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BRUXIUM
Nighttime grinding habits may wear away tooth enamel "ten times faster." *

      Bruxism is commonly know as tooth grinding, is the clenching together of bottom and upper jaw accompanied by the grinding of the bottom and upper jaw followed by the grinding of the lower set of teeth with the upper set. 

This behavior will:

  • Remove critical portions of healthy enamel from the chewing surfaces of your teeth 
  • May cause facial pain.

     People who grind and clench their teeth are called bruxers. This condition is found in 20% of adult population during waking hours and 8% during sleep, and up to 18% of children. These individuals unintentionally bite down too hard at inappropriate times like when they sleep, especially in the early part of the night. 

TMJ/TMD have to do with jaw joint discomfort

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     During sleep, the biting force (the force at which the jaws clench together) can be up to six times greater than the pressure during waking hours. Nighttime bruxer's teeth can grind up to 40 minutes for every hour of sleep, with as much as 250 pounds of force per square inch (this is enough force to crack a walnut!). 

Clenching by contrast (pressing the teeth together) is more a waking activity.  While equal numbers of women and men brux during sleep, more women clench their teeth during the daytime which may be do their vigilant reaction to stimuli perceived by the conscious mind. Bruxing is like clinching your two fists and holding them tightly against each other. This behavior would cause you to end up with sore hands, arms and shoulders. Well this same thing happens to your jaw muscles.

Grinding teeth can cause damaging wear, shorten teeth and a poor bite.

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    Bruxism is a force that is far more destructive to teeth than caries because your teeth are worn down so much that their enamel is rubbed off, exposing the inside of the tooth called dentin. This exposed dentin will become sensitive. About one in four people suffer from at least on of the following:

Symptoms: A person may have one or a combination

  • Pain or discomfort often around the ears and when yawning or chewing

  • Tenderness of the jaw muscles

  • Clicking, locking  or popping in the jaw

  • Jaw muscle contraction, spasms or cramping

  • Jaw clenching and/or teeth grinding, severe or very loud

  • Headaches and neck aches

  • Ringing in the ears

  • Tooth indentations on the tongue

  • Fractures of teeth and fillings especially on front teeth due to the high pressure

  • Teeth sensitive to cold, pressure and other stimuli

  • No symptoms because bruxism can be a subconscious behavior that you do not realize you do it.

  • Teeth that look flat at the tips

  • Tooth enamel is rubbed off causing extreme sensitivity

  • Tongue indentations

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Top 10 clues for detecting bruxism

1) Flat canines
2) Abfraction
3) Popping, clicking, and pain in TMJ
4) Frequent headaches and/or migraines
5) Chipped, worn incisal edges
6) Worn cusp tips
7) Isolated bone loss
8) Cracked teeth
9) Broken restorations
10) Patient indicates stress and anxiety, or state they grind or clench


Rachel Teel Wall, RDH September, 2004
September 2004issue of RDH magazine for a detailed review of bruxism.

 

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Complications-Over the years bruxism takes it toll.  When we bite our teeth flex and rock a bit from the gumline which will eventually affect the way they sit in the gums.

  • Damage to teeth

  • Front teeth worn to exactly the same length

  • May awaken sleep partner

  • Break fillings or other dental work-a specific result of the tip of the tooth biting action

  • Worsening of TMJ dysfunction

  • Worsening of dental disorders

  • Limitation or difficulty in jaw movement,  jaw locks open/close

  • The tips of the teeth wear flat

  • Headaches

  • Tooth sensitivity 

  • Tooth mobility

  • Chip teeth

  • Erode gums and supporting bones

  • Micocracked teeth that may damage the nerve

  • Possible increase in acid reflux, due to altered saliva flow

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Don't chew on hard objects, it can lead to TMJ

Don't use your teeth to open or hold objects.

Causes:

  • Emotional stress

  • Allergies

  • Lifestyle reactions to anxiety

  • Personalities characterized are aggression, controlling, precise, nervous, competitive, or who have time urgency and achievement compulsion

  • Malocclusion (teeth that are not aligned properly)

  • Jaw, head or neck injury

  • Taking medications for: depression like Zoloft, Prozac, paxil, celexa, etc, developmental disorders and schizophrenia or drugs like ecstasy and cocaine especially seen  in sideways movement of jaws with teeth just touching during sleep 24/7

  • Central nervous system
    dysfunction.

  • Diseases such as arthritis or missing teeth
  • Alcohol and caffeine intake can aggravate this condition

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     Bruxium is common in children.  Three out ten kids will grind their teeth before the age of five.  This is offend due to their jaw growing or because they are losing and gaining new teeth.  Most out grow it by the teens when their permanent teeth are all in place.

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What a Grind

Reducing your caffeine intake may help keep nighttime teeth grinding and jaw clenching to a minimum.

Consuming stimulants such as caffeine appears to increase the risk of bruxism, a sleep disorder characterized by nighttime teeth grinding or jaw clenching that can damage teeth. If you grind, cut back on caffeine and see your dentist or doctor for more advice

Treatments:

There is no cure for bruxism.  Instead the condition is managed.:

  • The procedure we recommend to help alleviate the pain and discomfort from this condition is: 

                          Nightguard Protect Your Teeth
                                 Nightguards Home Care

  • Relaxation techniques such as yoga

  • Daily exercise

  • Biofeedback

  • Stay away from spicy food, caffeine and other stimuli in the pre bedtime hours

  • Careful choose your mattress+

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How do I know if my bite is incorrect?

The human body is an amazing thing.  Our bodies try to tell us when something is wrong.  Sometimes the communication can be immediate and precise.  On other occasions the body tries to tell us that something is out of balance but we can’t understand the clues we’re being sent.   

Bite problems can fall into either category.  An unbalanced bite can cause hard-to-ignore problems like muscle tension headaches.   Some bite problems cause problems that may be just as serious but are not as easy to spot, such as 

  • uneven wear of your teeth

  • loosening of teeth

  • even breakage of teeth or fillings.  

Here’s a good analogy;  you could have a fine car with  top-quality tires.  If the wheels are out of alignment you might not be aware of the problem until your mechanic shows you that the tires have severely uneven wear.  The problem is something you can’t feel, but it affects your car in a way that can be damaging or even dangerous. 

 

How can you tell if your bite is unbalanced if you may not be able to feel that anything is wrong?  A thorough dental exam can spot uneven tooth wear,  sore head and neck muscles,  broken teeth or cracked fillings before such problems become catastrophic.    

 

How is an unbalanced bite corrected?  Severe abnormalities may require orthodontic treatment with braces or, in extreme cases, surgical repositioning of the jaws.  Fortunately, many bite-related problems can be corrected by  subtly reshaping the teeth so they mesh in a more balanced fashion.  This type of treatment is called an equilibration which may result in reduction in tension headaches or in teeth clenching or grinding. 

If you have an unbalanced bite it is important to correct the underlying problem  before the damage is severe.  The enamel coating on your teeth is the hardest substance in the human body;  it is even harder than bone.  Once you wear through your tooth enamel, the underlying layer (called dentin) is seven times less resistant to wear.  If you habitually grind or clench your teeth you may wear them down so rapidly that many crowns are required to replace the tooth structure you’ve worn away on your back teeth.  A complete equilibration is generally a completely painless procedure. 

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Reported bruxism and stress experience 

A standardized questionnaire was mailed to all employees of the Finnish Broadcasting Company with irregular shift work and to an equal number of randomly selected controls with regular 8-hour daytime work. The aim was to analyze whether irregular shift work, workload in terms of weekly working hours, dissatisfaction with current workshift schedule were associated with self-reported bruxism and experienced stress.  Irregular shift work was significantly associated with more frequent stress , but not with self-reported bruxism. Workers dissatisfied with their current schedule reported both bruxism and stress  more often than those who felt satisfied. Frequent bruxism was significantly associated with dissatisfaction with current workshift schedule  It was concluded that dissatisfaction with one's workshift schedule and not merely irregular shift work may aggravate stress and bruxism.

+The Brux of the Matter Beautiful Teeth Vol. 2, No. 2, 2004

Reported bruxism and stress experience in media personnel with or without irregular shift work Kristiina Ahlberg, Jari Ahlberg, Mauno Könönen, Markku Partinen, Harri Lindholm, Aslak Savolainen - Acta Odontologica Scandinavica 2003;61(5):315-318 

*According to Dr. Christensen, JADA Feb 2000

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