Teeth Grinding

What is teeth grinding?

Teeth grinding is the most obvious form of bruxism, which is an excessive muscular activity that results in prolonged and extremely vigorous contact between the teeth, unrelated to normal function, such as eating or talking. It usually happens at an unconscious level during sleep, but it can also occur during the daytime.

Bruxism can become a health concern as it wears away dental substances very quickly. It can also trigger the onset of other conditions such as chronic pain, toothache, headaches and tinnitus. It can affect people at any age.

Symptoms of teeth grinding

People who grind their teeth are usually not aware of the condition, either because they have no symptoms or do not associate the symptoms with the grinding condition. However, the signs and symptoms are numerous and can be spotted:

• Grinding noise during sleep – usually perceived by a partner or parent.
• Tooth wear with a specific pattern, easily spotted by a dentist.
• Cheek/tongue biting may be associated with bruxism
• Restricted mouth opening – particularly noticeable when at the dentist!
• Cracked teeth – especially in the case of clenching. Cracks can be inoffensive at first but could turn out catastrophic.
• Chronic and idiopathic pain (meaning pain of unknown origin) around the jaws/ear/neck. Recent research suggests that this seems to be more related to daytime bruxism, i.e., clenching.
• Broken restorations – bruxism is usually the dentist’s enemy number one!
• Indentations of the teeth in the tongue
• Hypertrophy (increase in size) of the chewing muscles and of the jaw bone.
• Inflammation of the periodontal ligament, can lead to tooth mobility.

What causes teeth grinding?

The cause of this condition is not fully understood. The factors are still debatable but the ones that seem to be more predominant are:

• Psychosocial risk factors, such as a stressful lifestyle, work responsibilities, intense intellectual activity, etc.
• Emotional stress and anxiety

• Sleep disorders such as sleep apnoea and snoring
• Genetics – some studies suggest that bruxism can run in the family
• Recreational and prescribed drug use – alcohol, cocaine, meta amphetamine, dopamine agonists, etc
• Malloclusion, meaning less than ideal contacts between upper and lower teeth, has been described as a factor, but this is highly debatable. What seems to be more widely accepted is that certain occlusal sub-optimal patterns, whilst probably not causing bruxism, make their consequences worse.

How to treat teeth grinding

Early diagnosis is essential mainly to avoid damage to teeth and restorations. As it is a condition still not fully understood, treatment to prevent further damage should be based on conservative and reversible approaches. The most important step for the patient is to understand the diagnosis and to learn to self-manage the condition. The following can be taken into account:

• Nocturnal teeth grinding occurs at an unconscious level and it’s unlikely we can modify it efficiently. In some patients, attempts to reduce stress levels and improve the quality of sleep may be useful.
• The consequences of grinding are felt mainly by the teeth, so protecting them with a highly precise night guard, designed and delivered by your dentist, can be crucial in order to avoid excessive tooth wear through the years. Remember, a tooth cannot grow back and all of its wear is irreversible.
• Book regular dental check-ups to monitor the impact of bruxism on your teeth. Photographs taken at different stages in your life will be extremely useful.
• Daytime bruxism (usually in the form of clenching) can be simply avoided, once brought to the attention of the individual. Becoming aware that your teeth should not be in contact except during eating and talking can make a big difference in symptoms.
• In severe cases of pain, fortunately not so common, painkillers, anti-inflammatories, heat therapy, Botox, massages, etc can be recommended.