Teeth grinding, or bruxism, can occur consciously or subconsciously. We consciously grind our teeth when we are chewing or at times, when we are angry. This type of grinding is rather benign because our conscious self stops the grinding before any damage is done. One of our patients is a professional sportsman and he grinds his teeth hard during training or competition.
The other type of grinding is subconscious. Anaesthesiologist colleagues have mentioned that patients may gnash their teeth when they are entering and/or waking up from general anesthesia. The most common type of teeth grinding by far would be grinding at night during sleep. Some earlier research studies also indicate that newly placed ill-fitting dental fillings may also cause teeth grinding.
Why does teeth grinding only happen at night?
Grinding can occur at any time, whether day or night. Unlike day time grinding, there is no inhibition mechanism operating to tell the person to stop grinding when he or she is asleep. Also, during the night, it is generally more quiet and family members are around. Therefore, this is the time when teeth grinding is often noticed.
Night time teeth grinding usually occurs during the time we are falling asleep, dreaming, or when we are waking up. That is the time when our brains are semi-active and the brain stem is actively giving out signals, including the activation of jaw muscles and results in night grinding.
It is also common for children to grind their teeth at night. However, this is mostly self-limiting and the vast majority of children out-grow this phase.
Day time stress is also another reason for grinding. When people are under stress, they generally do not sleep well.
What are the consequences of teeth grinding?
Regardless of the type of grinding, the concern is the magnitude of the grinding force. Research has shown that the force exerted during night time teeth grinding could be a multiple of normal day time maximum bite force as there is minimal inhibition mechanisms in place to prevent grinding with excessive force during this time.
Grinding of teeth over a long period of time may lead to accelerated wear on the teeth, which in turn, causes reduction in the height of the lower face, speech problems, incapacity in chewing, loss of support to the lips and generally, an aged-looking face. It can also lead to jaw, oral and facial pain, and head and neck muscle pain, which is sometime referred to as craniomandibular disorders or temporomandibular joint (TMJ or jaw joint) disorders.
Many times, patient who come to our clinic because of jaw joint problems turn out to be teeth grinders at night.
How does one stop grinding their teeth?
Many researchers have studied the clinical strategies to stop night grinding. These include muscle relaxant medication, electro-stimulation or relaxation, and bite correction. However, up to this point of time, there is no single predictable method that can totally stop a person from grinding their teeth at night.
From a management point of view, the strategy is to keep the teeth wear in check and manage other clinical symptoms when they arise. One of the proven treatments to reduce damage from grinding is through the use of a dental splint. A dental splint helps to relieve discomfort associated with teeth grinding and effectively reduces excessive teeth wear.
On the other hand, if the cause of the grinding is clearly due to a newly placed but ill-fitting dental filling and the patient reports that the filling feels ‘high’, then the obvious solution is to correct the ill-fitting filling.
It is also commonly believed that yoga and other forms of relaxation training may help to reduce teeth grinding through stress reduction.