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Teeth grinding: causes and treatment

by Josephine Andrews
Published: Last Updated on 346 views

When grinding their teeth (bruxism), those affected involuntarily press their teeth together again and again with great pressure (usually while sleeping). This wears down the enamel over time. The consequences are severe tooth damage and even tooth loss. In addition, there is often painful tension in the jaw muscles, which can lead to headaches, neck pain or facial pain. Read more about the causes, consequences and treatment options for teeth grinding here.

quick overview

  • Causes: stress, misaligned teeth or jaws, crowns or fillings that are too large , too much alcohol or caffeine , certain medications, underlying diseases such as restless legs syndrome, breathing pauses at night, circulatory disorders, cerebral hemorrhage, epilepsy , Huntington’s disease, Parkinson’s disease .
  • Symptoms: rhythmic, involuntary clenching of the teeth , often with grinding, chewing-like movements. Mostly at night, but sometimes also during the day. Possible accompanying symptoms: muscle tension with headache, neck, jaw and face pain. Pain-sensitive, porous teeth, severe tooth damage up to tooth loss.
  • Treatment: Depending on the cause, e.g. correction of crowns or fillings that are too large, bite splints, loosening and relaxation exercises for stress-related teeth grinding, physiotherapy and, if necessary, short-term use of painkillers and/or muscle-relaxing medication, psychotherapy for deeper psychological stressors, biofeedback procedures.
  • Diagnosis: based on typical signs such as pressure-sensitive chewing muscles, tooth impressions in the tongue/cheek, smoothly polished chewing surfaces, cracks/chips on the enamel, chips on the hard tooth substance, the tooth necks and the incisal edges, pain-sensitive teeth.
  • Prognosis: With early treatment, the prognosis is good. (Serious) consequential damage to the teeth can then usually be avoided.

Teeth grinding: causes

The main causes of teeth grinding (bruxism) are:

  • Stress : Every second responds to being overwhelmed professionally or privately by grinding their teeth at times. But only one fifth develops a chronic problem.
  • Disrupted clenching : When the clenching of the jaws is disturbed, teeth grinding may ensue. Misaligned teeth and unsuitable crowns or fillings can trigger such jaw problems. Another cause is teeth growing out. This happens, for example, when you lose a tooth. The corresponding counterpart (in the opposite jaw) then no longer meets with resistance and can grow unhindered – the result is a disturbed clenching of the upper and lower jaw , often accompanied by grinding of the teeth.
  • Alcohol, caffeine, medication: Excessive consumption of stimulants and certain medications can also cause teeth grinding.
  • Diseases : Sometimes teeth grinding is caused by diseases such as restless legs syndrome (restless legs syndrome), obstructive sleep apnea (nocturnal breathing stops), reduced blood circulation (ischemia), cerebral hemorrhage, nocturnal epilepsy, Huntington’s disease, Parkinson’s disease.

If no clear medical cause can be found for the teeth grinding, primary bruxism is present. Then stress can play a role. Physicians speak of secondary bruxism when a specific trigger for the teeth grinding is recognizable, for example a neurological or psychiatric disorder, sleep disorders or medication.

Teeth Grinding: Baby & Child

About half of all babies start grinding their teeth by the age of ten months. That’s no reason to worry, because in this way the new milk teeth are matched to each other or “ground in”. When the last milk tooth has fallen out, the bruxism usually disappears as well.

In school children, however, teeth grinding usually indicates stress – especially if other symptoms such as nail biting or gnawing on pencils are added. Children who talk in their sleep (somniloquia) or wet themselves at night ( enuresis ) often grind their teeth.

Teeth grinding: symptoms

In teeth grinding (bruxism), those affected involuntarily press the teeth of the upper and lower jaw together without pursuing a functional purpose (such as chewing). Rhythmic, grinding, chewing-like movements can also occur.  

The worst part of grinding your teeth is that it puts a lot of pressure on your teeth and jaw joints. Up to 480 kilograms per square centimeter (kg/cm2) are possible – that is ten times the pressure that occurs when chewing! And these enormous forces don’t just strain teeth and jaws for a short time – teeth grinding can last up to 45 minutes a day.

Due to this enormous load, the tooth enamel is worn down over time and the dentin (tooth bone) is exposed along with the nerve tracts. The result is pain-sensitive, increasingly porous teeth.

In the long term, grinding your teeth can cause serious damage to your teeth, including tooth loss. There is also often muscular tension, which can result in jaw, neck, face and headache pains. Tension and pain in the back area are also possible.

Grinding of teeth during sleep and during the day

Most sufferers grind their teeth while they sleep. Doctors then speak of nocturnal (nocturnal) bruxism or sleep bruxism.

Diurnal bruxism (waking bruxism), i.e. grinding your teeth during the day, is less common. The jaws are usually only strongly pressed together without grinding with the teeth.

Centric and eccentric bruxism

Some people unconsciously clench their teeth very tightly. With this centric bruxism, extremely strong forces act on the teeth and jaw joints.

In eccentric bruxism, the teeth are rubbed against each other, which produces a more or less loud grinding noise.

Teeth grinding: what helps?

There are good methods to treat teeth grinding. Sometimes just relaxing is enough. For example, regular walks and breaks at work, as well as a warm relaxing bath in the evening (for adults and children who grind their teeth at night) make sense.

If none of this helps, you should see your doctor or dentist. He will advise you on the choice of the appropriate therapy. If the cause of the teeth grinding is, for example, a crown or tooth filling that is too large, the dentist can grind it down and thus easily eliminate the bruxism. A bite splint protects the teeth from abrasion and further damage. If the teeth grinding is triggered by an underlying medical condition (such as restless legs syndrome), this must be treated accordingly.

In the following you will learn more about important therapy options for teeth grinding.

relaxation exercises

Mindfulness and targeted self-observation help against waking bruxism. For example, you can attach a colored adhesive dot to your mobile phone, your watch or your office screen. Whenever your gaze falls on this point, check whether you are clenching your teeth. If so, consciously relax your jaws. To do this, repeatedly open your mouth wide and gently move your lower jaw back and forth.

If you are grinding your teeth due to stress, you should also try relaxation methods. This reduces inner tension and counteracts the grinding of teeth. The exercises can also help with headaches and jaw pain associated with teeth grinding.

Proven ways to reduce stress include:

bite splint

A bite splint (occlusal splint) is individually adjusted by the dentist. It prevents direct contact of the teeth when biting, thus protecting the hard tooth substance and the periodontium and contributing to a relaxed position of the upper and lower jaw.

Tip: Have your teeth checked regularly (every six months) by the dentist. In this way, any damage to the teeth can be detected at an early stage.

physical therapy

Physiotherapeutic exercises loosen tense muscles, promote blood circulation in the tissue and train coordinated jaw movements. You can have your physiotherapist show you the exercises you can do at home.

medication

Pain-relieving medication or muscle relaxants may be useful for teeth grinding. However, they should only be used for a short time.

psychotherapy

Stress often triggers teeth grinding. If this stress has deeper psychological causes, in addition to relaxation exercises such as autogenic training or progressive muscle relaxation according to Jakobsen, psychotherapy can help.

biofeedback procedure

Biofeedback methods are also effective for teeth grinding. With the help of electronic devices, you learn to become aware of unconscious physical processes such as grinding your teeth. You can then control them at will – for example, by consciously relaxing the jaw muscles.

Teeth grinding: diagnosis

If you notice that you grind your teeth more often during the day or clench them tightly, you should see a dentist. This also applies if your partner informs you about grinding your teeth at night. Most of the time you don’t even notice it. However, you should be alert if your lower jaw is stiff and tired after waking up in the morning or if chewing hurts.

The dentist checks how severe the bruxism is and to what extent the teeth have already been damaged. Signs of bruxism include:

  • pressure-sensitive masticatory muscles
  • Teeth marks in tongue and cheek
  • smoothly polished chewing surfaces
  • Cracks and chips in the tooth enamel
  • Chipping of the hard tooth substance, the tooth necks and the incisal edges
  • painful teeth

Teeth grinding: prognosis

Most bruxism sufferers can be helped well. The earlier the teeth grinding is treated, the better the prognosis. If you wait too long, serious tooth damage and accompanying symptoms such as pain and tension are usually unavoidable. Therefore, if you suspect teeth grinding, you should do something immediately. Sometimes simple relaxation exercises are enough to get the teeth grinding under control. If not, you should contact your doctor or dentist.

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