Bruxism, the involuntary grinding or clenching of teeth, affects a significant portion of the population at any age and varying degrees. From the moment they are diagnosed with it or begin experiencing the most severe symptoms, some of the first questions they have are about the latest treatments.
Today, our blog post aims to provide insights into the advancements in this field, catering to an audience that desires to serve others.
From night guards, which have been a common treatment option, to non-invasive alternatives, the focus is on improving the quality of life for those affected by bruxism. By exploring the latest technologies and innovations, individuals can make informed decisions about their treatment options and seek long-term relief from this condition.
Definition of Bruxism
Bruxism is a condition characterized by excessive teeth grinding or clenching. It commonly occurs during sleep but can also happen during waking hours. Bruxism in children is relatively common, affecting around 15-40% of the population, while in adults, the prevalence is lower, at around 8-10%.
Bruxism is classified into how and when you experience it: awake bruxism (or diurnal bruxism), and sleep bruxism.
Awake bruxism is the type of bruxism that refers to tooth grinding or clenching that occurs while a person is, well, awake. This can be consciously or unconsciously done and is often associated with stress or anxiety. Diurnal bruxism is generally easier to diagnose and treat because someone suffering from it experiences it while conscious and can work towards preventing it.
On the other hand, sleep bruxism or nocturnal bruxism refers to teeth grinding or clenching that occurs during sleep. It is typically an unconscious behavior and may be influenced by factors like sleep disorders, abnormal bite alignment, anxiety, stress, or certain medications. Unlike diurnal bruxism, nocturnal bruxism is harder to diagnose or be aware of until symptoms get more severe.
The exact causes of either awake or nocturnal bruxism are not fully understood. Still, potential causes include psychological factors, such as stress or anxiety, abnormal bite alignment, sleep disorders (such as sleep apnea), certain medications (such as antidepressants), and genetic predisposition. In children, bruxism is common in their early years as their baby teeth come and go, with the prevalence rising to almost 30% by the age of six.
It is important to note that severe bruxism can have significant impacts on dental health and may lead to tooth damage, tooth sensitivity, jaw pain, or headaches. If you suspect bruxism, it is recommended that you consult with a healthcare professional for proper diagnosis and treatment.
Common Symptoms of Bruxism
While occasional teeth grinding may not cause significant harm, chronic teeth grinding and clenching can lead to various dental problems and discomfort.
Recognizing these symptoms of bruxism is crucial for early detection and appropriate management:
- Teeth grinding or clenching: This is the most obvious symptom of bruxism, occurring in both sleep and awake bruxism.
- Jaw pain or tightness: Both sleep and awake bruxism can cause discomfort and tightness in the jaw muscles.
- Headaches: Frequent headaches, particularly upon waking up, are common in sleep-related bruxism.
- Earaches: Pain in the ears, often mistaken for an ear infection, can be a symptom experienced by patients with bruxism.
- Facial pain: Both sleep and awake bruxism can cause facial pain, especially around the temples or cheeks.
- Tooth sensitivity: Grinding can wear down the enamel, leading to increased tooth sensitivity to hot and cold temperatures. This symptom is common in both types of bruxism.
- Tooth damage: Chipped, fractured, or flattened teeth are more common in awake bruxism due to the force exerted during grinding or clenching.
- Tired or tight jaw muscles: Waking up with tired or tight jaw muscles is a common symptom of sleep bruxism.
- Disrupted sleep: Sleep-related bruxism can cause disruptions in sleep patterns, leading to fatigue and daytime sleepiness.
- Stress and anxiety: While not exclusive to bruxism, patients with bruxism typically also exhibit stress and anxiety, which can contribute to both awake and sleep-related bruxism.
It is important to note that these symptoms can vary in intensity and may not always be present.
Risk Factors and Causes of Bruxism
Chronic teeth grinding can be caused by various risk factors and underlying medical conditions, although the exact reason why bruxism may appear in a person can be hard to pinpoint to a single root cause or risk factor. All these various contributing factors mean that effective treatment methods to address the root causes and movements associated with teeth grinding and clenching are typically more than just a single one.
Nonetheless, the following are several known conditions and factors that are predominant in patients with teeth grinding.
Medical Conditions
Several medical conditions have been associated with bruxism, from gastrointestinal diseases to Parkinson’s and even autism. These conditions include:
- Gastroesophageal reflux disease (GERD): People with GERD experience acid reflux, which can cause irritation and damage to the esophagus. The pain and discomfort associated with GERD may lead to teeth grinding during sleep.
- Parkinson’s disease: Teeth grinding and clenching are commonly seen in individuals with Parkinson’s disease, a neurodegenerative disorder that affects movement. It is believed to be a side effect of medication or a result of changes in the basal ganglia, the brain region involved in movement control.
- Huntington’s disease: Huntington’s disease is a genetic disorder that leads to the progressive breakdown of nerve cells in the brain. Bruxism can occur as a result of involuntary movements and muscle rigidity associated with this condition, as the muscles involved in chewing and grinding, such as the temporalis and masseter muscles, play a role in teeth clenching and grinding.
- Epilepsy: People with epilepsy, a neurological disorder characterized by recurrent seizures, may experience bruxism during or after a seizure. The muscle contractions and involuntary movements during a seizure can cause teeth grinding.
- Autism spectrum disorder (ASD): Teeth grinding is sometimes observed in individuals with ASD, although the exact cause is not well understood. It may be related to sensory processing issues or as a self-stimulatory behavior.
- Medications: Certain medications, such as selective serotonin reuptake inhibitors (SSRIs) used to treat depression and anxiety, as well as antipsychotic medications, have been associated with teeth grinding as a side effect.
- Dental misalignment: An abnormal bite or crooked teeth can lead to both awake and sleep bruxism, as the patient will develop inappropriate biting habits to avoid pain or chew better, which can lead to teeth grinding, clenching, or TMJ. Misaligned teeth are both a symptom and a possible risk factor for bruxism.
- Attention Deficit Hyperactivity Disorder (ADHD): Several studies have suggested a potential link between Attention Deficit Hyperactivity Disorder (ADHD) and bruxism. ADHD is a neurodevelopmental disorder characterized by difficulties in attention, hyperactivity, and impulsivity. While the exact mechanism of the relationship is not fully understood, it is believed that the hyperactivity and impulsivity associated with ADHD may contribute to increased muscle activity in the jaw, leading to teeth grinding excessively. Further, the use of certain medications commonly prescribed for Attention Deficit Hyperactivity Disorder, such as stimulants, may also contribute to an increased risk of bruxism. However, further research is needed to establish a definitive causal relationship between these two conditions.
It is important to note that bruxism can have multiple underlying causes, and often, a combination of factors contributes to its development. A comprehensive review of the patient’s medical history and symptoms is essential in determining the most appropriate course of treatment.
Genetic Factors
Research has shown that variations in certain genes may increase the risk of developing bruxism. These genes are often involved in regulating muscle activity, neurotransmitter function, and stress response.
Some studies have found that many families have a history of bruxism across generations, suggesting a hereditary component. By identifying these genetic factors, healthcare professionals can better understand the underlying causes of teeth grinding and develop personalized treatment plans.
Stress and Anxiety
Research has highlighted stress and anxiety as significant risk factors and causes of bruxism, shedding light on the crucial role they play in the development and exacerbation of teeth grinding and clenching.
Stress and anxiety are common in today’s fast-paced world, and they can have detrimental effects on our overall health, including our oral health. Many individuals experience increased teeth grinding and clenching at night when they are under stress or feeling anxious.
This can result in pain and discomfort in the teeth and jaw and can even lead to more serious dental issues if left untreated.
Sleep Disorders
Sleep disorders have been identified as significant risk factors and contributors to the development and exacerbation of nocturnal bruxism, as it occurs during sleep and can lead to various dental problems and discomfort.
Sleep disorders such as obstructive sleep apnea, insomnia, and restless leg syndrome have been found to be associated with an increased risk of developing sleep or nocturnal bruxism. For example, obstructive sleep apnea is a disorder characterized by pauses in breathing during sleep. The grinding and clenching of teeth may be a response to the airway obstruction and attempts to open the air passage.
These disorders overall disrupt proper sleep patterns and diminish the quality of rest at night and can result in increased muscle activity, including jaw muscle activity, leading to tooth-grinding episodes.
Temporomandibular Joint Disorder (TMJ)
Temporomandibular joint disorder (TMJD or just TMJ) refers to a condition that affects the temporomandibular joint, which connects the jawbone to the skull. It is characterized by pain, discomfort, and dysfunction in the jaw joint and surrounding muscles, often leading to difficulties in chewing, speaking, and opening/closing the mouth.
Temporomandibular disorders can be caused by various factors, including jaw misalignment, arthritis, or injury, and typically require a multidisciplinary approach for diagnosis and treatment involving dentists, orthodontists, and physical therapists. Suffering from TMJ can also increase the risk of bruxism or be a consequence of it, as the misalignment or dysfunction of the jaw joint can lead to increased muscle tension and stress on the teeth.
Lifestyle Factors
Lifestyle factors can play a significant role in the development of bruxism. For example, individuals who lead high-stress lives or have demanding jobs may be more prone to grinding their teeth, especially during sleep.
Certain lifestyle habits such as smoking, excessive alcohol consumption, and the use of recreational drugs can increase the likelihood of developing bruxism in adults. Poor sleep hygiene and irregular sleep patterns can also contribute to nocturnal bruxism, as sleep disturbances can cause muscle tension and lead to teeth grinding.
Overall, adopting a healthy and balanced lifestyle, managing stress effectively, and prioritizing good sleep hygiene can help reduce the risk of developing bruxism.
Night Guards for Teeth Grinding
Night guards are a common treatment option for those who grind their teeth at night, also known as sleep bruxism. There are different types of night guards available, including custom-made guards that are specifically designed to fit an individual’s teeth and over-the-counter guards that are more generic in shape and size.
For awake bruxism, the treatment is similar to using mouth guards specialized for preventing teeth grinding during the day, but because of how sleep bruxism is experienced, most of the innovations in bruxism treatment are in night guards.
The choice of night guard depends on the severity of the problem and the individual’s preferences and needs.
Types of Night Guards Available
Night guards are an essential part of bruxism treatment, offering protection and relief for those who grind their teeth at night.
There are several types of night guards available to cater to individual needs:
1. Custom Night Guard
One effective option for treating teeth grinding is the use of a custom night guard. Custom night guards, which are made specifically for each individual, have shown promising results in reducing the frequency and intensity of grinding and reducing damage to teeth.
2. Dental Over-The-Counter Night Guard
These pre-made night guards are available in different sizes to accommodate various mouth shapes and can be easily purchased without a prescription from most pharmacies or online retailers. They are a convenient and cost-effective option for individuals who suffer from teeth grinding and want to protect their teeth from further damage. It is important to follow the instructions provided by the night guard and ensure proper cleaning and maintenance to prolong its lifespan and effectiveness. If you have any concerns or experience persistent discomfort while using a night guard, it is always advisable to consult with a dentist for a personalized assessment and recommendation.
3. Boil and Bite Night Guard
An innovative option for addressing teeth grinding is the boil and bite night guard, as it offers a customizable fit at a lower price.
It’s designed to be boiled in water to soften the material, making it easy to mold to the shape of your teeth.
This allows for a personalized fit that ensures some effectiveness in preventing teeth grinding and minimizing discomfort. However, it is not as effective as a truly customized night guard from a dentist or oral healthcare professional.
4. Soft Night Guard
The soft night guard is made from a soft and flexible material that provides comfort and protection during sleep. This guard is designed to fit the contours of the teeth and gums, providing a customized fit for each individual. Its gentle cushioning effect helps to reduce the impact of teeth grinding, preventing damage to the teeth and jaw.
This type of night guard is ideal for those who desire a comfortable and effective solution for their mild bruxism.
5. Dual Laminate Night Guard.
A dual laminate night guard, also called a bilaminar splint, is a dental device used to treat severe teeth grinding. It consists of two layers of ethylene-vinyl acetate: a soft inner layer and a harder outer layer. While they are pricier than soft night guards or store-bought ones, they are also more durable. However, some people may find them uncomfortable, even if they are custom-fit.
6. Mandibular Advancement Device
A mandibular advancement device (MAD) is a dental appliance primarily used to treat snoring and obstructive sleep apnea in adults. However, it has also shown effectiveness in addressing nighttime teeth grinding caused by sleep disorders. The MAD works by repositioning the lower jaw forward, which helps keep the airway open and prevents it from collapsing during sleep. Typically made of plastic or acrylic material, the device is custom-fitted to match the individual’s dental structure. By maintaining an open airway, the mandibular advancement device enhances airflow and decreases the chances of snoring or experiencing breathing interruptions while sleeping.
7. NTI-tss TMD Device
The NTI-tss Plus, or Nociceptive Trigeminal Inhibition Tension Suppression System, is a non-drug option for treating migraine pain caused by jaw and teeth grinding. According to the Migraine Research Foundation, there are over 30 million people in the United States alone who suffer from migraines. This presents an opportunity for dental clinicians to help their patients find relief. Despite being relatively new to the market, the device has already shown great promise. It has received FDA clearance for preventing migraines and tension-type headaches. One study even found that it can reduce clenching forces by approximately 70%. Additionally, 82% of migraine sufferers experienced a significant decrease in migraine events, with a reduction of 77%, when using the NTI-tss Plus.
Other Technology and Innovations in Bruxism Treatment
In addition to night guards, other technologies and innovations in bruxism treatment can help alleviate the symptoms of teeth grinding.
Jaw Muscle Relaxants and Muscle Relaxants
Jaw muscle relaxants and other muscle relaxants are emerging as innovative medications in the treatment of bruxism.
These relaxants work by reducing the activity and tension in the muscles responsible for grinding and clenching. By reducing jaw muscle activity, these technologies aim to alleviate the symptoms of bruxism and prevent further dental complications.
Muscle relaxants, such as benzodiazepines and muscle relaxant medications, may also be prescribed to manage bruxism. These medications work by reducing muscle tension and promoting relaxation throughout the body, including the jaw muscles.
While these muscle relaxants offer potential benefits in bruxism treatment, it is important to consult with a healthcare professional to determine the most suitable approach for individual cases.
Botox Injections
Botox injections are a notable innovation in the treatment of bruxism.
Botox, a neurotoxin derived from the bacterium Clostridium botulinum, is commonly used for cosmetic purposes but has also proven effective in treating bruxism in adults. The injections work by temporarily paralyzing the muscles responsible for grinding, reducing the intensity and frequency of teeth-grinding episodes.
Patients who receive Botox injections for bruxism often experience relief from their symptoms, specifically jaw joint pain or orofacial pain, and a significant improvement in their overall oral health. This technology offers a non-surgical and minimally invasive option for individuals seeking relief from the discomfort and potential damage caused by bruxism.
Dental Restorations for Tooth Wear
One notable advancement in bruxism treatment involves the use of dental restorations to address tooth wear caused by the condition. Dental restorations are a form of treatment that focuses on rebuilding and restoring the damaged teeth and their chewing surfaces to their original shape and function. These restorations can be made from various materials, such as composite resin, porcelain, or metal alloys, depending on the severity of tooth wear and the patient’s specific needs.
The use of dental restorations for tooth wear caused by grinding offers several benefits. Firstly, it helps to restore the aesthetics of the smile by filling in gaps, repairing chips or cracks, and improving the overall appearance of the teeth. Secondly, it restores the functionality of the teeth, allowing the patient to chew and speak properly. Lastly, dental restorations can also help to alleviate any pain or discomfort that may be associated with bruxism-related tooth wear.
Non-Invasive Treatments of Bruxism
Non-invasive treatments for bruxism include cognitive behavioral therapy (CBT), biofeedback devices for monitoring activity during sleep, and relaxation techniques.
These non-invasive approaches offer potential alternatives to more invasive treatments for bruxism.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) is an effective non-invasive treatment for bruxism. This therapy focuses on identifying and changing negative thought patterns and behaviors associated with teeth grinding. CBT aims to help individuals manage stress, anxiety, and other underlying psychological factors that contribute to any type of bruxism.
By working with a trained therapist, patients learn techniques to recognize and modify their thoughts and reactions to stressors, ultimately reducing the frequency and intensity of teeth-grinding episodes. CBT also helps individuals develop healthier coping mechanisms to deal with stress, improving their overall well-being.
This non-invasive approach is particularly beneficial for individuals who prefer a holistic and drug-free treatment option.
Biofeedback Devices for Monitoring Activity During Sleep
Biofeedback devices, or the biofeedback method, provide a non-invasive method for monitoring activity during sleep to achieve a clinical diagnosis and treatment for sleep-related bruxism. There are several types of biofeedback devices, all designed to measure various physiological parameters, also called biofeedback stimuli, such as muscle activity, heart rate, and breathing patterns. By providing real-time feedback to the user, biofeedback treatment helps individuals become more aware of their sleep-related bruxism behaviors.
A common name for the use of all these types of biofeedback devices is a polysomnographic study, which is the diagnostic test used to evaluate and monitor a person’s sleep patterns and overall sleep quality. It involves the simultaneous recording and analysis of various physiological parameters during sleep, such as brain waves (electroencephalogram or EEG), eye movements (electrooculogram or EOG), muscle activity (electromyogram or EMG), heart rate, and oxygen levels. These recordings help sleep specialists look for the criteria for sleep bruxism or diagnose other sleep disorders like sleep apnea, insomnia, narcolepsy, and restless leg syndrome. Polysomnographic studies are typically conducted in a sleep laboratory and provide valuable information to guide treatment plans and improve sleep health.
An electromyography (EMG) monitor is especially useful as it uses sensors placed on the face or jaw to detect muscle activity. The EMG data is then analyzed and displayed on a screen in real time, allowing the user to see patterns of muscle tension associated with their average bruxism activity.
Relaxation Techniques
Relaxation techniques play a crucial role in the non-invasive treatment of bruxism, helping individuals alleviate stress and promote muscle relaxation. Since teeth grinding is often linked to stress and anxiety, it’s thought that by incorporating relaxation techniques into their daily routine, individuals can reduce the tension that contributes to bruxism and improve their overall well-being.
One effective relaxation technique is deep breathing exercises. Taking slow, deep breaths can help calm the nervous system and relax the muscles involved in bruxism. Progressive muscle relaxation is another technique that involves tensing and then releasing different muscle groups to promote overall relaxation and some relief from orofacial pain.
In addition to these techniques, mindfulness meditation and yoga have also been found to be beneficial in managing bruxism. A warm bath before going to bed has also helped manage nocturnal bruxism, as it relaxes the muscles. These practices help individuals become more aware of their body and mind, allowing them to recognize and release tension before it escalates.
Take Advantage of New Tech and Innovations in the Treatment of Bruxism
Advancements in technology have led to innovative treatments for bruxism, from a variety of night guards to new devices that help diagnose and guide treatments for bruxism in adults and children. Don’t delay and be afraid of taking action in bruxism treatment. There are many non-invasive treatments and night guard technology for every case of teeth grinding.
These advancements provide a range of options for individuals suffering from bruxism, improving their quality of life and oral health.
