Bruxism is a condition whose main symptom is jaw clenching, which leads to teeth grinding. The symptom is more common at night and is an unconscious habit called nocturnal bruxism. There are people who have this habit during the day as well – daytime bruxism. Today we will talk about both.

For the most part, bruxism remains undiagnosed until dental problems have arisen against the background of the condition. Or until the sleeping partner reports this problem, because it prevents him from resting.

What is bruxism?

Bruxism is a condition that belongs to the class of parafunctional actions, that is, without a functional role, such as speech, chewing or swallowing. Lip biting, cheek biting, reddening of various objects such as the tips of pencils or pens, eyeglass handles, and reddening of nails are actions that belong to the same parafunctional class.

Night bruxism, daytime bruxism

Nocturnal bruxism, named by many for its primary symptom, involuntary teeth grinding during sleep, is a condition characterized by teeth grinding or clenching during periods of rest and sleep.

This is the most common type of bruxism, but also the most difficult to diagnose. As a rule, the diagnosis is made only after dental problems arise due to the grinding of tooth enamel, or if the problem is noticed by family members who hear the noise created by the grinding of the teeth at night.

Daytime bruxism (that is, daytime) happens less often, a person can realize his behavior and seek help. A symptom of this type of bruxism, which occurs during the day, is represented by continuous biting of the lips or cheeks, biting pens, pencils or eyeglass frames, or even nails.

What other symptoms occur with night bruxism?

The main symptom of this condition occurs during sleep, so a person suffering from nocturnal bruxism does not know that they suffer from this sleep disorder. However, you should pay attention to certain symptoms that may occur during the day.

It:

• facial pain;
• pain and stiffness of the jaw;
• jaw cracking while eating;
• aching headache during the day;
• tooth sensitivity or cracked/lost teeth.

Some people also complain of ear pain. The explanation is that the joint that allows you to open and close the jaw is very close to the ear.

What are the symptoms of daytime bruxism?

Daytime bruxism is different from nighttime bruxism. Daydreaming is not a sleep disorder, instead it is an involuntary habit. This does not cause grinding of the teeth, but a strong tension of the muscles around the jaw.

Here are all the symptoms:

• pain in the jaw area;
• aching headaches;
• stiffness of the jaw muscles.

What are the causes of bruxism?

Bruxism does not always have a single or identifiable cause, but we can talk about certain factors that are associated with this condition. Depending on the causes, experts divide bruxism into primary and secondary.

Primary bruxism, which occurs without the influence of another disease, can be caused by:

• teeth growth This is common in young children (according to one study, it occurs in almost 40% of teething children). In their case, bruxism usually goes away on its own without causing lasting damage;
• malocclusion (in medical language: malocclusion). This happens either to people with misaligned dental arches or missing teeth;
• bad habits that irritate the mucous membrane of the oral cavity. Here we are talking about smoking, drinking alcohol, coffee or drugs – all these can be factors that affect the appearance of bruxism. According to a 2016 review, people who regularly smoke and drink alcohol have almost twice the risk of developing bruxism; also drinking more than 8 cups of coffee per day increases the risk of developing this condition by 1.5 times;
• stress. A 2020 review shows that one of the main causes of nocturnal and daytime bruxism in adults is stress.

Secondary bruxism occurs as a result of another disease, for example:

• anxiety and depression. The existence of bruxism has been observed in people suffering from anxiety and depression, and this relationship may be largely related to stress, an important factor in triggering the aforementioned conditions;
• neurological conditions. Parkinson’s disease or Huntington’s disease are two neurological conditions that cause movement during sleep, which can lead to bruxism;
• certain medications Bruxism can be a side effect of some medications, such as antidepressants and antipsychotics. In fact, a 2018 study found a link between selective serotonin reuptake inhibitors and bruxism. Of all the drugs included in the study, fluoxetine (Prozac) and sertraline (Zoloft) were the most common culprits;
• apnea Sleep apnea is a condition that causes temporary cessation of breathing during sleep. In addition to affecting sleep quality, it can trigger bruxism.

How is bruxism diagnosed and by whom?

Worn tooth enamel, enlarged jaw muscles, dull, broken or chipped teeth, as well as broken or damaged tooth crowns are all symptoms that a dentist can use to diagnose bruxism.

How is bruxism treated?

If we are talking about primary bruxism, then avoiding risk factors is the best way out. If we are talking about secondary bruxism, then the first option is to solve the medical problems that led to the appearance of bruxism.

Treatment of secondary bruxism

Usually, treatment for anxiety and depression includes psychotherapy and medication to reduce symptoms, but because some medications specific to these conditions can cause bruxism, many experts recommend starting treatment with psychotherapy. In the case of a person with sleep apnea, treatment for secondary bruxism may involve the use of an appliance that continuously presses on the airway to prevent sleep interruptions.

Wearing a mouth guard to reduce tooth friction

Your dentist may recommend wearing a mouth guard while you sleep to combat the primary symptom of nighttime bruxism. The mouthguard reduces pressure in the jaw area and acts as a barrier between the teeth, reducing teeth grinding and actual friction.

drugs

In addition to ibuprofen, which is used to reduce the pain associated with bruxism, your doctor may recommend medications that relax the jaw muscles and stop teeth grinding. Although this is short-term, it can reduce symptoms.

Biofeedback therapy

This is a form of therapy in which a person is helped to become aware of involuntary body movements and taught to control them. There isn’t much research on this therapy yet, but a 2018 study found that random electrical stimulation, a specific biofeedback therapy tool, reduced bruxism symptoms after a few nights of use.

Botox

Botox injections can be a solution in severe cases of bruxism, as this substance is known to paralyze the muscles responsible for bruxism. But this treatment is expensive, especially since regular interventions are needed to maintain the effect.

How can we prevent bruxism?

Preventing bruxism can be difficult because the exact causes of the condition are not always clear. However, there are some steps we can take to reduce the risk of developing or worsening bruxism. Here are some tips to prevent bruxism:

• Manage stress. Learn stress reduction techniques such as meditation, yoga, breathing exercises, or other relaxation activities to help you feel more balanced.
• Avoid excessive use of stimulants. Reduce or avoid caffeine, alcohol, and tobacco, as these substances can worsen bruxism.
• Schedule time to relax before bed. Create a relaxation ritual before bed, such as reading, listening to soothing music, or taking a warm bath.
• Avoid biting objects. Certain habits, such as chewing a pencil or chewing gum excessively, can increase the tension in the jaws and make bruxism worse. Try to be attentive to your gestures and avoid such behavior.
• Avoid chewing solid food before bed. Do not eat foods that require a lot of effort to chew, such as chewing gum or nuts, before going to bed, as they can stimulate the bruxism reflex.
• Use the chute. If your dentist thinks you are prone to bruxism, they may recommend wearing a mouth guard at night. This protects the teeth from wear and tear and can help relax the jaw muscles.
• Avoid clenching your teeth during the day. If you involuntarily clench your teeth during the day, become aware of this habit and force yourself to relax your jaws.
• Check the dental bite. If you have problems with your bite, see your dentist to see if correcting your bite can help prevent bruxism.
• Consult a specialist. If bruxism is associated with other problems, such as sleep apnea or other medical disorders, see a specialist doctor for proper treatment.
• It is important to be aware of any symptoms or signs of bruxism and speak to your dentist or GP for proper assessment and advice according to your situation. In some cases, bruxism can be effectively managed with lifestyle changes and relaxation techniques, while in other cases, specialized treatment may be required. (Photo: Dreamstime.com)