signs and symptoms) and various examinations.

How can it be prevented?

Treatment depends on the causes and must be individualised. It may include:

• Medication for anxiety (such as anxiolytics)

• Psychotherapy

• Exercises / relaxation techniques

• Occlusal splints (bite guards)

• Sleep hygiene measures

• Reduction or avoidance of caffeine, tobacco and alcohol consumption (central nervous system stimulants)

It is important to understand that if the cause is sleep apnoea, bruxism can be treated by addressing the underlying cause, namely sleep apnoea, using a mandibular advancement device or CPAP.

If the cause of bruxism is gastro-oesophageal reflux, treating this condition with the support of a gastroenterologist may eliminate the bruxism.

Important!

Children of parents with bruxism are more susceptible to being affected; however, genetic markers are still unknown.

Nevertheless, it is not normal for children to grind their teeth. You should consult an ENT specialist (otolaryngologist) to assess possible respiratory problems and/or a psychologist to evaluate excessively high levels of anxiety.