The Nightly Grind: Diagnosing & Treating Sleep Bruxism

Dentist Blog

Bruxism is the medical term for teeth grinding, and it is one of the more common conditions in the field of health. Despite this, many sufferers of bruxism will never seek treatment. This is because bruxism often occurs only while the sufferer is sleeping, a condition known as sleep bruxism.

The damage caused by nocturnal grinding over a period of months or years is gradual, but can become very serious, and in too many cases a sufferer only begins to realise that they are grinding their teeth while they sleep when serious tooth damage occurs. For this reason, knowing the symptoms of sleep bruxism is very important.

What are the symptoms of sleep bruxism?

• Tooth wear: The most obvious symptom, caused by the teeth rubbing against each other as well as pressure creased by tension in the jaw. You may notice flattening of the biting surfaces, particularly in the incisors and premolars, and in advanced cases small patches of enamel may be completely worn away to expose the dentin below. This wear also applies to fillings, veneers and other dental implants.
• Sensitive teeth: A side effect of enamel loss caused by wear. Sensitivity to both heat and cold are possible symptoms.
• Tooth fractures: A result of excessive, untreated tooth wear. This may be something as noticeable as a chipped incisor, or as subtle as hairline cracks around the base of the tooth, close to the gum line. Inspect your teeth thoroughly and regularly.
• Cheek and tongue biting: Pretty self-explanatory. Check for painful indentations or broken skin.
• Muscle and ligament tension: This is caused by constant tension in the muscles of the cheeks and jaw. You may find opening your mouth difficult or painful. Headaches caused by facial muscle tension are also possible.

If you suspect you are grinding your teeth during the night, checking for these symptoms as soon as you wake up is important, as they may wear off within a matter of minutes. If you sleep with a partner, ask them to check on you while you sleep for signs of bruxism. The most obvious sign is a surprisingly loud clicking noise coming from the mouth.

How can you cure sleep bruxism?

This is a difficult proposition, as the causes of sleep bruxism remain largely unknown. There is mounting evidence that the condition has roots in psychological distress, as well as genetic factors that may come into play, but until a definitive cause has been ascertained, treatment largely consists of management of symptoms i.e. repairing damage that has already been done and preventing more from occurring. Common treatments include:

Dental guards: These devices resemble the mouth guards used by boxers, but are generally more close-fitting so they don't become too obtrusive to sleep in. These guards prevent the teeth from wearing against each other, but must be crafted for your teeth specifically to be effective - a dentist or dental professional will take a mould of your teeth for this purpose. Make sure to have them replaced if and when they become too worn to protect the teeth.

Psychological treatments: Stress in your day-to-day life has been linked with sleep bruxism, and reducing levels of stress during the day can potentially stop bruxism altogether. This may be as simple as taking up yoga or having a hot bath before bed, or as in-depth as professional cognitive behavioral therapy.

Medication: A variety of medications can help, such as anti-convulsants, muscle relaxants and antidepressants. However, a clear link between any specific medication and reduction of sleep bruxism is hard to come by, so you may be prescribed various drugs in the hope that something sticks. You may also receive pain medication.

Dental reconstruction: Existing damage caused by untreated bruxism can usually be treated in the same ways as other dental damage. Contact a clinic like Bright Smile Dental Clinic to learn whether or not you qualify.

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14 May 2015