What is Bruxism and Clenching?
Have you been told that you grind your teeth while you sleep, or do you notice that you clench your teeth and jaw muscles when you are stressed? Teeth grinding or bruxism is repeated, involuntary grating and gnashing of the teeth, usually during sleep. Clenching is when you clamp your teeth together and tighten your facial muscles.
Without intervention, continued bruxism or clenching can cause flattened or worn teeth, fractured teeth, and broken dental restorations (fillings, crowns, bridges, or implants). Along with dental problems, bruxism and clenching can trigger headaches or facial pain and contribute to jaw joint (temporomandibular joint) inflammation and tissue damage.
Because bruxism and clenching typically occur during sleep, most patients are often not even aware of these harmful patterns until they develop facial or muscle pain, headaches, toothaches or other symptoms.
How are Temporomandibular Disorders (TMD), Bruxism and Clenching related?
Our ability to open and close our mouth, chew and speak is largely made possible by two temporomandibular joints (TMJ), with one TMJ located slightly forward of each ear. While not always the cause of temporomandibular joint disorders (TMD), bruxism and clenching can make TMD pain and symptoms much worse.
Jaw joint disorders generally involve inflammation around the temporomandibular joint or displacement of the articular disc that serves as a buffer between the jaw bone (mandibular) and facial bone (temporal) during jaw movement. Repetitive teeth grinding and clenching places additional strain on the muscles and tendons in the jaw joints; this constant source of irritation makes healing difficult and can intensify TMD pain.
Obstructive Sleep Apnea and the connection to Bruxism and Clenching
There is ongoing research surrounding the link between bruxism and clenching with obstructive sleep apnea (OSA), an illness that causes the body to stop breathing several times during sleep due to airway blockage. Recent evidence suggests that the sleeping OSA patient will react without waking as the body struggles to breathe by clenching and grinding their teeth in an attempt to re-position the mouth and keep the airway open.
Dental Sleep Medicine
As a dentist with a focus on TMJ disorders and oral appliance therapy for obstructive sleep apnea, Dr. Leigh Bennett will talk with you about your sleep patterns during your consultation appointment to screen for possible obstructive sleep apnea or sleep bruxism. Dr. Bennett will make recommendations for a referral to sleep medicine specialists as needed to address any concerns about your sleep health.
What are the Signs and Symptoms of Bruxism and Clenching?
Most people first become aware that they are grinding their teeth when a sleep partner tells them. (Grinding your teeth can be noisy; it probably won't wake you up, but it can disturb your partner's sleep.)
There are also telltale dental signs that you dentist will discover during a dental examination, common indicators are flattened teeth chewing surfaces (molars and premolars) or chipped edges in the front teeth (incisors) that are the result of persistent teeth grinding or clenching.
The impact of bruxism and clenching can cause a number of symptoms, including:
- Jaw or facial pain that is especially noticeable just after you wake up
- Morning headaches
- Teeth pain, broken restorations or gum (periodontal) disease
- Earaches
- Neck stiffness and pain
What Causes Bruxism and Clenching?
The cause of bruxism and clenching is not always a direct relationship. As with temporomandibular disorders and obstructive sleep apnea, bruxism and clenching may be a related symptom to a number of other health problems, including:
- Stress or anxiety
- Poor bite alignment (malocclusion)
- Medication side effects
- Sleep disorders
- Acid reflux disease, or Gastroesophageal reflux disease (GERD)
- Hyperactivity
- Substances, including alcohol, nicotine and excess caffeine
- Childhood dental conditions or sleep issues
How are Bruxism and Clenching Treated?
Developing a treatment plan to alleviate your bruxism and clenching symptoms begins with a detailed oral examination and consultation with Dr. Leigh Bennett at the Hartley Bridge TMJ & Dental Sleep Center. During this visit, Dr. Bennett will talk with you about your medical and dental history to learn more about your health, followed by a teeth and jaw joint examination with any necessary digital x-rays. She will consult with your physician as needed to determine if your symptoms are related to an underlying medical condition.
Oral Appliance Therapy
Treatment for bruxism and clenching often requires the use of a removable oral appliance (bruxism appliance, biteguard or nightguard). The bruxism appliance is a plastic custom mouth tray that is designed by Dr. Bennett and our laboratory to fit your bite.
Based on individual patterns, some patients may only wear their oral appliance while they sleep, others may wear it as much as possible throughout the day.
While it is not always feasible to eliminate bruxism altogether, oral appliance therapy can help to reduce teeth grinding and clenching and minimize the harmful impact on the teeth surfaces and jaw joints.
Dr. Bennett may also design the function of the oral appliance to align the jaw in the proper position for support of the facial muscles, jaw joints or soft tissues of the airway, as with management of TMJ disorders or obstructive sleep apnea. Learn more about oral appliance therapy.
Medications and Follow-Up for Treatment of Bruxism and Clenching
In addition to oral appliance therapy, Dr. Bennett may prescribe medication to reduce inflammation and pain around the jaw joint. Typically medication is a temporary measure to manage symptoms as the appliance provides relief from bruxism and clenching and creates the opportunity for the joints and facial muscles to heal.
Dr. Bennett will schedule follow-up visits to monitor how your muscles and jaw joints are responding to oral appliance therapy and make adjustments as needed to prevent and reduce bruxism and clenching.
If your symptoms and diagnostic information indicate that bruxism and clenching are related to obstructive sleep apnea, Dr. Bennett will recommend that you schedule an appointment with a medical sleep specialist for evaluation. The sleep specialist may prescribe a sleep study to monitor the quality of your breathing as you sleep. Learn more about how sleep apnea is diagnosed.
Your Local Macon Dentist for Treatment of Bruxism and Clenching
If you know that you grind or clench your teeth, early intervention can help prevent dental problems and uncover any related health issues. Contact Dr. Leigh Bennett and Team at Hartley Bridge TMJ & Dental Sleep Center to schedule a New Patient Consultation and let us help you get relief from teeth grinding and clenching.