Do you notice yourself waking up with jaw pain in the morning? Or, do you notice yourself clenching or grinding your teeth when stressed or angry? Both scenarios can be signs of bruxism, an involuntary habit of clenching or grinding your teeth. Bruxism can happen while awake or asleep, but usually those affected by night grinding are unaware until they experience symptoms such as jaw pain or tooth discomfort, or are diagnosed due to tell-tale signs.

Individuals with sleep bruxism are not grinding their teeth continually, but instead have periods of clenching and grinding that may last seconds. The frequency of periods of grinding is not usually consistent, and grinding may not occur every night. Usually, bruxism happens early in the sleep cycle, but the pain or discomfort is only noticed upon waking. Pain occurs due to the tightening of the jaw muscles during the acts of bruxism.

Symptoms of bruxism may include audible grinding during sleep and can be severe enough to disrupt sleep. Dental findings may include flattening, chipping or fracturing of teeth, increased tooth sensitivity, tooth wear that can lead to erosion and recession, or even cheek biting. Facial pain such as tight or sore jaw muscles, jaw-lock, headaches and ear discomfort are also signs of bruxism.

Bruxism can be a primary disorder not associated with other conditions, or secondary where multiple contributing factors are present.

Primary bruxism (not resulting from another condition):

Common in children when their teeth are growing. Since the jaw and teeth grow quickly as children grow, bruxism tends to resolve on its own.
In adults, stress tends to be one of the main causes, whether symptoms appear when awake or asleep.
Misaligned bite or missing teeth can also cause habits of grinding.
Secondary bruxism (a result of another condition):
Medications: Bruxism can be a common side effect of some medications including antipsychotics and antidepressants. Specifically, selective serotonin reuptake inhibitors (SSRIs) have been linked to the condition.
Sleep apnea: A condition where breathing stops periodically while sleeping, resulting in a reduction in sleep quality which can ultimately cause teeth grinding
Anxiety and depression: May be precursors to stress related bruxism

Bruxism does not always require treatment, and treatment depends solely on the cause. If malocclusion (misaligned teeth) is the cause, then the best treatment option may be orthodontic alignment. If the action is only happening at night, then a great treatment option might be a night guard. When properly fitted, a guard redistributes the grinding forces from the teeth, which ultimately relaxes the muscles and reduces symptoms. Nightguards do not cure the cause of bruxism, but ultimately help to reduce or eliminate the negative effects that grinding can cause. In severe cases, one treatment option is injections of botulinum toxin, also known as Botox, which helps to paralyze the muscles of mastication responsible for bruxism.

If you have questions or are experiencing symptoms related to bruxism, contact your dentist for further evaluation.

Sarah Khoshniyati (“Dr. Sarah”) is a dentist with Palm Desert Smiles and can be reached at (760) 568.3602.