Bruxism Treatments

Bruxism is an involuntary or habitual grinding of the teeth and clenching of the jaw. These actions usually occur during a person’s sleeping hours, but serious destruction can also result from daytime bruxism as well.

Mild bruxism may not require treatment. However, in some people, bruxism can be totally symptom free or have unrecognized signs and symptoms. It also may cause frequent and severe symptoms that lead to other problems like jaw disorders, headaches, damaged teeth and more.  Because you may have sleep bruxism and be unaware of it until complications develop, it’s important to know the signs and symptoms of bruxism and to seek regular dental care.

Signs and symptoms of bruxism may include:

  • Increased tooth sensitivity (the most common cause is bruxism)
  • Teeth grinding or clenching, which may be loud enough to awaken your sleep partner
  • Teeth that are flattened, fractured, chipped or loose
  • Worn tooth enamel, exposing deeper layers of your teeth
  • Jaw or face pain or soreness
  • Tired or tight jaw muscles
  • Pain that feels like an earache, though it’s actually not a problem with your ear
  • Dull headache originating in the temples or in front of the ear. 
  • Damage from chewing on the inside of your cheek

When to see a doctor

See your doctor or dentist if:

  • Your teeth are worn, damaged or sensitive
  • You have pain in your jaw, face or ear
  • Others complain that you make a grinding noise while you sleep
  • You have a locked jaw that won’t open or close completely

If you notice that your child is grinding his or her teeth — or has other signs or symptoms of bruxism — be sure to mention it at your child’s next dental appointment.

Bruxism usually occurs during a person’s sleeping hours, but occasionally it occurs during the day. Bruxism is one of the most common known sleep disorders. Chewing is a neuromuscular activity controlled by a subconscious process, but more highly controlled by the brain. During sleep, the subconscious process may become active, while the higher control is inactive (asleep), resulting in bruxism. 

A BiteStrip® is a device available through our office used to diagnose bruxism at home. The device itself is a small electromyography, which can sense and monitor activity in the jaw muscles during sleep. The frequency and severity of the condition can then be assessed and a plan of treatment can be determined.

WHY SHOULD I SEEK TREATMENT FOR BRUXISM? 

  • Gum recession. Bruxism is a leading cause of gum recession and tooth loss. Grinding can damage the soft tissue or cause chipping of the root structure at the gum line removing the anchoring fibers for the tissues. This will effectively start recession and may lead to loose teeth and deep pockets where bacteria are able to colonize and decay the tooth or supporting bone.  Generally cold sensitivity is present especially throughout the 20’s and 30’s with teeth naturally getting less sensitive with time.
  • Facial pain. Grinding can eventually shorten and blunt the teeth.  This can lead to muscle pain in the region of the cheek bone and ear and in severe cases, incapacitating headaches.
  • Occlusal trauma (overloading the support of teeth). The abnormal wear patterns on the occlusal (chewing) surfaces of the teeth can lead to fractures, which, if left untreated, may require major restorative treatment at a later time (such as crowning all your remaining teeth).  The damage to support ligaments and bones can cause bone and attachment loss, accelerating periodontitis. This may be the reason some teeth are affected severely by gum disease and others are spared.
  • Arthritis. In the most severe cases, bruxism can eventually lead to painful arthritis in the temporomandibular (TMJ) joints that may prevent the jaw from opening and closing smoothly without pain.

TREATMENT OPTIONS

Though there is no known cure for bruxism, there are a variety of devices and services available through our office to help treat bruxism:

  • Mouthguards. An acrylic mouthguard can be designed from teeth impressions to minimize the abrasive grinding action during normal sleep. Mouthguards must be worn on a long-term basis to help prevent tooth damage. Mouthguards will usually decrease muscle activity and help to eliminate bruxism related headaches.
  • NTI-tss device: This device only covers the front teeth and must be fitted at our office. The idea behind the NTI-tss is to prevent grinding the rear molars by limiting the contraction of the temporalis muscle on the sides of the forehead and in the jaw.
  • Botox®: Botox® can be injected into the muscles responsible for bruxing by disabling them enough to prevent grinding, but not enough to disrupt normal chewing.
  • Occlusal or Bite Adjustment: This can be very helpful if you have teeth that meet prematurely or on incorrect/angled surfaces.  Removing incorrect contacts may serve to eliminate bruxism triggers.  These triggers may inhibit the jaw joint from reaching its most relaxed state. Small muscles are recruited to move the jaw where the teeth fit best, thus pulling against larger stronger jaw closing muscles which are hyperactive.

Once bruxing is under control, we can perform a variety of dental procedures to restore the pleasant aesthetic appearance to your smile such as crown application, gum grafts, and crown lengthening.