Teeth grinding and clenching can be a distressing condition that leaves many in need of effective and quick relief from acute symptoms, like painful tension-type headaches and tooth and jaw pain. Or at least moderate symptoms as part of a longer-term treatment plan.
While there are several treatment options available to manage bruxism, one question that arises is whether teeth grinding medications can help prevent it. So, today we will explore the potential role of medications in the prevention of bruxism and their effectiveness in addressing the condition.
By understanding the available options, individuals can make informed decisions regarding their oral health.
First: What is Bruxism?
Bruxism is a condition characterized by the unconscious grinding or clenching of teeth. It’s more than just occasional grinding and clenching during moments of stress, anger, or anxiety. Rather, it’s a chronic condition that can lead to serious oral health problems and can have many root causes, like medical conditions or lifestyle choices.
There are two ways to classify the condition. The first two types of bruxism are primary and secondary bruxism. Primary is when bruxism is not a consequence of another condition or health issue and might only be due to stress, anxiety, or lifestyle issues.
Secondary bruxism refers to teeth grinding and clenching that results from other medical conditions or causes.
Those two types can further be classified into the other two well-known and used classifications: awake bruxism and sleep bruxism.
Let’s explore these two further:
Awake Bruxism
Awake bruxism, a condition characterized by the grinding or clenching of teeth during wakefulness, can be further classified into either primary or secondary as well.
Also known as daytime bruxism or diurnal bruxism, it is the most common type, with around 20% of the general population reporting being aware of clenching and pressing their teeth together during the day, with women reporting higher numbers than men.
Sleep-Related Bruxism
Sleep-related bruxism, also known as nocturnal bruxism or teeth grinding, is a condition characterized by the involuntary clenching or grinding of teeth during sleep. It is a sleep disorder that can lead to various dental problems such as tooth wear, jaw pain, and morning headaches in severe bruxism cases.
Sleep-related bruxism is a more complicated case for both the bruxism patients and their healthcare providers. As it occurs only during the night and while asleep, it can be difficult to diagnose or even treat effectively. In many cases, dentists and physicians have to refer to sleep studies that monitor the activity of patients with sleep bruxism during sleep.
For many, nocturnal bruxism can only become apparent once the signs and symptoms get too severe and are typically noticed first by bed partners.
Sleep-related bruxism in children is much more common than the prevalence of sleep bruxism in adults, with only around 8% of adults being diagnosed with it, although this figure could be higher because of the propensity of sleep-related bruxism to be underreported.
Risk Factors for Teeth Grinding
While the exact cause or etiology of bruxism is still uncertain, there are several risk factors that have been identified:
- Stress and anxiety: These psychosocial factors are commonly associated with teeth grinding and are the likely culprit of a majority of cases around the world. Stress and anxiety always cause muscle tension and teeth clenching and disrupt sleep, which initiates a vicious cycle detrimental to your health.
- Psychological and psychiatric disorders: Other risk factors for sleep bruxism or awake bruxism are depression and attention deficit hyperactivity disorder, which disrupt the normal functioning of our brains and can lead to a cascade of issues that also disrupt sleep and lead to anxiety.
- Neurological disorders and movement disorders: Parkinson’s, cerebral palsy, GERD, acid reflux. Current knowledge of teeth grinding and sleep disorders has also led to an association between sleep bruxism and sleep apnea.
- Malocclusion and TMJ: Misalignment of teeth and temporomandibular joint disorder (TMJ) are other common causes, as they affect the normal functioning of chewing and talking, leading many to grind their teeth at night.
- Lifestyle choices: Other risk factors include recreational drugs, substance abuse, smoking, and even certain medications for treating many common diseases.
- Genetic factors: Simple genetics can play a role and lead to primary sleep bruxism or awake bruxism in many cases. If several members of your family have a clinical history of teeth grinding, then it’s highly likely you will develop it at some point in your life.
Signs and Effects of Bruxism on Oral Health
Teeth grinding can have several negative effects on oral health if left untreated, especially cases of severe bruxism that quickly leave their mark on a person’s daily life. Learning about these consequences is the first step in a successful management of bruxism.
Sore Jaw Muscles, Jaw Pain, and Facial Pain
Jaw soreness, jaw pain, and facial pain are common consequences of teeth grinding and can significantly impact oral health.
The continuous grinding and clenching of the teeth put excessive strain on the jaw muscles and the jaw joint, causing them to become sore and fatigued. This can lead to discomfort and pain in the jaw area, as well as radiating facial pain.
Individuals who experience these symptoms may find it difficult to eat, speak, or even open their mouths fully.
The tension involved with clenching and grinding can also extend and lead to neck pain or other types of myofascial pain in severe bruxism cases or even to temporomandibular disorders (which we will discuss further.)
Tooth Damage and Wear
Regular teeth grinding can unsurprisingly lead to significant tooth damage and wear.
When individuals grind their teeth, the excessive force can cause various dental problems. The constant grinding and clenching can wear down the enamel, leading to cracked or sensitive teeth.
This results in flattened, chipped, or broken teeth, along with gum recession on top of the common jaw muscle discomfort.
Morning Headaches and Earaches
Many sleep bruxism patients experience morning headaches and earaches, which is one of the main symptoms of sleep bruxism, along with possibly the first sign for many individuals that they have an aggravating sleep bruxism problem.
Morning headaches are a common complaint among sleep-related bruxism sufferers due to the excessive pressure exerted on the teeth and jaw during sleep. This can result in muscle tension and inflammation, leading to pain that radiates to the head.
The constant grinding and clenching of teeth can also cause referred pain to the ears, resulting in ear pain.
Sleep Disorders
One of the effects of bruxism on oral health is the disruption of sleep patterns. Sleep disorders such as obstructive sleep apnea (OSA) can be exacerbated by bruxism, making it difficult for individuals to achieve restful and rejuvenating sleep. While no single study has been able to prove a definitive link between the two conditions, systematic reviews of cases do make it clear there’s a prevalence of sleep bruxism in adults with OSA and vice-versa.
OSA is a condition where the throat muscles relax and block the airway during sleep, leading to pauses in breathing and loud snoring. Bruxism can further worsen the symptoms of OSA by causing tooth grinding and clenching, which can contribute to the collapse of the airway.
In some cases, a dental device called a mandibular advancement device (MAD) may be used as a tool in the management of sleep bruxism and OSA by repositioning the jaw and keeping the airway open.
Painful or Loose Teeth
Teeth grinding can result in painful loosening or loss of teeth, causing significant long-term damage to oral health. The constant grinding and clenching of teeth can lead to pain and discomfort in the mouth. The excessive force exerted during severe episodes of bruxism can cause the teeth to become loose, making them more susceptible to fractures and other dental problems.
The pain experienced can be severe and can affect the ability to chew and speak properly.
Temporomandibular Joint Disorder (TMJ)
TMJ or TMD is a condition that affects the jaw joint and the muscles that control jaw movement. It can cause pain, inflammation, and difficulty in opening and closing the mouth.
Teeth grinding puts excessive pressure on the temporomandibular joint, leading to its disorder or dysfunction. The constant grinding and clenching can strain the muscles and ligaments surrounding the joint, causing them to become inflamed and painful. In severe teeth-grinding cases, it can even result in the dislocation of the jaw joint.
Tooth Enamel Loss
Tooth enamel loss is a significant consequence of excessive and involuntary grinding of teeth, leaving the teeth vulnerable to various dental problems.
Enamel loss occurs when the enamel, the outermost layer of the teeth, becomes eroded or damaged. The constant friction and pressure exerted on the teeth during severe teeth grinding can gradually wear away the enamel, exposing the sensitive underlying layers of the teeth. This can result in tooth sensitivity, tooth decay, and an increased risk of developing cavities.
Jaw locking
Jaw locking is one of the potential effects of both teeth grinding and TMJ. With excessive jaw clenching, the temporomandibular joint (TMJ) can become locked, making it difficult to open or close the mouth.
While medications may not directly prevent jaw locking, they can help manage the symptoms associated with bruxism. Muscle relaxants can be prescribed to reduce the tension in the jaw muscles, relieving the strain on the TMJ. Additionally, pain relievers and anti-inflammatory medications can alleviate any discomfort or swelling caused by bruxism.
Medications Used to Treat Bruxism
Most management of bruxism focuses on treating the primary root causes or risk factors that are leading to severe teeth-grinding episodes, both during the day or night while asleep.
Medication can play a vital role in this effort. They can either alleviate symptoms and offer quick and temporary treatment to protect the teeth from damage or be part of a more comprehensive treatment plan to attack both the causes and secondary bruxism. Almost every case of bruxism will need more than just medication to resolve the condition.
Here are just some of the common medications used to prevent and treat teeth grinding.
Muscle Relaxants
Muscle relaxants are commonly prescribed to treat bruxism, with frequent administration ensuring optimal effectiveness. These medications work by reducing muscle tension and relaxing the muscles involved in teeth grinding, called the masticatory muscles, thus helping to alleviate the symptoms and prevent further damage.
Muscle relaxants can be an effective treatment option for individuals experiencing bruxism, especially when other conservative measures have failed.
It is important to note that muscle relaxants should only be prescribed by your healthcare provider and someone who is knowledgeable in treating bruxism. The dosage and frequency of administration should be carefully determined based on the individual’s specific needs and medical history. Regular follow-up appointments are crucial to monitor the effectiveness of the medication and make any necessary adjustments.
Benzodiazepines
Benzodiazepines are a class of medications commonly used when treating teeth grinding as these medications work by reducing muscle tension and anxiety, which always increases the risk of sleep bruxism.
By promoting relaxation, benzodiazepines can help prevent excessive grinding of teeth during sleep or even awake periods. They are typically prescribed for short-term use, as long-term use may lead to dependence or other side effects.
It is important to note that benzodiazepines, like muscle relaxants, should only be used under the guidance and supervision of a general or oral health professional.
Botox Injections
Botox, a neurotoxin called botulinum, produced by Clostridium botulinum bacteria, works by temporarily paralyzing the muscles responsible for grinding and clenching the teeth. The injections are typically administered into the masseter muscles on both sides of the jaw, relaxing the muscles and reducing the intensity of teeth grinding.
Treating bruxism with botulinum toxin injections has shown promising results in managing it, providing relief for individuals suffering from the condition. More on this here. However, it is important to note that the effects of Botox are temporary, lasting for about three to four months. Regular follow-up treatments may be required to maintain the desired outcome.
Needless to say, but worth repeating that it is recommended to consult with a healthcare professional to determine if Botox injections are a suitable option in this fight.
Selective Serotonin Reuptake Inhibitors (SSRIs)
Selective Serotonin Reuptake Inhibitors (SSRIs), a class of medications used to treat various mental health conditions, have also been explored as a potential option in the management of bruxism.
SSRIs work by increasing the levels of serotonin, a neurotransmitter that regulates mood in the brain, and are regularly used as antidepressant medications.
This increase in serotonin can help regulate the muscle activity involved in bruxism, reducing the intensity and frequency of teeth grinding. However, it is important to note that the use of SSRIs for teeth grinding is still being studied, and more research is needed to determine their effectiveness and potential side effects.
SSRIs are typically prescribed for mental health conditions and should only be used for bruxism only under the guidance of a healthcare professional. It is always advisable to explore non-medication approaches and consult an oral health professional or sleep specialist before considering medication options.
Other Options for Prevention and Treatment of Bruxism
In addition to medications, there are other options available for the prevention and treatment of bruxism.
Night Guards or Occlusal Splints
Dental professionals commonly recommend night guards or occlusal splints as a viable option for the prevention and treatment of bruxism. These devices are custom-made and fit over the teeth to provide a protective barrier between the upper and lower jaws.
Night guards and occlusal splints work by redistributing the forces of grinding or clenching, reducing the strain on the teeth and jaw muscles. They also help to stabilize the bite and alleviate symptoms such as tooth sensitivity, headaches, and jaw pain.
It might be obvious, but night guards are used for treating sleep-related bruxism, while the other types of occlusal splints (mouth guards) are used to treat awake bruxism. More on this here.
These oral appliances are typically made from a durable and comfortable material that allows for a proper fit and easy maintenance.
One study published in the Journal of Oral Rehabilitation found that a combination of exercises and splint therapy resulted in significant improvements in jaw muscle pain and function in cases of TMD and bruxism, for example.
Mandibular Advancement Devices
Mandibular advancement devices offer an alternative option for the prevention and treatment of bruxism, providing a quantifiable and professional solution. These devices are designed to position the lower jaw forward, which helps to open up the airway and reduce the intensity of teeth grinding during sleep. By keeping the jaw in a more relaxed position, mandibular advancement devices can alleviate the symptoms associated with TMJ and bruxism, such as jaw pain and headaches.
These devices are typically custom-made by a dentist or orthodontist, ensuring a proper fit and maximum effectiveness. They are made from a comfortable, durable material that allows for easy adjustment and maintenance. Mandibular advancement devices are non-invasive and do not require any medication, making them a safe and convenient option for those seeking relief from teeth grinding.
Lifestyle Changes
One of the first actions people with bruxism will be told to take are changes to their lifestyle and diet. No more late owl routines, stop ingesting alcohol and caffeine, smoking or vaping tobacco, and definitely no stimulants in the form of either legal recreational drugs or illicit drugs.
Behavioral Therapy
Behavioral therapy focuses on addressing the underlying causes and modifying behaviors to reduce teeth grinding. This form of therapy recognizes that it can be triggered by various factors such as stress, anxiety, and certain habits. By identifying and addressing these underlying causes, individuals can learn techniques to manage their stress and anxiety levels effectively.
Behavioral therapy aims to modify behaviors that contribute to teeth grinding. These behaviors may include jaw clenching or biting on objects. Techniques such as relaxation exercises, cognitive-behavioral therapy, and biofeedback can be employed to help individuals develop healthier habits and reduce the frequency and severity of bruxism episodes.
Stress Management and Relaxation Techniques
One option for preventing and treating bruxism is through the use of stress management and relaxation techniques. Bruxism, or teeth grinding, can be exacerbated by stress and anxiety. Therefore, finding ways to manage and reduce stress levels can have a positive impact on preventing or minimizing teeth-grinding episodes.
There are various stress management and relaxation techniques that can be beneficial for individuals experiencing bruxism. These techniques aim to promote relaxation, reduce muscle tension, and relieve stress. Some commonly recommended techniques include deep breathing exercises, meditation, yoga, progressive muscle relaxation, and mindfulness practices.
Deep breathing exercises involve taking slow, deep breaths in through the nose and out through the mouth, focusing on relaxing the body and calming the mind. Meditation and mindfulness practices involve focusing one’s attention on the present moment and letting go of worries and stressors. Yoga combines physical movements, breathing exercises, and meditation to promote relaxation and improve overall well-being. Progressive muscle relaxation involves tensing and relaxing different muscle groups to release tension and promote relaxation.
Incorporating stress management and relaxation techniques into one’s daily routine can help to reduce stress levels and potentially alleviate bruxism symptoms.
Pick the Treatment That’s Best For You
As we’ve seen, medications can be effective in preventing teeth grinding or bruxism. They help relax the muscles and reduce the frequency and intensity of grinding.
However, teeth grinding medications are always the most effective when combined with other preventive measures, such as stress management techniques and wearing a mouthguard, which can also be considered for the treatment of bruxism.
It is important to consult with a physical therapist and oral health professional for personalized recommendations and guidance on the most suitable treatment plans for each individual’s needs.
