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Bruxism is the term used to describe tooth gritting or grinding. It can impact significantly on the health of your teeth and is associated with periodontitis. There are a number of things you can do to reduce the damage bruxism may cause to your teeth.

What is bruxism?

Bruxism is a generic term used for a number of behaviors: gnashing, grinding, clenching, or gritting of teeth. Teeth grinding typically happens during sleep (but may also occur when awake), and there are a number of associated conditions such as sleep apnea. Teeth grinding may be caused by a number of things including stress, anxiety, personality (hyperactive types and those diagnosed with attention-deficit/hyperactivity disorder), abnormal bite or uneven teeth. Medications, such as certain anxiolytics (medication to treat anxiety), for instance, also have side effects that can include jaw clenching or teeth grinding.

Symptoms of bruxism

There are a number of indicators of the presence of bruxism:

  • Ear pain
  • Headaches
  • Pain in the jaw 
  • Sensitive or worn teeth or enamel;
  • Tooth pain
  • Pain in the mouth or ear area
  • Damage to the inside of the cheeks
  • Marks on the tongue.

Consequences of bruxism

Whilst bruxism may sound trivial, dentists are concerned about its cumulative effect: continual, frequent clenching or grinding will have serious consequences and necessitate serious dental treatment.

The cheek muscle that helps us chew is a strong muscle which can exert considerable force on the rear molars in particular and have a considerable impact on jaw and mouth health. This muscle can exert up to 600 pounds of force per square inch on the molars in the rear of our mouths and The following may be consequences of chronic bruxism:

  • Aching jaws, recurrent headaches or tooth pain

  • Wearing away of teeth, enamel or other structures supporting the teeth including loss of bone

  • Loosening or fracturing teeth

  • Receding gums

  • Developing jaw joint disorders
  • Periodontitis​

How is bruxism connected to periodontitis?

A patient with healthy gums is unfortunately at greater risk of developing periodontitis, and a patient with existing gum disease will find their infection spreads more rapidly than might be expected.

As stated earlier, bruxism can lead to receding gums and bone loss, two key indicators of periodontitis. It can seriously aggravate periodontitis because the nature of persistent grinding means that the periodontium is never given any chance to recover but is continually being placed under further stress. Tissue regeneration is a continual process in the body but bruxism disturbs the circulation and so interferes with this process; this, in turn, increases the likelihood of additional tissue breakdown. 

When patients grind their teeth, two key forces are at work:

  • Axial stress, which is a huge force applied vertically to the teeth and periodontium.

  • Bone-in stress which is the response of the bony structure to the force that is utilized.

When excessive pressure is continually applied to bone, this can lead to the formation of dysfunctional bone tissue. In addition, bone structures can be damaged to the point of destruction and periodontal pockets may occur.

Bruxism is also connected to loosening of teeth and therefore periodontitis. When you grind your teeth, they are being frequently moved in the socket and are forcefully rocked back and forth. Over time, this movement leads to the tooth becoming permanently loose. 

What can you do about bruxism?

There are several ways you can try to avoid or address bruxism:

  • Try to reduce stress, perhaps by using talking and behavioural therapies or stress or anxiety management techniques.

  • Try biofeedback or contingent electrical stimulation (CES) devices.

  • Avoid caffeine or alcohol, especially in the evening.

  • Practice good sleep hygiene.

  • Ask your sleep partner to alert you if you are grinding teeth.

  • Ensure regular dental inspections.

However, in severe bruxism, there are also other options such as dental-specific approaches, therapies and medication to reduce the impact of the condition and relieve pain or discomfort. Dentists may prescribe

  • Splints or mouth guards
  • Dental correction.

Medications such as muscle relaxants, Botox injections or anxiolytic may be prescribed.  However, medications aren't very effective for the treatment of bruxism, and more research is needed to determine their effectiveness. Physiotherapy or other complementary therapies may be advised to address pain and discomfort.

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