What is Bruxism?
Bruxism refers to the subconscious clenching and grinding of the teeth. People with this condition are known as “bruxers”. Bruxism commonly take place at night when the person is asleep. This is known as “nocturnal bruxism” and most people do not know they have been clenching or grinding as they are sound asleep. Many times, they only realise it when their partners told them about it. The other kind is known as “daytime bruxism” which as the name suggests takes place in the day and may happen subconsciously when they are deep in their thoughts or at work.
Causes of bruxism are largely unknown. Most people attribute it to stress or stressful
environments. Some postulated causes of bruxism include:
- Sleep apnea
- Family history of bruxism
Problems arising from bruxism include:
- Damage to dentition include attrition, advanced teeth wear, cracks and fractures, abfraction cavities
- Damage to dental restorations and dental implants
- Damage to the periodontium (gum and bone bearing the teeth)
- Damage to mouthguards
- Severe facial or jaw pain including muscle ache, spasm and soreness especially at the chewing muscles
- Tension-type headaches
- Temporomandibular joint (jaw joint) dysfunction including pain, clicking, crepitus (rough grating sounds), locked jaw (cannot open or cannot close the mouth)
- Squarish jaw due to hyperthrophy of the chewing muscles (masseter muscles) resulting in broad-looking and squarish face
- Disturbed sleep
Signs and symptoms
- Worn down teeth
- Abfraction cavities (they may resemble exuberant teeth brushing cavities but are actually due to bruxism)
- Cracked and fractured teeth
- Poor periodontal health despite having no oral hygiene problems
- Fractured or dislodged dental restorations and dental implants
- Pain or tenderness of your jaw or joints.
- Pain when chewing
- Generalised facial pain
- “Locking” of the joint, making it difficult to open or close your mouth
- Clicking sound or crepitus (rough grating sounds) when opening and closing mouth
- Squarish jaw or broad lower face
- Disturbed sleep
- Tension- type headaches
At the first consultation appointment, we will look at the range of motion of your jaw, discuss symptoms, and feel around for sore spots that elicit pain.
We may also need more information like:
- Dental X-rays to examine your teeth and jaw
- CT scans and/or MRI to provide detailed images of the joint.
We may prescribe medication to relieve pain such as:
- Pain killers
- Muscle relaxants to relieve pain caused by muscle spasms.
- Botulinum Toxin injections to the muscles of mastication
- Mouth guard
Botulinum Toxin injections may also be necessary to reduce the strength of the chewing muscles (muscles of mastication). By relaxing the chewing muscles, Botulinum Toxin injections can reduce the collateral damage to the teeth, dental restorations, periodontium, muscles, temporomandibular joints that can arise from bruxism. Other benefits may involve facial slimming and improved sleep.
You may also need to wear a mouth guard (occlusal appliance) inserted in between the upper and lower jaw to provide a cushion between the upper and lower teeth and reduce pressure on the joint.
If the pain does not resolve with more-conservative treatments and it appears to be caused by a structural problem in the joint, we may suggest a joint washout (arthrocentesis) to remove the inflammatory mediators, a scope or open-joint surgery (arthrotomy) to repair the joint.