Oral Appliances for Grinding/Bruxism
Teeth in pain due to grinding
What is Grinding/Bruxism?
Bruxism is the clenching or grinding of teeth, or both simultaneously. It often happens during sleep but it can also occur when you are conscious. Most people are unaware of this habit.
What causes bruxism?
Bruxism is correlated with stress, anxiety and poor sleep quality. Driven and motivated personality types are more likely to suffer from bruxism. The American Academy of Sleep Medicine has classified sleep bruxism as a type of sleep movement disorder, similar to sleep walking.
Bruxism is also associated with obstructive sleep apnea as well as upper airway resistance syndrome, and is common in patients who breathe through their mouth and snore.
Patients with nocturnal gastric reflux are also at risk. Gastric acid softens the tooth surface and accelerates the rate of tooth wear.
14%-17% of children may grind their teeth. This persists into adulthood in about 8% of cases. 20%-50% of bruxers have a family history of bruxism.
What damage does bruxism cause?
Over time, bruxism wears away the surface of the teeth causing disfigurement of the teeth and the bite. If you have worn teeth, you may be prone to:
- Sensitive teeth
- Hairline cracks
- Tooth fractures
- Frequent breakage and accelerated wear of fillings and crowns
- Implant loosening/breakage
- Frequent headaches
- Ear ache
- Jaw pain
- Facial and neck pain
- Overgrowth of jaw muscles leading to a square jawed appearance
Hairline Cracks
Headaches
Treatments for Bruxism
Mouthguard
Dental Orthotic
The most common method to manage the effects of bruxism is the use of a custom-fitted mouth guard during sleep. The mouth guard helps protect your teeth from being worn down even more and distributes the grinding force over the plastic surface. Patients with severe bruxism may even wear through the mouthguard in a matter of months.
In some instances, orthodontic treatment may help to reduce the harmful effects of bruxism by creating a balanced bite with well aligned teeth ensuring that forces are distributed evenly.
Patients with suspected sleep or airway issues should be assessed urgently by a sleep physician or ENT specialist.
Patients with gastric reflux should also be managed by a GP or gastroenterologist.
Botox injected into the masseter muscles or temporal jaw muscles can help reduce pain from recurrent headaches caused by bruxism. Botox also weakens the muscles so that less tension can be generated which also makes the grinding less severe.
Teeth that have been excessively damaged by grinding can be restored with crowns and/or onlays, to restore the tooth to a healthy state.
Frequently
Asked
Questions
Got questions? We’ve got answers! Check out our FAQ section for common inquiries and helpful information to guide you.
What are the signs and symptoms of bruxism?
Common signs and symptoms include tooth grinding sounds during sleep, tooth wear with exposed dentin, morning masticatory muscle fatigue or tenderness, and masseter muscle hypertrophy. Other manifestations include tooth sensitivity, gum recession, persistent headaches, ear pain, and tinnitus.
Patients may also experience jaw muscle pain, jaw locking, hypersensitive or painful teeth, and fracture of restorations or teeth.
How is bruxism diagnosed?
Diagnosis of bruxism typically comes through self-report or caregiver report, clinical examination, and in some cases, polysomnography (sleep study). Clinical examination assesses the presence of abnormal tooth wear, wear facets, or chipped teeth. For a more definitive diagnosis, full-night polysomnography with electromyographic (EMG) recording of masseter muscle activity can be performed.
What are the complications of untreated bruxism?
Untreated bruxism can lead to significant tooth wear and damage, temporomandibular disorders (TMD), tooth sensitivity, gum recession, and persistent headaches. Other complications include masticatory muscle hypertrophy, tooth surface loss, fracture of restorations or teeth, hypersensitive or painful teeth, and loss of periodontal support.
Severe bruxism can result in significant consequences including tooth damage, jaw pain, fatigue, and headaches. While mild bruxism may not necessitate treatment, severe cases can negatively impact oral health-related quality of life. The co-occurrence of bruxism with temporomandibular disorders may worsen pre-existing headache conditions.
What are the treatment options for bruxism?
Treatment options include occlusal splints (night guards), botulinum toxin injections, behavioral strategies, and in some cases, medications. Occlusal splints, both conventional and 3D-printed, are widely studied for their ability to reduce nighttime muscle activity and protect teeth from damage. These devices help distribute occlusal forces and alleviate symptoms, though their effectiveness varies depending on design and material.
Botulinum toxin type A has been examined as a treatment option, particularly for reducing pain and muscle activity in patients with bruxism, though evidence of efficacy remains inconclusive. Behavioral strategies include biofeedback, relaxation techniques, and improvement of sleep hygiene. Initial treatment often focuses on treating underlying anxiety and/or depression and improving sleep quality. A multidisciplinary approach combining different therapies may yield the best results.
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