Up to one in 10 of children and adults are estimated to grind their teeth – a habit known as bruxism. Dentist Dr Sej Patel gives his tips on spotting the symptoms, treatment and prevention.
What is the term for teeth grinding?
Bruxism is the medical term for grinding your teeth and/or clenching your jaw. You do this subconsciously in most cases - according to the NHS in 80 per cent of cases it happens when you are asleep.
Teeth grinding doesn’t always cause problems (although the gnashing noise can put your partner’s teeth on edge too!), but if you do it regularly for an extended period, you could suffer facial pain, headaches, ear ache and even tooth damage and lose teeth as a result.
What causes teeth grinding?
“Bruxism almost always occurs in association with other factors,” advises Dr Patel. These include:
Stress and anxiety: “About 70 per cent of bruxism cases that occur during sleep are thought to be related to stress and anxiety,” says Dr Patel.
Obstructive Sleep apnoea: “There is also a strong association between bruxism and obstructive sleep apnoea (OSA). OSA is a sleep disorder where your breathing is interrupted during your sleep.
The Bruxism Association says research shows there is also evidence that people with other sleep disorders, including parasomnias such as sleep talking, violent or injurious behaviours during sleep, sleep paralysis, hypnagogic/hypnopompic hallucinations (semi-consciousness between sleeping and waking), are also more frequently reported to be teeth grinders.
Other possible causes include:
Alcohol: Regularly drinking alcohol (it causes muscles to relax including those in the mouth and palate).
Drugs: Prescription drugs including some selective serotonin reuptake inhibitors, antidepressants and recreational drugs such as Ecstasy and cocaine may also increase the risk of suffering bruxism.
Too much caffeine: The NHS says that drinking more than six cups of tea or coffee a day is also associated with an increased risk of bruxism.
If you grind your teeth in your sleep you might be unaware of the problem at first unless your partner hears you, but if you do it regularly you may wake with an aching jaw or in pain.
Other symptoms include:
- Worn teeth, which can result in short teeth, increased tooth sensitivity and, possibly, the loss of your teeth
- Headaches – according to the Bruxism Association teeth grinders are three times as likely to suffer from these
- Gum inflammation or receding gums
- Loose or sensitive teeth
- Difficulty opening your mouth
- Facial muscle pain (facial myalgia)
- Shoulder pain or stiffness
- Sleep problems
In severe cases bruxism can lead to temporomandibular disorders — these occur in the temporomandibular joints (TMJs), located in front of your ears and felt when opening and closing your mouth and ultimately tooth loss.
How to treat it
“There are a number of possible treatments for teeth grinding but only a few have been shown to be effective,” says Dr Patel.
‘Behavioural therapies and the use of mouth guards, mouth splints and mandibular advancement devices (MADs) are the recommended treatments for bruxism.
Other treatments, such as muscle-relaxation exercises and sleep hygiene (controlling of all behavioural and environmental factors that precede sleep and may interfere with sleep), may also help manage your symptoms.”
- Mouth guards and MADS: If you grind your teeth while you are asleep, you may need to wear a small plastic mouth guard, mouth splint or a MAD at night to protect your teeth from further damage. Mouth guards protect teeth from premature wear, reduce jaw muscle activity and the noise of teeth grinding (so your bed partner’s sleep is not disrupted).
- Cognitive behavioural therapies: If you have an anxiety or stress-related problem, a course of cognitive behavioural therapy (CBT) may be recommended. CBT aims to manage your problems by changing how you think and act.
- Hypnosis: It may be possible to break the habit of teeth grinding using habit-reversal techniques e.g. hypnosis.
- Lifestyle changes: Making some simple lifestyle changes, such as giving up smoking (if you smoke), drinking less alcohol and caffeinated drinks in the evening before bedtime and managing your stress levels by using relaxation techniques or CBT, may also help.
"It is important to have regular dental check-ups which can prevent the effects that bruxism may have on your teeth, including worn or broken teeth, advises Dr Patel.
"Your dentist will be able to offer you treatments that can repair damaged or broken teeth, like dental bonding."
What about children?
Some estimates suggest between 15 and 33 per cent of children grind their teeth regularly, says the NHS.
It usually occurs after they develop their first teeth and again after they develop their permanent teeth. The habit usually stops after the adult teeth are fully formed.
After teething, a child may grind their teeth for the same reasons that adults do. For example, it may occur at stressful times, such as during school exams.
In most cases treatment isn’t necessary though, as the majority of children will outgrow the habit.