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Bruxism

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Teeth grinding and clenching

Treatment:

The goals of treatment are to reduce pain, prevent permanent damage to the teeth, and reduce clenching behaviors as much as possible.

To help relieve pain, there are may self-care steps you can take at home. For example:

• Relax your facial and jaw muscles throughout the day. The goal is to make facial relaxation a habit.
• Massage the muscles of the neck, shoulders, and face. Search carefully for small, painful nodules called trigger points that can refer pain throughout the head and face.
• Learn physical therapy stretching exercises to help the restore a normal balance to the action of the muscles and joint on each side of the head.
• Apply ice or wet heat to sore jaw muscles. Either can have a beneficial effect.
• Avoid eating hard foods like nuts, candies, steak.
• Drink plenty of water every day.
• Try to reduce your daily stress and learn relaxation techniques.
• Get plenty of sleep.

To prevent damage to the teeth, mouth guards or appliances (splints) have been used since the 1930s to treat teeth grinding, clenching, and TMJ disorders. A splint may help protect the teeth from the pressure of clenching. It may also actually help reduce clenching behaviors, but some people find that it makes their clenching worse. In others, the symptoms go away as long as they use the splint, but pain returns when they stop or the splint loses its effectiveness over time.

There are many different types of splints. Some fit over the top of the teeth, some on the bottom. They may be designed to keep your jaw in a more relaxed position or provide some other function. If one type doesn't work, another may.

For example, a splint called the NTI-tss fits over just the front teeth. The idea is to keep all of your back teeth (molars) completely separated, under the theory that most clenching is done on these back teeth. With the NTI, the only contact is between the splint and a bottom front tooth.

As a next phase after splint therapy, orthodontic adjustment of the bite pattern may be beneficial for some people. Surgery should be considered a last resort.

Finally, there have been numerous approaches to try to help people unlearn their clenching behaviors. These are more successful for daytime clenching, since nighttime clenching is cannot be consciously stopped. In some people, just relaxing and modifying daytime behavior is enough to reduce nighttime bruxism. Methods to directly modify nighttime clenching have not been well studied. They include various biofeedback devices, self hypnosis, and other alternative therapies.

Expectations (prognosis):

Bruxism is not a dangerous disorder. However, it can cause permanent damage to the teeth and uncomfortable jaw pain, headaches, or ear pain .

Complications:

If clenching leads to jaw pain, this in turn can lead to insomnia, depression, and eating disorders. Clenching and grinding can worsen existing dental or TMJ problems. Nightly grinding can awaken roommates and sleeping partners.

Calling your health care provider:

See a TMJ specialist immediately if you are having trouble eating or opening your mouth. Keep in mind that a wide variety of possible conditions can cause TMJ symptoms, from arthritis to whiplash injuries. Therefore, see a TMJ specialist for a full evaluation if self-care measures do not help within several weeks.

Grinding and clenching does not fall clearly into one medical discipline, and TMJ specialists have a variety of treatment approaches. For a massage-based approach, look for a massage therapist trained in trigger point therapy, neuromuscular therapy, or clinical massage, particularly as it applies to TMJ disorders.

Dentists who specialize in evaluating and treating TMJ disorders will typically perform x-ray exams and prescribe a mouth guard. Surgery is now considered a last resort by the vast majority of TMJ experts.

• Review Date: 7/20/2006
• Reviewed By: Johanna Jacobs, D.D.S., General and Cosmetic Dentistry, New York, NY. Review provided by VeriMed Healthcare Network.

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