There are times when we have had our siblings or partners tell us that we make unusual facial movements or sounds in our sleep. Before we dismiss them as crazy, we must check for signs of teeth grinding, also known as bruxism, and the people who have this habit are called bruxers. But how to stop clenching teeth at night? Treatment options include mouth splint or mouth guard, muscle relaxants, addressing the psychological problem such as stress, anxiety, etc.

Through this article, we will know more about teeth clenching or grinding, and it’s symptoms, causes, and treatment options.

What is bruxism?

Bruxism forms under the category of ‘parafunctional habits,’ which are those activities that are not functional habits, or regular physiological habits.

Teeth grinding is of two types as nocturnal and awake bruxism. Nocturnal bruxism is one that is done subconsciously while sleeping, while awake bruxism is the teeth grinding done during wakefulness.

Causes of Bruxism

Though bruxism manifests as a disorder of the oral cavity and teeth mainly, it’s underlying reasons may have a more systemic connection.

  • Psychological factors – Stress is a common cause of bruxism and is linked mainly to awake bruxism. Individuals experiencing a stressful lifestyle, difficulty at work or home, or frequent bouts of anxiety, are more likely to be bruxers. (1)
    While the exact relationship between one’s mental health and bruxism has not been mapped out, it is noticed that children suffering from anxiety too are teeth clenchers, showing that this habit has an early onset.
  • Malocclusion – The relationship of our upper and lower teeth with each other, and with the respective jaws is called occlusion. When our teeth fall out of occlusion, there is some imbalance or force on the teeth. This can also be a cause for bruxism since our muscles try to adjust to the malocclusion and in turn exert excessive force on the teeth. (2)
  • Medications – Anti-depressants are a class of drugs that are known to have bruxism as a side effect.
  • Systemic disorders – Parkinsonism, Dementia, GERD, sleep apnoea, are also known to cause clenching. (3)
  • Bruxism is also linked to having a particular kind of personality trait – one that is aggressive and hyperactive. (4)
  • Habits like alcohol consumption, smoking, usage of drugs like cocaine can also cause or aggravate the condition.

Diagnosis

Though it may seem like a simple condition, if left undiagnosed and untreated, bruxism can have some serious complications. A visit to a dentist can give a definite diagnosis and treatment plan after the identification of the cause.

  • Early diagnosis of bruxism can be achieved by clinical examination of the teeth which show wear, though it is often overlooked. This clubbed with detailed history taking helps to identify the condition correctly.
  • The easiest way to diagnose bruxism is by knowing from your family members or those who sleep beside you at night. They can comment on your habit of clenching teeth at night, or you can also seek the help of various devices to record the clenching while you are asleep.

Symptoms

Clenching the teeth may have several manifestations, which help a person and their dentist diagnose the condition.

  • Flattening of the edges of teeth – The condition called attrition is the most apparent sign of bruxism. It is characterized by wearing off of the edges of the teeth due to the clenching force.
  • There may also be notches or depressions in the teeth near the gums, called abfraction.
  • Grinding sound at night or irregular muscle movements.
  • Waking up to a headache in the morning, especially in the temple region.
  • Breaking or dislodgement of fillings in the teeth, or tooth fractures.
  • Pain in the jaws, neck, ear or any muscles of the face.
  • The tightness of the jaw muscles or pain while opening your mouth, especially in the mornings. The pain is due to TMJ problems. However, the direct relationship between TMJ disorders and bruxism is still unclear.
  • Hypersensitivity in the teeth – This is because there is wear of the enamel, exposing the underlying dentin, which is sensitive. Particularly on having something very hot or cold, a person may feel hypersensitivity.
  • Pain in the teeth, gums, indentations on the tongue, loosening of teeth are some other symptoms to watch out for.

How to stop teeth clenching at night? – Treatment options

Like any multifactorial condition, the treatment of bruxism involves two-fold-treatment of the cause and symptoms.

Dental Treatment

To prevent further damage to the teeth due to clenching, it is recommended to use a mouth guard or mouth splint. A mouth guard is a prosthesis that is worn over the teeth at night, which prevents the teeth from clenching against each other.

It is usually made of acrylic, and maybe a full coverage guard, or one that covers only the affected teeth. It is quite similar to the one used by sportspersons or boxers. A mouth splint is used to relieve the excess strain on the muscles and even out the pressure.

In addition to this, the existing dental fillings that have failed or come out should be re-done. If there is excessive wear of the enamel, desensitizing medications can be given.

Medicines

Though no medicine directly treats bruxism, muscle relaxants can be given. Secondarily, painkillers can be provided to control the pain caused due to teeth grinding.

Addressing the psychological problem

If bruxism is diagnosed with stress or anxiety as an underlying cause, the dentist has to work in association with a mental health expert to address the issue.

Counselling, stress-relieving exercises, habit breaking methods, etc. may have to be relied upon to stop teeth clenching. Cognitive behavioral therapy is also recommended.

An individual can seek help from several relaxing exercises or hobbies, or turn to any activities that may help them to remain calm. It could be walking, yoga, or even listening to music.

A person can also be trained to practice mindful awareness, where one can consciously keep the muscles in a relaxed state as they fall asleep. If you wake up in the middle of the night, you must relax your muscles again, to reduce the tension in the jaws.

The latest addition to the management of this condition is the biofeedback system device. (5)

Over to you on how to stop teeth clenching at night

Bruxism is a common parafunctional habit seen in adults and children that causes several dental problems. Early diagnosis is the key to prevent excessive tooth damage and even worsen your psychological health.