A common issue that affects up to 80% of the population, the grinding of teeth and clenching of the jaw can cause tooth wear, breakages, pain, limited movement of the jaw joint (Temporo-mandibular joint disorder), migraines and headaches. Most common in adults over 25 years old, the cause is not fully understood, though symptoms often worsen during stressful periods.
Effects of bruxism
Bruxism sufferers are affected in many ways and it can lead to more serious issues, often requiring a dentist’s intervention.
Many symptoms are not dental, which often leads to bruxism being untreated for many years. It is common for patients to turn to their GP and have a magnitude of investigations for other medical conditions, including MRI and brain scans.
Short-term effects of bruxism
Headaches and migraines
Facial myalgia (aching jaw & facial muscles – often diagnosed as atypical Facial Pain)
Earache, tinnitus and sinus pains
Stiff neck and shoulders
Limited mouth opening
Poor sleep quality
Sleep disturbance of bed partner due to noise
Tooth mobility and tooth wear
Fractured tooth cusps and broken fillings
Receding and inflamed gums
Long-term effects of bruxism
Prolonged untreated migraines
Excessive facial muscle tone
Temporo- Mandibular Joint Disorder (sometimes called TMJD or just TMJ)
Clicking or popping jaw joint
Tooth wear and tooth loss
Bruxism (tooth grinding and tooth clenching) has many effects on the sufferer, most commonly – tooth wear and broken teeth. One of the most debilitating effects of bruxism is headaches, migraines and chronic tension headaches. These symptoms often go untreated because who would think that it is caused by tooth grinding or clenching
During sleep we all do strange things, such as snore, kick our legs and even talk. But one of the most common things we do at some time during our lives is grind our teeth. For lots of people, this goes unrecognised. Some people may notice their teeth are wearing down or breaking, but for the unlucky ones, they suffer with headaches and migraines.
Tooth wear and broken teeth
Your teeth should last you a lifetime and not wear down. However, bruxism is a destructive condition. Normal chewing and eating does not cause wear or damage to your teeth. If you suffer from bruxism, you are putting your teeth and gums under massive amounts of pressure. During sleep, there is no feedback mechanism to tell your brain that your teeth are hurting because of too much pressure, hence we can put up to 40 times the amount of pressure on our teeth whilst we sleep – it is no surprise to see a lot of damage.
The most common sign of bruxism is shortened front teeth (incisal wear). However, in more severe cases, we see signs of cracks in enamel, abfractions (enamel loss at gum level), gum recession, bone overgrowths (bony exostosis), broken cusps of molar teeth, and damage to restorations (crowns & bridges).
Treatments for Bruxism
There are many ways to manage bruxism, the most common treatment being occlusal splints (dental appliances). There are other therapies and treatments available, but these are generally seen as less effective. It is becoming more popular for dentists to recommend a more holistic treatment plan. This may include combined treatments with physiotherapists, chiropractors, and sometimes hypnotherapists.
Occlusal splints are generally designed to act as a mechanical separation of the teeth and may be as simple as a soft mouthguard. Other dental treatments may also be considered, such as equilibration (grinding away tooth surface to make the teeth fit together better), orthodontics, or crowns and veneers.
Sleep related breathing disorders demonstrate, to varying degrees, the collapsibility of the airway. With simple palatal snoring, there is no full obstruction of the airway – the noise is simply the vibrations of soft tissue. Whilst this often has little impact on the snorer, some do wake feeling unrefreshed, suffer headaches and a tenderness in the upper airway. More often, it is those within close proximity that are profoundly affected.
Excessive daytime sleepiness (EDS) can result from insufficient oxygen entering the body and poor quality sleep caused by multiple wakings. Effects of EDS include an inability to concentrate, poor memory, reduction in performance and, in extreme cases, can lead to the sufferer falling asleep unexpectedly. Severe sleepiness has even been found to increase the chances of having an accident whilst driving by seven times.
EDS can be a result of obstructive sleep apnoea, a more severe collapsing of the airway in which it is obstructed for multiple periods of time during sleep. Both in the form of a total pause or a significant shallowing of breath, oxygen levels dip and can result in a multitude of symptoms: extreme tiredness, snoring, abnormal movements whilst sleeping, headaches, and psychological issues to name a few.
There are a number of solutions for both snoring and sleep apnoea. Mandibular Advancement Splints (MAS) are commonly used for both, gently holding the lower jaw forward to keep the airway open.
For severe sleep apnoea (typically tested in a sleep clinic, but can also be done in your own home), Continuous Positive Airway Pressure (CPAP) is recommended and offers the highest clinical success. Compliancy, however, can prove to be an issue. For those that cannot get on with CPAP and for moderate sufferers, (less than 30 interruptions an hour), a splint is the most common treatment of choice – highly effective, less expensive and more patient friendly.
Customised for each patient, we can help by advising and providing a suitable appliance.