When the topic of bruxism is discussed, most often, it revolves around the concern of sleep bruxism or nighttime teeth grinding because of the unique ways it presents itself and how hard it can be to diagnose while its effects take hold.
But the most common form of the condition is actually its daytime or awake variant, and it should be taken just as seriously.
Daytime bruxism or awake bruxism can have significant negative impacts on oral health and overall well-being. Learn and explore the symptoms and effects of daytime bruxism and understand the importance of recognizing and treating this condition.
Be proactive and learn as much as you can about this crucial oral health condition and how you can improve your quality of life.
Definition of Bruxism
Bruxism is a condition characterized by the grinding of teeth or jaw clenching in an unconscious way. The condition can be present as severe or mild bruxism or, most likely, will vary depending on several factors.
Most of those who suffer from any type of bruxism are children, with almost 15% to 33% of them grinding their teeth at night or day (most commonly at night.) Nonetheless, adults can suffer from teeth grinding or clenching as well because of several factors, with a majority of them experiencing it at some point in their lives, but only about 21% to 31% developing it into bruxism itself.
There are two types of bruxism: primary and secondary. Primary bruxism is not caused by any underlying medical condition, while secondary bruxism is linked to factors such as stress, anxiety, or medication use.
Both types of bruxism can occur during the day (daytime bruxism) or at night (nocturnal bruxism).
Daytime bruxism or awake bruxism is the most common of the two, with a 2013 systematic study review finding that almost 31% of adults experience it compared to the 9.7 to 15.9% range of sleep bruxism. Curiously, adult females are more likely to be affected by daytime bruxism than males, while both sexes are affected by sleep bruxism.
It is also very common in children, with 3 out of 10 children suffering from daytime bruxism, according to the Children’s Hospital of Philadelphia. Bruxism in children under the age of six typically goes away without needing much treatment, as it’s a normal consequence of teething, with many simply outgrowing bruxism by the time they start to lose their baby teeth and the permanent teeth come in.
Awake bruxism (or diurnal bruxism too) is, for the most part, unconscious, even though people who suffer from it are much more aware of their problem than those who grind their teeth at night and thus have better odds at treating it.
It is often associated with stress, anxiety, or an abnormal bite. It can cause jaw pain, headaches, and tooth damage. Individuals with daytime bruxism may have increased muscle activity in their jaw during the day, leading to the grinding and clenching of teeth, with pain and soreness in the jaw only getting worse throughout the day and not in the morning, like with sleep bruxism.
The constant pressure and friction can wear down tooth enamel, resulting in tooth sensitivity, crooked teeth, broken teeth, and an overall increased risk of tooth decay.
Sleep bruxism, or teeth grinding at night, on the other hand, happens during sleep. Affecting individuals of all ages (although more commonly children and teenagers), it is often accompanied by a grinding sound that can disturb sleep partners, which is how many first realize they suffer from the condition. Asleep bruxism or nocturnal bruxism is considered by most in the medical community as a sleep-related movement disorder, with the exact cause of sleep bruxism not being fully understood. It is believed to be related to factors such as stress, anxiety, other sleep disorders, and certain medications.
Over time, sleep bruxism can lead to various dental problems, including tooth damage, jaw pain, headaches, and disrupted sleep patterns.
Effects and Symptoms of Teeth Grinding While Awake
Both daytime and nocturnal bruxism can lead to several negative effects and symptoms, although it should be noted that not every case, even severe bruxism, leads to all of these symptoms and has these effects on your health.
On the other hand, symptoms or signs of bruxism may appear even cases of mild bruxism and lead to severe and costly long-term effects. You could still see tooth pain, loose teeth, or headaches even if you only clench or grind infrequently.
Jaw Pain and Discomfort
Jaw pain and discomfort are common symptoms experienced by individuals with daytime bruxism.
The habit of grinding or clenching the teeth during the day can lead to various effects on the muscles and temporomandibular joints, causing jaw pain and discomfort, mostly as the day progresses. Unlike sleep bruxism, the symptoms of daytime bruxism get worse during the day and not only upon waking up.
The constant pressure and strain on the jaw muscles can result in muscle tension and soreness, making it difficult to perform everyday tasks such as eating or speaking. The excessive force exerted on the temporomandibular joints can also cause inflammation and pain in the jaw joint area.
Headaches or Earaches
Individuals who experience daytime grinding may often suffer from frequent headaches or earaches as a result of their teeth grinding or clenching habit. These symptoms can be quite debilitating and can significantly impact one’s quality of life.
Headaches caused by bruxism are typically tension-type headaches that occur due to excessive muscle tension in the jaw and surrounding areas.
On the other hand, earaches can occur when the grinding or clenching puts pressure on the temporomandibular joint (TMJ), which is located near the ears. This can lead to pain and discomfort in the ears.
Facial Muscle Pain
People who experience daytime bruxism may often suffer from facial pain as a result of their habit of grinding or clenching their teeth while awake. Facial muscle pain can manifest as tightness, soreness, or even spasms in the muscles of the face and jaw. This discomfort can make it difficult to perform everyday tasks such as eating, speaking, or even smiling.
The constant strain on the facial muscles can also lead to tension headaches or migraines. Treatment may include muscle relaxant therapy or medication prescribed by a healthcare professional. Practicing stress management techniques, such as relaxation exercises, behavioral therapy, or meditation, can also help reduce muscle tension and pain in the face.
Problems with Jaw Joint and Movement
The habit of grinding or clenching teeth while awake can lead to problems with the jaw joint, jaw movement and even lockjaw. This can cause discomfort and hinder normal oral functions.
When individuals grind their teeth during the day, the excessive force exerted on the jaw joint can result in pain and inflammation. This can lead to symptoms such as jaw stiffness, difficulty opening or closing the mouth, and a clicking or popping sound when moving the jaw.
Furthermore, the continuous grinding motion can wear down the teeth, leading to tooth sensitivity and even tooth fractures. If left untreated, daytime bruxism can also contribute to the development of temporomandibular joint disorder (TMD), a condition that affects the functioning of the jaw joint and can cause chronic pain, sore jaw muscles, and limited jaw movement.
Tooth Damage, Loss, Misaligned Teeth, or Sensitivity
Another result of daytime bruxism is tooth damage, loss, sensitivity, and even misalignment (crooked teeth.)
Your teeth can become misaligned from the constant pressure applied on them by clenching constantly and slowly your smile will be affected, while continuous grinding will also lead to tooth damage, such as worn enamel and cracked or fractured teeth.
Moreover, the excessive pressure on the teeth can cause tooth loss over time. Tooth sensitivity is another common consequence of daytime bruxism, as the grinding action can wear down the protective layer of enamel, exposing the sensitive dentin underneath and leaving you with extremely sensitive teeth. If left untreated, these issues can lead to further oral health problems and make patients need root canals, bridges, crowns, or even partial dentures.
What Are the Risk Factors for Daytime Bruxism?
Both daytime and sleep bruxism are difficult to narrow down to having only risk factors, as they often result from a confluence of causes. Nonetheless, there are several consistent risk factors that have been identified with daytime bruxism, starting with stress and anxiety, TMJ, and even your personality.
Stress and anxiety
High levels of emotional stress or anxiety can contribute to daytime bruxism. It is the most common factor that can put anyone at risk of bruxism, although the correlation is stronger during the day.
The constant tension will translate sooner or later into actual muscle activity, including in the jaw. It then turns into an unconscious habit of daytime teeth grinding and jaw clenching. You will first likely notice jaw soreness, and then the symptoms will progress to damaged teeth or temporomandibular disorders.
Type A personality
Individuals with Type A personality traits, such as competitiveness, impatience, a tendency to be highly driven, and even attention deficit hyperactivity disorder (ADHD), may be more prone to daytime bruxism.
Some neurological and developmental disorders like cerebral palsy, Down syndrome, or epilepsy can increase the chances of bruxism in many children, while Parkinson’s and Huntington’s disease are some of the neurological illnesses that can cause it in adults.
Misaligned teeth or jaw
Dental issues, such as malocclusion (misaligned teeth), can increase the risk of daytime bruxism while also being a symptom.
Temporomandibular Joint Disorder (TMJ)
As mentioned above in the symptoms section, TMJ can be both a sign of daytime bruxism or a cause. In TMJ, the jaw joint or jaw muscles are damaged, sore, or constantly tense, causing constant clenching and problems with opening and closing the mouth. This, in turn, leads to bruxism and all the consequences it can carry, on top of the issues with TMJ.
A major risk factor is certain medical conditions and the medications used to treat them, such as antidepressants or antipsychotics for mental health issues. If you have a history of bruxism or your family does, make sure your healthcare provider is aware of that before prescribing certain medications. ADHD and some of the medication that is prescribed to treat it is a common cause of daytime bruxism in some children and adults.
Similar to how certain legal and prescribed medications can cause daytime bruxism, the use or overuse of substances like nicotine, caffeine, or alcohol can increase the likelihood.
Conditions like sleep apnea or insomnia can contribute to daytime bruxism. Obstructive sleep apnea, a sleep disorder characterized by pauses in breathing during sleep, has been associated with an increased risk of diurnal bruxism, although whether it is a cause or a symptom is still disputed. This may be due to the tension and strain placed on the jaw muscles and teeth during episodes of interrupted breathing.
There may be a genetic predisposition to all forms of bruxism, so having a family member with the condition increases the risk. However, while there are studies that point to several genetic factors for bruxism, it should be noted that these do not condemn anyone to a life of chronic teeth grinding. It only makes them more at risk of bruxism if other risk factors are in place, so it can still be prevented or controlled with any treatment of bruxism plan.
Diurnal bruxism is more common in children and tends to decrease with age, but it can still occur in adults, especially under certain medical conditions (as we’re explaining here) and psychosocial factors.
Certain professions that involve high levels of stress or require intense concentration, such as musicians or athletes, may increase the risk of daytime bruxism.
Although more common in patients with sleep bruxism, acid reflux problems can cause sleep disruptions and stress that lead to teeth grinding both at night and during the day. During the day, acid reflux causes us to tense several muscles as we struggle to control our esophagus and the constant pain and burning sensation in our chest, with the unintended consequence of teeth grinding or clenching our jaw.
Daytime Bruxism Treatment Options
There are several treatment options available for daytime bruxism. If the case is severe enough, an oral health professional may recommend the use of orthodontic treatments like a mouth guard or night guard in the case of nighttime bruxism, which is a custom-made dental appliance that can help protect the teeth from grinding during the day.
In some cases, medication or relaxation techniques may be prescribed to address underlying factors that contribute to daytime bruxism. Read on as we expand further on several of these treatment options.
Mouth Guards or Occlusal Devices
Mouth guards or occlusal devices are essential treatment options for managing daytime bruxism.
Mouth guards, also known as bite guards, dental splints, or occlusal splints, are custom-made devices that are worn over the teeth to protect them from grinding and clenching during the day. These guards create a barrier between the upper and lower teeth, preventing them from coming into contact and reducing the force of the grinding. They are typically available in several other forms, including over-the-counter ones that can be boiled and molded to fit any size or harder ones that come in more average sizes.
When dealing with sleep bruxism, night guards are used instead, as they are meant to be worn during sleep only, when the worst effects of night-time teeth grinding occur.
In addition to protecting the teeth, mouth guards also help alleviate symptoms such as jaw pain, headaches, and muscle tension. By wearing a mouth guard, individuals with daytime bruxism can effectively manage their condition and prevent further damage to their teeth and oral health.
Other types of occlusal devices besides guards are mandibular advancement devices (MADs), which are devices that are worn during the night and bring the bottom mandible forward. But this is a more common treatment option for sleep bruxism, not awake.
Stress Management Techniques
To effectively address daytime bruxism at its root, one must also explore stress management techniques as a treatment option. Stress has been identified as a major contributing factor to teeth grinding while awake, making it crucial to address its root cause.
By implementing stress management techniques, individuals can reduce their stress levels and alleviate the symptoms of daytime bruxism. There are several effective techniques that can be employed, such as deep breathing and relaxation exercises, meditation, yoga, and mindfulness practices, along with possible therapy. These techniques help individuals relax, relieve tension, and promote a sense of calmness, ultimately reducing the likelihood of teeth grinding during the day.
Regular physical exercise also helps immensely; maintaining a balanced diet and getting enough sleep are also important in managing stress and preventing any form of teeth grinding.
Medication for Relaxing Jaw Muscles
Continuing the exploration of daytime bruxism treatment options, one effective approach is the use of medication to relax jaw muscles.
Medication can be a valuable tool in managing the symptoms of daytime bruxism, providing relief and reducing the frequency and intensity of teeth grinding and jaw clenching.
Muscle relaxants, such as benzodiazepines, are commonly prescribed to help relax the muscles in the jaw and face, promoting a more relaxed state and reducing the urge to grind or clench.
These medications work by targeting the central nervous system, inhibiting the signals that trigger muscle tension and contraction.
It is important to note that medication should always be prescribed by a healthcare professional, and a thorough evaluation of the individual’s medical history and symptoms should be conducted to determine the appropriate dosage and duration of treatment. Medication should be used in conjunction with other treatment approaches, such as stress management techniques and dental interventions, for optimal results.
The Importance of a Timely Bruxism Diagnosis
Diagnosing daytime bruxism involves a dental visit to evaluate the presence of symptoms and conducting a thorough examination of the jaw muscles and teeth.
Since daytime bruxism occurs while awake, it can be easier to notice and diagnose the symptoms compared to the grinding of teeth during sleep. Household members will likely alert you to the sounds of your teeth grinding or notice changes in your jaw and face. Dentists may look for signs such as loss of teeth, tooth wear, sensitivity, gum inflammation, and muscle tenderness. They may also take dental impressions for custom-made mouthguards, which are a common treatment for bruxism.
The dentists may also ask about any related factors, such as stress or anxiety in your life, recommending you fill out a questionnaire to detect any form of bruxism. After several visits, your dentist will notice if your grinding and clenching habit has evolved into daytime bruxism or if it has gotten worse.
While most people would visit a dentist to confirm a bruxism diagnosis, it can sometimes be the combined work of several medical experts and professionals, including orthodontists, oral and maxillofacial surgeons, ear, nose, and throat (ENT) specialists, and even psychologists or psychiatrist can be the ones to alert a patient of signs of bruxism.
Early diagnosis and treatment are crucial to preventing further damage to the teeth and alleviating discomfort.
By recognizing and addressing this condition, we can prevent potential long-term consequences and ensure better oral health outcomes.