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Definition

Bruxism is the chronic, involuntary grinding or clenching of teeth. It usually occurs during sleep, but may also occur while awake.

Closed Jaw

Causes

The exact cause of bruxism is unknown, but it is believed to be related to:

Stress and anxiety
Abnormal alignment of the teeth or jaws

Risk Factors

A risk factor is something that increases your chances of getting a disease or condition.

Risk factors include:

Chronic stress or anxiety
Aggressive or competitive personality
Abuse of drugs or alcohol —especially methamphetamines
Post-traumatic stress disorder
Age: 40 or younger; especially common in women aged 27-40
Family member with bruxism
Facial or oral trauma
Use of psychiatric medications, especially antidepressants such as Zoloft, Paxil, and Prozac
Prior serious head injury

Symptoms

Symptoms may include:

Grinding sounds during sleep
Teeth sensitive to heat, cold, or brushing
Tense facial or jaw muscles
Hairline crack of the enamel on some teeth
Sore teeth
Inflammation of the gums ( gingivitis )
Headache especially if it is present when waking in the morning
Damage to the inside of the cheek (from biting or chewing)
Temporomandibular joint disorder (TMD)

Diagnosis

The doctor or dentist will ask about your symptoms and medical history and examine your teeth and jaw. With bruxism, teeth will have flattened tips, excessive wear, or thin enamel.

Treatment

Methods of treatment include:

Behavioral or Cognitive Treatment

This method focuses on changing behavior through various techniques, such as:

Biofeedback
Stress management
Relaxation therapy or exercises

Orthodontic Treatment

Your dentist may recommend a protective mouth appliance, such as a night guard, that can absorb the pressure of constant night grinding.

Medication

Medication is only recommended for short-term use. Medications may include:

Muscle relaxants
Mild sleeping aids
Injection of botulinum toxin (Botox) in severe cases
Novel medications, such as clonidine, are being explored as alternative treatments for some patients.

Bruxism that is not treated may result in gum damage, loss of natural teeth, and jaw-related disorders.

Prevention

The same methods used to treat bruxism can be used to prevent the condition.

RESOURCES:

Academy of General Dentistry

http://www.agd.org

American Dental Association

http://www.ada.org

CANADIAN RESOURCES:

Canadian Dental Association

http://www.cda-adc.ca/

The Canadian Dental Hygienists Association

http://www.cdha.ca/

References:

Academy of General Dentistry website. Available at: http://www.agd.org .

Chang H. Botulism toxin: use in disorders of the temporomandibular joint. Dent Today . 2005;24:48,50-1; quiz 51.

Huynh N, Lavigne GJ, Lanfranchi PA, Montplaisir JY, de Champlain J. The effect of two sympatholytic medications—propranolol and clonidine—on sleep bruxism: experimental randomized controlled studies. Sleep . 2006;29:307-316.

Orofacial Pain Research Center at UKCD website. Available at: http://www.mc.uky.edu/COHR/orofacial_pain.htm .

Tan EK, Jankovic J. Treating severe bruxism with botulinum toxin. J Am Dent Assoc . 2000;131:211-216.

Last reviewed December 2007 by Laura Morris-Olson, DMD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Bruxism

(Teeth Grinding)