Tooth Grinding

Bruxism (teeth grinding) occurs in about 15% of people. The teeth are ground together or the jaw clenched tightly during sleep. Bruxism can be mild and occasional or can be so frequent and/or violent that the teeth are damaged.

The cause in some cases is abnormal dental occlusion (the way the upper and lower teeth fit together when the person shuts the mouth). More often, the disorder is associated with anxiety, tension, and suppressed anger. Bruxismis usually worse after intake of alcohol.

Symptoms

• Teeth grinding, severe or very loud, that occurs during sleep
• Jaw clenching
• Jaw pain or earache (referred pain caused by violent jaw muscle contractions)
• Abnormal alignment of teeth
• Jaw muscle contractions
• Anxiety, stress, and tension
• Personality, suppressing anger

Signs and tests

Examination will rule out other disorders that may cause similar jaw pain or ear pain, including ear disorders such as otitis media, temporomandibular joint (TMJ) dysfunction, and dental disorders. Detailed history may reveal abnormal stress or tension.

Treatment

The goal of treatment is to prevent permanent damage to the teeth and reduce pain.

A night guard or protective dental appliance may be helpful if bruxism is severe enough to cause damage to the teeth or pain to jaw muscles. Orthodontic adjustment of the occlusion or bite pattern may be beneficial for some people.

Psychotherapy or counseling may help the afflicted person to express anger and deal with anxiety or stress. Relaxation or stress management techniques can be beneficial in reducing anxiety or stress.

Avoidance of alcohol use may be advised for some people.