Bruxism

Overview

Bruxism refers to grinding of the teeth during sleep (and sometimes during the day). In addition to being detrimental to oral and dental health, the noise from bruxism is often disturbing for others. Bruxism can lead to headaches, jaw pain and daytime tiredness (from disruption to normal sleep brain-rhythms). If left undetected, dental damage will usually occur, leading to tooth loss and gum disease. The most reliable way to diagnose bruxism is during a sleep study with a recording known as an electromyogram (EMG). This picks up electrical signals from the jaw’s chewing muscles.

Approximately 8% of adults are conscious of teeth-grinding sounds at night-time.

Severe bruxism can contribute to daytime tiredness by causing awakenings from sleep and sleep-fragmentation. Bruxism is sometimes associated with snoring, sleep apnoea, or other night-time movement disorders.

Bruxism frequently occurs due to psychological factors (including anxiety, stress and emotional problems), however it can be caused by a variety of other medical disorders (neurological and psychiatric disorders, substance abuse, and as a side-effect of medications). Bruxism can occur at any age, and is often noted in children and adults. There are no significant differences in bruxism rates between males and females.

Patients with bruxism usually experience cycles of improvement and worsening in their symptoms over time.

Risk factors for bruxism include: stress and anxiety, restless legs syndrome, sleep apnoea, smoking, use of illicit substances, and excessive caffeine and alcohol consumption.

Diagnosis

The diagnosis of bruxism is often made clinically (based on patient symptoms and history) and by your dentist or oral healthcare provider (based on evidence of damage to your teeth). Although polysomnography is not essential to diagnose sleep bruxism, a sleep study is often very helpful to:

  • Assess whether the bruxism is associated with another sleep or movement disorder (such as sleep apnoea, restless legs syndrome, periodic limb movement disorder)
  • Assess arousals from sleep and the level of related sleep-disruption (ideally both before and after treatment)
  • Ensure that suspected bruxism is not secondary to epilepsy or seizure-activity while asleep.

Treatment

Bruxism treatment should be multifactorial, and is highly dependent on whether or not an underlying cause (such as stress, anxiety, sleep-disorder or movement-disorder) is identified. In severe cases, an anti-depressant, anti-anxiolytic or muscle-relaxant medication may be prescribed for you.

In many cases, your dentist or oral healthcare provider can prepare an occlusal appliance (like a sports mouth guard) to be worn at night in order to protect your teeth from damage.

Your treating practitioner should also discuss with you behavioural modifications that may be helpful in preventing the problem. It is also advisable to ensure that you practice good sleep hygiene and sleep-habits (click here to visit our comprehensive sleep-habits information page).