Bruxism (Tooth Grinding) in Adults

“Habitual grinding and/or clenching teeth are forms of abnormal behaviour. Individuals may be aware of the habits during the day, but often they occur at night during sleep.” – U.S. Surgeon General’s Report

1. What is bruxism?

  • Bruxism is the unconscious and involuntary habit of clenching or grinding teeth. This means that a person with bruxism is mostly unaware of, and unable to stop the habit.
    • It can take place at night when asleep or during the day.
    • As bruxism is related to stress, it is a fairly common problem.
    • Bruxism can affect the teeth, muscles, jaw joints (Temporomandibular joints), and the appearance of the face.

2. What are the signs and symptoms of bruxism?

  • Excessive tooth wear caused by bruxism is not the same as normal tooth wear. These are the symptoms:
    • The teeth will be worn down, and become shorter. The dental term for this toothwear is attrition.
    • The teeth will become flattened, and the creamy/yellow dentine will be visible.
    • If bruxism is not treated, the teeth may be worn down to the level of the gums.
    • Teeth have a tendency to chip as a result of the grinding.
    • Tenderness and pain may be felt in the muscles and jaw joints on waking in the morning.
    • Eating may become painful because of restricted jaw movement.
    • Teeth can become sensitive, painful and loose after they have been worn down or cracked by the grinding.
    • Extensive tooth wear can cause the jaws to close down too far, resulting in facial changes.
    • Unsightly creasing at the corners of the mouth will be evident.
    • Bruxism may also cause the development of prominent jaw muscles.
    • The sound of grinding teeth can disturb other people.

3. What causes bruxism?

  • The main causes of bruxism are stress, psychological problems, and medical conditions.
  • It may occur in people with cerebral palsy, or learning difficulties.

4. How is bruxism treated?

  • Bruxism is treated psychologically, dentally and by medication.
    • The psychological and medical causes are dealt with by psychologists, psychiatrists and doctors.
    • Behaviour modification through relaxation training may be used to treat bruxism.
  • The dental treatment for bruxism is directed to preventing further damage to the teeth, and to the repair of the worn down teeth.
  • The preventive treatment is to use a nightguard.
    • Nightguards can lessen the effects of bruxism:
    • They cannot cure the bruxism as they do not treat the cause, but they can protect the teeth from further damage.
    • Nightguards prevent the upper and lower teeth from grinding against each other.
    • An acrylic night guard or bite plate may also relieve the symptoms of jaw joint disorders caused by bruxism.
    • Nightguards are provided by the dentist:
    • Impressions are taken of the upper and lower teeth.
    • They are sent to the dental laboratory where the night guard is made.
    • Nightguards are designed to cover the biting and chewing surfaces of the teeth in one of the jaws, usually the upper.
    • They can be made from a soft plastic or a hard acrylic material.
    • A mouthguard is often supplied with the cast from which it was made.

5. How does the dentist treat the attrition caused by bruxism?

  • Where bruxism has resulted in severe attrition, the teeth will need to be restored:
    • Replacement crowns or onlays can be used to restore the worn down teeth.
    • These measures will restore the teeth to their normal size, and the jaws will regain their normal position.
    • The dimensions and appearance of the teeth and face can be aesthetically improved with dental restorations.

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