Teeth clenching or teeth grinding can start when you feel anxious or stressed. The action is involuntary and can occur during the day or at night. Is there a way to control these involuntary movements? Can you permanently stop teeth clenching and grinding?
Bruxism, or grinding/clenching of teeth, can be bothersome. But it can be managed well with psychological and pharmacological treatments.
If you are experiencing symptoms of bruxism, consult your dentist and primary healthcare provider.
Bruxism is a condition in which a person experiences abnormal teeth movements such as grinding and clenching. Bruxism, as defined by the Glossary of Prosthodontic Terms, is the parafunctional grinding of teeth.
It is also defined as “an oral habit consisting of involuntary rhythmic or spasmodic non-functional gnashing, grinding, or clenching of teeth, in other than chewing movements of the mandible, which may lead to occlusal trauma.”
The grinding or clenching of teeth can occur during sleep or while you’re awake. These are considered two separate conditions. In the first, awake bruxism occurs during the day with signs of clenching activity, usually related to stress from the pressures of life.
In the second condition, bruxism occurs during sleep, whether during the day or at night. This type is characterized by a stereotypic movement disorder that occurs while you are sleeping, while clenching and/or grinding your teeth.
Risk factors for Bruxism
Risk factors for bruxism can be put into three groups: pathological, demographic, and psychosocial factors.
- Reflux esophagitis (when stomach acid flows into the esophagus).
- Sleep apnea syndrome (pauses in breathing).
- Nocturnal frontal lobe epilepsy (a rare form of epilepsy).
- Female gender.
- Military service.
- Social phobias.
- Emotional stress.
Recent studies have focussed on various disorders of the neurotransmitter system, in which chemical messages in the body send signals from nerve cells to your muscles, glands, and other parts of your body.
It’s been shown that basal and subcortical ganglion pathway dysfunction plays an important role in causing disturbances in the coordination of tooth/jaw movement in people who have bruxism, including those who have movement disorders such as Parkinson's disease.
It’s also known that dopamine can disrupt teeth clenching and grinding. A drug called L-dopa, which is a dopamine precursor, can be used to minimize bruxism.
In addition, psychosocial factors can also cause clenching or gnashing of teeth. There is an increased risk of bruxism in people experiencing depression and stress, as they’re more anxious than normal.
Children and adolescents have some additional risk factors are associated with bruxism:
- Increased media consumption.
- Bad dietary habits.
- Noise in the child’s room.
- Sleeping with the lights on.
- Trouble falling asleep.
- Somniloquy (talking in their sleep).
- Respiratory diseases.
Teeth clenching and/or grinding can be managed through lifestyle management and self-prevention at home.
As stress can trigger bruxism, managing the level of stress and anxiety you feel is a crucial preventative strategy. Relaxing your body by using progressive muscle relaxation, taking a warm bath, and doing light exercise can help to prevent bruxism.
You should also improve your sleep quality to prevent bruxism. Don’t consume substances that stimulate adrenaline, such as coffee and tea due to their caffeine content.
For children and adolescents, promoting sleep hygiene is a critical factor. Reduced noise levels, dimming the lights at night, and reduced media consumption are some measures that parents and guardians can encourage to promote a good night’s sleep in youngsters.
It’s important to have regular dental check-ups at least every six months to determine the best strategies to prevent teeth clenching and/or grinding. Your dentist can evaluate the condition of your jaw and mouth to determine the best preventive measures.
For example, your dentist can prescribe an occlusal splint made of hard acrylic resin to be used to protect your teeth from bruxism.
Treating clenched and/or gritted teeth should be multipronged.
Physical therapy has been widely applied for the treatment of bruxism, consisting of relaxation exercises, massage, moist heat, microwave lasers, and electrotherapy. These methods are useful for massaging the muscles to reduce tension, improve blood circulation, prevent adhesions of gum tissue, and reduce pain in the jaw and mouth.
Treatment of bruxism may also include psychotherapies or counseling. This might include training to change behavior and thinking patterns. Calming the mind and reducing stress can lower the risk of bruxism. Most specialists recommend that psychotherapies should last for three to six months.
Another mind-body technique to manage bruxism is the biofeedback method. In this treatment, a patient is trained to manage their responses to a given stimulus in the form of visual, audio, or vibration. Biofeedback-based cognitive behavioral therapy can increase awareness of body functions and responses, reduce jaw muscle tension, and minimize the severity of bruxism.
Contingent electrical stimulation (CES) has been employed to reduce masticatory (chewing) muscle activity and tension associated with sleep bruxism. In CES, low-level electrical stimulation is applied to the active jaw muscles during teeth clenching and/or grinding. This procedure aims to reduce the episodes and severity of bruxism.
When the severity of bruxism is high, medication is required to treat the condition.
Several dopamine agonists, anti-epileptic drugs, non-benzodiazepine hypnotics, anxiolytics, buspirone, and botulinum toxin can be used for this purpose.
For example, botulinum toxin, which functions as an inhibitor of acetylcholine release at the neuromuscular junction, can reduce teeth clenching and/or grinding through a paralytic effect on the jaw muscles. Botulinum toxin injections for 20 weeks showed significant bruxism reduction.