Bruxism Causes and Treatment

If you routinely grind or clench your teeth, you may also be experiencing symptoms ranging from headaches or facial pain to a temporomandibular joint (TMJ) disorder that can lead to its own host of health problems. Or you may be grinding without even realizing it: Lots of people clench and grind their teeth in their sleep and wouldn't notice unless a spouse or partner points it out.

What may seem like an innocuous nervous habit is actually considered a medical condition called bruxism. Certain medications increase the risk of bruxism. So, a prescription change could be all it takes to ​resolve the condition.

Other people may need more help, such as taking measures to relieve stress (people often grind their teeth when they're nervous or under pressure) or wearing a mouth guard during sleep.

Most of the time, bruxism is not severe enough to cause major problems. When symptoms do occur they include:

• Facial pain
• Headaches—tension headaches from day grinding and morning headaches for nighttime bruxism
• Earaches
• Damage to teeth: chips fractures, worn enamel, flattened tops, loose teeth 
• Teeth that are very sensitive to cold, heat, or pressure
• Chewed places on the tongue or cheek
• Noise from the grinding or clenching that wakes your sleeping partner
• Temporomandibular joint (TMJ) disorders

There are lots of reasons a person grind their teeth. These are the most common causes and risk factors for bruxism:

• Emotions. Frustration, stress, tension, anxiety, and suppressed anger are all potential culprits. 
• Youth. Kids are more likely to grind their teeth than adults. In fact, sleep-related bruxism affects 15% to 40% of children compared to 8% to 10% of adults.
• Medications. Research shows that certain medications are known to cause bruxism—in particular, some that are used to treat psychiatric conditions. It's thought that these drugs cause changes in the central nervous system that lead to teeth grinding and jaw clenching. Examples of such medications include antipsychotics and antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) like Prozac (fluoxetine), Zoloft (sertraline), and Paxil (paroxetine). 
• Certain substances. Cigarette smoking, caffeine, alcohol, and recreational drugs all may increase the risk of bruxism, studies have found.
• Genetics. Bruxism tends to run in families.
• Certain medical, sleep, and psychiatric problems. Disorders associated with teeth grinding include Parkinson's disease, dementia, gastroesophageal reflux disorder (GERD), epilepsy, night terrors, sleep-related disorders such as sleep apnea, and attention-deficit/hyperactivity disorder (ADHD).

Bruxism is highly treatable. The key is to figure out what's causing you to grind your teeth and then target your treatment based on that. 

If your bruxism is causing you pain, try these steps at home to help:

• Don't chew gum—this can make pain worse.
• Stay away from hard candies, nuts, steak, and other foods that are difficult to chew.
• Try to relax your face throughout the day. Self-massage may be helpful too: Feel for small, painful nodules called trigger points that can cause pain throughout your head and face.
• Manage stress. Do whatever you can to reduce your stress because stress makes bruxism worse. Take a bubble bath, go for a walk, or listen to your favorite music. Learn relaxation exercises such as mindfulness, deep breathing or meditation.
• Change your behavior. Discuss with your dentist techniques for practicing proper mouth and jaw positioning. 
• If you tend to grind in your sleep, don't have foods or beverages that contain caffeine before bed. Alcohol and smoking in the evening also can trigger bruxism worse.
• Stay on top of your dental care so that your dentist can monitor any damage you might be doing to your teeth.
• Get plenty of sleep.

When chronic stress or anxiety is driving you to gnash and grind your teeth, it may be helpful to see a therapist.

If other efforts fail to help you break the bruxism habit, biofeedback may be worth trying. This is a method that uses monitoring procedures and equipment to teach you to control muscle activity in your jaw. 

If you're a night grinder, a mouthguard, also known as an appliance or splint, may be helpful. Some fit over the top teeth, some fit over the bottom teeth. They may be designed to keep your jaw in a more relaxed position or to provide some other function.

One such splint, for example, called the NTI-tss, fits over just the front teeth in order to keep the back teeth (molars) completely separated. This is based on the theory that most clenching is done on these back teeth. With the NTI, the only contact is between the splint and a bottom front tooth. In studies, the NTI-tss splint has been found to help prevent bruxism.

There is some evidence that certain medications may be helpful in managing bruxism. Muscle relaxants, and even Botox injections, have shown promise as temporary antidotes for teeth grinding teeth when it's not caused by a medication.

If your bruxism is caused by medication, your doctor may consider either changing your dose or putting you on a different medication.