Bruxism is the involuntary clenching, grinding and gnashing of the teeth, with about half of people doing this from time to time. Five percent of people regularly grind their teeth in a very forceful way and the majority of the time it happens during sleep.
Bruxism is the grinding or clenching of teeth at other times than for the eating of food. The forces that are generated can be as much as six times the forces generated by normal chewing, which can damage the teeth, fracture them, cause them to ache, and lead to overactivity and an increase in the size of the jaw muscles, as well as pain in the jaw joint.
Most people do not realise that they grind their teeth in their sleep.
- Teeth grinding or bruxism is an involuntary clenching and grinding of the teeth, usually during sleep.
- Causes can include stress, anxiety, concentration, poor sleep patterns, or excessive physical activity in the evenings
- Treatments include custom made occlusal splints also called night guards which are worn at night, repair of tooth damage, muscle-relaxant medication and stress management therapy, if required
- The muscle relaxant Botulinum Toxin Type A can be directly into injected into the masseter muscle (the large muscle that moves the jaw), so that the muscle is weakened enough to stop involuntary grinding of the teeth and clenching of the jaw. This relaxes the muscle and reduces the wear and tear on the teeth due to grinding and amage to the TMJ (temporomandibular joint) and headaches should be reduced or eliminated as well, while voluntary movements, such as chewing and facial expressions, are not affected, and typically lasts for three to four months.
If you think you grind your teeth, see your dentist as soon as possible, where they will look at your teeth and talk about treatment options to
- repair any damaged teeth
- assess the bite and adjust any areas where fillings may be too high
- prevent further wear and tear by creating a custom made occlusal splint to wear at night
Other treatments to manage teeth grinding are
- stress management
- relaxation techniques
- psychological therapy
- regular exercise
- medication that relax the muscles.
about OCCLUSAL SPLINts
Occlusal splints and night guards are removable devices that are made by a dentist and technician to fit over the teeth to prevent the wearing away of teeth during sleep due to night time grinding and clenching.
- Occlusal splints have ramps or indentations built into them to limit the movement of the lower jaw to eliminate damage to the jaw joint
- Most splints function by separating the teeth so that pressure cannot be applied to the tooth structure
They provide the dentist with diagnostic information so that the way the splint is wearing allows the dentist to analyse and diagnose the amount and position of wear areas on the splint
They allow muscles that are in spasm to relax
They protect the teeth and jaws from excessive wear and tear
They limit the stress on the teeth and jaw joint
They can allow repositioning of the jaws into a bite that places less forces on the teeth
They can show interferences of teeth in the bite that might cause the jaw muscles that close the jaw to become overactive, with very small interferences with the fullness of fillings causing changes in jaw muscle activity
They promote muscle relaxation by providing a platform for the teeth that allows equal tooth contacts
They immediately separate the back teeth in all movements to reduce stress on the jaw joint
They allow harmony of the nerves and muscles in the jaw and jaw joint that allow for optimal function and comfort
TMJ DISORDERS AND MUSCLE RELAXANT INJECTIONS
Disorders of the jaw joint, or TMJ (temporomandibular joint) are not uncommon and may lead to symptoms of pain and discomfort in the jaw called temporomandibular dysfunction (TMD) . Patients may complain of earaches, headaches and a limited ability to open their mouth. Other symptoms can include clicking, popping or grating sounds in the jaw joint, pain when opening and closing the mouth, a general tightness and pain in the muscles of the jaw, or broken teeth due to the excessive forces.
Muscle relaxant injections in the jaw muscles are a proven treatment option for targeting and treating excessive muscle activity. Other treatments, such as anti-inflammatory medications and occlusal splints or night guards may not address the source of the issue. Custom made occlusal splints are able protect teeth from damage at night for teeth grinders, but they may not fully stop the painful side effects because some people continue to grind away at their splint.
By injecting small doses of Botulinum Toxin Type A muscle relaxant directly into the masseter muscle (the large muscle that moves the jaw), the muscle is weakened enough to stop involuntary grinding of the teeth and clenching of the jaw. This relaxes the muscle and reduces the wear and tear on the teeth due to grinding and amage to the TMJ (temporomandibular joint) and headaches should be reduced or eliminated as well, while voluntary movements, such as chewing and facial expressions, are not affected.
Although muscle relaxant injections are not a cure for bruxism, they can effectively control the uncomfortable symptoms better than a night guard for some patients. Botox used for treating bruxism typically lasts for three to four months.
Night time grinding can lead to the permanent loss of tooth structure, and breakdown of teeth which may require extensive reconstruction of the entire bite.
symptoms of teeth grinding
- grinding sounds of the teeth while asleep
- headache, ear pain or jaw joint pain
- aching teeth, especially when waking up
- ache or stiffness in the jaw especially when waking up or eating food in the morning
- clenching the jaw when anxious or concentrating
- sensitive teeth
- cracked, chipped or broken tooth enamel
- tooth indentations on the tongue
- raised tissue on the inside of the cheek or scar tissue caused by biting
- loose teeth in extreme circumstance
- cracked tooth enamel or dentine
- more wear and tear on the teeth than would usually be seen
- broken teeth or broken fillings or crowns
- strain on the jaw joint
- pain in the jaw joint and limited movement
- tenderness or aching in the jaw muscles
- tooth loss is rare, however teeth can fracture under the forces of grinding
- enlargement of the jaw muscles due to grinding
- a square looking jaw
- emotional stress, such as anxiety
- mental concentration
- physical stress, such as illness, poor nutrition or long-term pain
- some dental treatments, such as fillings that are too full in the bite
- recreational drug use (especially metamphetamines and ecstasy)
- some pharmaceutical medications