It’s called bruxism and it can damage your teeth and give you headaches and jaw pain
by Jason S. Kasarsky, DDS
Do you grind or clench your teeth at night? It is estimated nearly 10 percent of the adult population suffers from this condition -- known to medical science as sleep bruxism. In fact you need not be asleep to do it. There are many individuals who unconsciously clench or grind their teeth during the day. However, daytime teeth grinding is nowhere near as bad as during sleep. When you are asleep your body’s protective mechanisms for countering teeth grinding are inactive.
But whether you grind your teeth at night or during the day, the result is the same. There can be damage to your teeth, plus headaches and jaw pain. In short, your quality of life is compromised.
What are the causes of teeth grinding? Most often Bruxism is caused by stress. But it should be noted that daytime and nighttime teeth grinding may have different origins. The important thing to note is that left untreated teeth grinding can cause damage to the teeth and surrounding tissue -- and leave the hapless sufferer with on-going headaches and jaw pain. Bruxism can disrupt healthy sleep patterns -- turning this vital time of physical and mental rejuvenation into a kind of restless, exhausting nocturnal misery.
So, what is going on physically during sleep bruxism? The upper and lower teeth can come into direct grinding contact for as long as 40 minutes every hour! The jaw can be exerting on the teeth -- typically the first molar -- a force of approximately 250 pounds. Under normal circumstances, a person's teeth will make contact only for about 20 minutes in a 24 hour period -- and that is while chewing. And chewing exerts only about 20 to 40 pounds of pressure on teeth. Sufferers from sleep bruxism generate a crunching noise while sleeping, and this can be a disturbing sound.
In my practice, I can spot a bruxism sufferer easily due to the wear patterns on their teeth.
I want to stress that sleep bruxism is not a disease. Rather, it is a sleep disorder. It is the third most common sleep disorder behind sleep talking and snoring. Interestingly, teeth grinding is more prevalent in children. Luckily children usually outgrow it. But the origin of bruxism in adults is difficult to pinpoint. In fact, the exact causes are unknown.
In the 1960s, bruxism was thought to be the body's response to malocclusion, or problems with how the upper and lower teeth fit together. Researchers have found clinical evidence to support this. Research has also focused on stress. However, stress fails to explain why not everyone with sleep bruxism was stressed and not everyone with stress ground their teeth. Recent research suggests a relationship between sleep bruxism and neurochemicals like dopamine. But there is disagreement in the medical community on how significant a role neurochemicals play. The most recent studies have identified a pattern of activation in the autonomic nervous system that correlates strongly with sleep bruxism. This is not to say that sleep bruxism is an indicator of neurological disease.
The bottom line? Medical science still does not know the exact cause of sleep bruxism. In time research may identify the underlying cause or causes. What we do know is that stress, smoking, alcohol, caffeine and other factors may cause the condition -- or worsen it.
If you grind your teeth what should you do? You can be fitted by your dentist with a mouth guard, a small plastic device that covers some or all of the teeth. However, this does not stop the teeth grinding action; it is simply worn to protect the teeth. But there are downsides to using a mouth guard. A mouth guard has been found to induce a chewing response and thus actually increase bruxism. A mouth guard can also damage the bite, or arrangement of the teeth, and should be used only temporarily. I do not recommend the inexpensive mouth guards found in drug stores. Your dentist will make you a mouth guard that lasts longer, fits better, and does a better job of distributing the force of grinding to reduce jaw pain.
Some suffers of bruxism, assuming their teeth grinding was caused by stress. have tried relaxation through yoga, exercise, and even hypnosis and accupuncture -- with mixed results. What about medication? Anti-anxiety medications like buspirone and clonazepam may provide some relief. But these can be habit forming and thus are not recommended.
If you wake up with headaches or jaw pain, you may be clenching or grinding your teeth. I recommend you first consult your dentist or doctor. In Addition, a university-affiliated oral-facial pain center may be advisable. There, patients may be directed to try some of the techniques listed above, or others, and may be assessed for associated conditions like snoring. These approaches may reduce bruxism, but since there is no known cure, only the effects can be reliably treated. In the end, mouth guards are still the best defense.
Dr. Jason Kasarsky practices dentistry in New York City (212-838-8230). His practice was one of the first in Manhattan to use an extensive array of lasers in daily practice. Dr. Kasarsky is founder of the New York City Center for Sedation Dentistry. He is a graduate of New York University College of Dentistry and a member of numerous professional organizations including American Academy of Cosmetic Dentistry, American Academy of Implant Dentistry, American Academy of Laser Dentistry, the American Dental Association -- and the Crown Council, a prestigious alliance of leading-edge dental teams throughout North America. On the cutting edge of the latest advances in oral care, Dr. Kasarsky has long advocated total wellness as a means of achieving optimum oral health.
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