Teeth grinding and teeth clenching are conditions that affect a large percentage of the population, both children and adults. People with bruxism are unconsciously clenching or grinding their teeth together while awake or asleep, more often when they feel anxious or tense.
Many people are not aware that they have a bruxism problem because they grind/clench their teeth at night while asleep, without realizing it until they (or their dentists) notice signs of tooth or jaw damage caused by the disorder.
Tooth grinding or clenching that occurs at night is called sleep bruxism. Sleep bruxism is often the bigger problem because it is harder to control.It is one of the most common sleep disorders, especially in children and during periods of stress.
Teeth clenching is a condition when you tightly hold your top and bottom teeth together, especially the back teeth. Most people clench their teeth when they perform tasks that require intensive force. The real problem is when :
teeth clenching becomes a habit. Some people clench their teeth even for mental tasks; others while just watching tv.
teeth clenching happens during the night. Besides the problem of not realising the habit, during sleep, the biting force is usually much greater than the pressure of clenching while awake.
Clenching puts pressure on the muscles, tissues, and other structures around the jaws. This can be the cause of TMJ disorder related symptoms as jaw pain and soreness, headaches, damaged teeth, and other problems.
Teeth grinding is a condition when the teeth of the bottom and upper jaw are moved against each other with a side to side action. This can wear down the occlusal (biting) surfaces of the teeth. In most cases, teeth grinding involves the front teeth, canines and incisors.
Nighttime teeth grinding can be noisy enough to be a real annoyance for sleeping partners. Like clenching, grinding can lead to jaw pain and other problems.
Bruxism is an occasional problem of little consequence for most people. But for others, teeth grinding and/or teeth clenching can cause permanent damage to the teeth and TMJ disorder problems.
Related pages : Causes of Bruxism Treatments for Bruxism
Signs and symptoms of bruxism
Symptoms of bruxism, can vary from mildly irritating to dangerous for both dental and physical health, depending on the severity of the condition.
In most cases, bruxism doesn’t cause serious complications and because grinding often occurs during sleep, most people are unaware that they grind their teeth.
Early diagnosis of damage caused by severe bruxism often includes the following symptoms :
Worn down teeth abraded teeth
A person can actually grind their teeth so hard while asleep, that sometimes significant amounts of tooth structure can be lost over time.
Usually it is the canines and incisors that are moved against each other in a side to side action. This abrades tooth enamel, removing the sharp biting surfaces and flattening the edges of the teeth. The front teeth become worn to exactly the same length and the teeth look flat at the tips.
If bruxism involves the back teeth, worn cusp tips is a first symptom. In some cases the loss of tooth enamel is even more than in severe tooth decay. Damage to the tooth enamel makes it easier for bacteria to penetrate to the softer part of the teeth, increasing the possibility of tooth decay and tooth fractures.
Fractures of teeth or fillings is a common symptom in bruxism patients.
Teeth clenching puts teeth under high pressure. As a result, the edges of front teeth and the cusps of molar teeth may start to show micro-fractures or cracks. Eventually the teeth will break. In some cases the fracture goes deep down to the pulp area causing acute pain (creacked tooth syndrome), requiring a root canal treatment.
Teeth grinding wears down the enamel, weakening the tooth structure. The force applied during teeth grinding may make the tooth structure to collapse, especially if it has restorations (fillings or crowns) due to previous tooth decay.
Tooth sensitivity Teeth become sensitive to cold, pressure and other stimuli. Worn tooth enamel exposes the softer part of the tooth the dentine- making the affected teeth susceptible to tooth sensitivity problems.
Loose teeth Increased teeth mobility Teeth grinding keeps teeth under constant lateral motion. Although the motion is minor, by time it may lead to loss of supporting bone around the teeth resulting in loose teeth.
Bony ridges – Instead of losing bone support – some people actually develop “extra” bone to support the teeth. These appear as bony ridges that can be seen and felt on the jawbones as a smooth raised area about at the level of the roots.
Cheek or tongue irritation – It is common for people with a bruxism problem to bite their tongue or inner cheek, especially close to the molars area.
Annoying sounds while sleeping – Teeth grinding may be loud enough to annoy other family members and especially sleeping partners.
TMJ problems – Chronic bruxism is one of the leading causes of TMJ syndrome. Some of the symptoms of temporomandibular joint disorders, that could be caused by bruxism, are :
– Sore jaw muscles facial pain around the jaw or ears area when chewing.
– Frequent headaches or pain in the neck or shoulders
– Clicking, locking or popping in the temporomandibular joint (TMJ).
– Ringing in the ears.
Usually the bruxism patient is unaware of his problem, until the accumulated problems slowly lead to more severe problems.
Many of the bruxism symptoms may resemble other conditions or medical problems. Consultation of a dentist or physician is necessary for correct diagnosis.
Diagnosis of bruxism
As bruxism initially causes minor symptoms, people with sleep bruxism usually aren’t aware of their habit or ignore it, until serious complications occur. Therefore, it is important to visit your doctor or dentist if you notice unusual wear of your teeth or pain in your jaw, face or ear or any other bruxism symptom. But none of these symptoms provides a 100% accurate diagnosis.
During regular dental visits and examinations, your dentist will check for physical signs of bruxism.If symptoms are present, the dentist will observe the condition for changes over the next several visits before a treatment program is established.
If you suspect that you have bruxism you can have a polysomnographic test performed. This tests looks for evidence of jaw muscle activity during the sleep.
A device called the BiteStrip enables at-home overnight testing for sleep bruxism and might help diagnose bruxism before damage appears on the teeth. The device is a miniature electromyograph machine that senses jaw muscle activity while the patient sleeps. A dentist can establish the frequency of bruxing, which helps in choosing a treatment plan.
Another approach is the BruxChecker, a comparatively non-invasive, thin, transparent, polyvinyl chloride plate, painted red. Tooth grinding leaves clear marks on this thin plate, thus serving as confirmation of the bruxism diagnosis.
Early diagnosis of bruxism problems is very important in order to minimize long-term damage to the teeth and jaws.