Awake and Sleep Bruxism
There are two types of bruxism. Awake bruxism occurs while the sufferer is fully conscious and mainly involves clenching. Sleep bruxism occurs while the sufferer is sleeping.
Patients who suffer from sleep apnea, including obstructive sleep apnea (OSA), are prone to teeth grinding. For many OSA sufferers, bruxism is often synonymous with a lack of using breathing treatments while sleeping. Grinding usually stops when breathing aids are used during sleep.
Within these two groups, bruxism is further categorized as primary or secondary. Primary bruxism is diagnosed when the grinding or clenching is the main issue. Secondary bruxism is the grinding that occurs as a result of an underlying condition such as sleep disorders, medication side effects, or excessive stress. Treatment will usually depend on whether the bruxism is primary or secondary.
Many instances of bruxism occur while the sufferer is asleep, so he or she may be unaware of the clenching or grinding when it happens. There are, however, some common symptoms that can occur and signify the actions.
- Chipped, flattened, or loose teeth
- Excessive tooth enamel wear
- Tooth sensitivity
- Jaw pain or stiffness
- Ear pain
- Cheek damage/tongue indentations
- Dull headache around temple region
Damage to the teeth that can be a result of the chronic grinding often leads to the most difficulties. Sufferers may need substantial repair to damaged teeth. This repairing can include root canals, extractions, crowns, bridges, and even dentures. Jaw pain and tooth sensitivity can lead to weight loss and/or vitamin deficiencies if sufferers experience difficulty eating properly. Some type of eating disorder may also occur. Excessive jaw irritation can also lead to, or worsen, TMJ.
During an exam, the dentist will determine the extent of damage, if any, and discuss how to handle necessary tooth repairs. Sufferers of bruxism can be fitted with a mouth guard that should be worn during sleep. For bruxism that only involves clenching, mouth splints may be recommended to help reduce tooth pressure during clenching. Mouth pieces will be made of either a hard acrylic material or a soft rubbery material. They may also be pieces that cover both the upper and lower teeth, or just the upper or lower alone. If the problem is due to a misalignment of the teeth, the dentist may recommend braces or other similar corrective measures.
When the bruxism is secondary, there are several ways the issue can be addressed. If medications are responsible, consult with the prescribing physician about making adjustments. Other underlying causes, including sleep disorders and excessive stress or anxiety should be managed by the appropriate medical professional. Often, receiving proper treatment for underlying conditions stops the occurrence of bruxism. The use of muscle relaxant medications may also be recommended.
After discussing the bruxism with the dentist and receiving appropriate care for any tooth damage, there are some things that can be done at home to help ensure that tooth damage does not continue. Avoid any food or drink that contains caffeine. Reduce stress and utilize relaxation techniques. Use warm compresses to relax jaw muscles. Avoid chewing gum and other non-food items. If necessary, seek advice on how to retrain the actions through behavioral modification. Behavioral modification efforts can include activities such as learning to change how you position your jaw and corresponding muscle usage.
In general, a dentist can repair damage to the teeth and fit sufferers with mouth apparatus to prevent future damage from grinding or clenching. If sufferers are aware of conditions that may be responsible for the bruxism, this can be discussed with the dentist. Following an exam, the dentist will recommend the best course of action based on the severity of grinding and damage that has occurred. The most important thing is to receive care before damage leads to more serious issues.