How To Stop Grinding Teeth In Sleep
Bruxism or night-time teeth grinding affects around 20% children below 11 years of age and 13% of adults in the age group of 18 to 29. Causes may vary from physiological to psychological and even lifestyle habits like smoking and alcoholism. Treatment options include using customized mouth guards, cutting down on stimulants, and/or trying hypnotherapy.
Do you often get up from sleep with clenched teeth or aching jaws or even headache? If yes, you could be suffering from bruxism or nocturnal tooth grinding.
What is bruxism? It is a movement sleep disorder where you clench your jaws and grind your teeth as you sleep. In this, there is rhythmic contraction and release of the jaw muscles accompanied by teeth grinding. While this may seem completely natural, it is considered a pathological condition when it results in lack of sleep and severe tooth damage.1
According to the book The Sleep Disorder published by The National Sleep Foundation, bruxism affects around 20 percent children below 11 years of age and 13 percent of adults in the age group of 18 to 29. While most children outgrow this condition, overall 8 percent of adults suffer from bruxism throughout their lives.2
How Do You Know You Have Bruxism (Teeth Grinding)?
When you find yourself waking up with clenched jaws, or hear your bed partner complaining of grinding noise from you at night, you know you are suffering from bruxism. You know you have the problem when you often get clicking noise from your jaws, your lower jaw is swollen or you wake up with regular headaches. Here are some other symptoms3:
- Stiffness of facial joints.
- Pain around the jaw area and generalized facial pain.
- Difficulty in opening mouth in severe cases.
- Disturbed sleep.
Bruxism also leads to fractured or chipped teeth, increased tooth sensitivity due to worn down enamel, swollen gums and chipped tooth fillings in case you have them.
What Causes It?
Even though it is very common, experts are still trying to find out what causes nocturnal tooth grinding. According to National Health Services (NHS) UK, in 70 percent of the cases, nocturnal bruxism is caused due to stress and anxiety.4 Other causes include certain types of medication, sleep apnea, and lifestyle habits like smoking and alcoholism.5.
Here are some causes explained:
1. Sleep Apnea
Studies have shown that sleep bruxism occurs mainly in non-REM (Rapid Eye Movement) stages 1 and 2 of the sleep, rarely in deep sleep and almost never in deep restorative non-REM stages 3 and 4.6
Sleep apnea is considered as one cause. In normal cases, the jaw remains open during sleep due to motor suppression. The contact between teeth happens with sleep arousal making the researchers believe that sleep arousal is associated with bruxism.7
This intermittent pausing of breathing during sleep affects the motor neurons of your face as you sleep leading to grinding and clenching. Bruxism is also accompanied by snoring. So when your apnea or paused breathing ends, your body automatically reacts through gasps, snoring, and teeth grinding.
A study done on the effect of continuous positive airway pressure or CPAP on sleep apnea further substantiate the claim that sleep apnea and the breathing problem that results from it does contribute to sleep bruxism. It was found that breathing difficulty in the sleep apnea patient was eliminated which helped in eradicating teeth grinding.8
Sleep bruxism is also found to be associated rhythmic masticatory muscle activity or RMMA which manifests as repetitive jaw muscle contractions.9
2. Lifestyle Habits And Drugs
Lifestyle choices like cigarette smoking, excessive alcohol consumption, irregular sleep timings, and excessive caffeine can also cause bruxism.10
Other causes are the illicit use of drugs and prescription medication. Research also shows that long-term use of antidepressant drugs has a direct impact on nocturnal teeth grinding. Medications like venlafaxine, citalopram, and fluvoxamine, as well as addiction to amphetamine, can all induce a severe case of bruxism.11
These habits actually cause a disturbance in your central dopaminergic system (it controls our stress reactions and neural mechanism) which in turn leads to bruxism.12
3. Psychological Factors
Excessive stress and anxiety also lead to bruxism. Research shows that in 70 percent of the cases, bruxism is aggravated due to stress and anxiety.13 Interestingly, job-related stress is found to have more impact on nocturnal teeth grinding. Simple issues like work hours and irregular work shifts can aggravate stress which in turn causes instances of teeth grinding at night.14
According to a report by the UK-based The Bruxism Association, it was seen that job-related stress led to not just sleep loss and caused daytime sleepiness but also contributed significantly to nocturnal teeth grinding. The Association also found that men in stressful conditions at work had higher chances of experiencing nocturnal bruxism than women in similar situations.15
Another study claims that the severity of bruxism has a direct correlation to the amount of job-related stress.16
How Can It Be Treated?
Research shows that bruxism can have a major impact on your life.17 You may wake up with headaches or unexplained pain. Your dental health also suffers.
Use Customized Mouth Guard
The most common method to deal with bruxism is with a customized mouth guard or occlusal splints made of silicon or plastic to wear at night to prevent the grinding.18 The mouth guard also prevents excessive muscle activity at night as you sleep.19
Psychologically, you may be tired and irritable, leading to further stress. According to health experts, if your bruxism is related to stress, therapy and relaxation technique may help a great deal.20
Cut Down On Stimulants
It is a good idea to cut down on stimulants such as tobacco and caffeine. You can also try to reduce stress levels through exercises, changing your sleep pattern etc.21
Another effective way to treat nocturnal bruxism is through hypnotherapy. Studies have shown that individuals who tried assisted and self-hypnosis showed a positive result. They actually were able to get up in the morning with less pain and without the clenched jaw.22
Causes Of Bruxism In Children
Like in adults, stress continues to be a major trigger for bruxism in children. Children also react to stressful conditions around them like impending tests at school, change in routine or lifestyle with subconscious jaw clenching or teeth grinding at night. A study on the levels of stress hormones catecholamines in children with bruxism showed that those with high levels of these hormones were prone to nocturnal teeth clenching.23
There are physiological factors, too, like the blockage of nasal passage that prevents regular breathing.24 or enlarged tonsils.25
How To Deal With Bruxism In Children
Most children grow out of bruxism naturally. Parents should be concerned only if the child complains of facial pain or has chipped teeth.
In the case of excessive night-time teeth grinding that is damaging your teeth, you will need to use a professionally made mouth guard. This holds the jaw in its original position and prevents clenching and grinding while you sleep.26
In cases where bruxism is caused by anxiety and stress, the child will need help in reducing the same through calming or stress-busting activities before bedtime.27
Bruxism is more prevalent than you expect it to be. Curing it is not difficult. So start working on it right away.
References [ + ]
|1.||↑||Bader, Gaby, and Gilles Lavigne. “Sleep bruxism; an overview of an oromandibular sleep movement disorder: review article.” Sleep medicine reviews 4, no. 1 (2000): 27-43.|
|2.||↑||Prevalence of Sleep-related Bruxism. National Sleep Foundation.|
|3.||↑||Symptoms of Teeth Grinding. NHS.|
|4.||↑||Teeth Grinding. NHS.|
|5.||↑||Causes of Teeth Grinding. NHS.|
|6.||↑||Kato, Takafumi, N. M. R. Thie, Jacques Y. Montplaisir, and Gilles J. Lavigne. “Bruxism and orofacial movements during sleep.” Dental Clinics of North America 45, no. 4 (2001): 657-684.|
|7.||↑||Kato, Takafumi, Norman MR Thie, Nelly Huynh, Shouichi Miyawaki, and Gilles J. Lavigne. “Topical review: sleep bruxism and the role of peripheral sensory influences.” Journal of orofacial pain 17, no. 3 (2003).|
|8.||↑||Oksenberg, Arie, and Elena Arons. “Sleep bruxism related to obstructive sleep apnea: the effect of continuous positive airway pressure.” Sleep Medicine 3, no. 6 (2002): 513-515.|
|9.||↑||Lavigne, G. J., T. Kato, A. Kolta, and B. J. Sessle. “Neurobiological mechanisms involved in sleep bruxism.” Critical Reviews in Oral Biology & Medicine 14, no. 1 (2003): 30-46.|
|10.||↑||Madrid, Gilbert, Samara Madrid, Jon G. Vranesh, and Robert A. Hicks. “Cigarette smoking and bruxism.” Perceptual and motor skills 87, no. 3 (1998): 898-898.|
|11.||↑||Lobbezoo, Frank, Jac van der Zaag, and Machiel Naeije. “Bruxism: its multiple causes and its effects on dental implants–an updated review.” Journal of oral rehabilitation 33, no. 4 (2006): 293-300.|
|12.||↑||Lobbezoo, F., and M. Naeije. “Bruxism is mainly regulated centrally, not peripherally.” Journal of oral rehabilitation 28, no. 12 (2001): 1085-1091.|
|13.||↑||Teeth grinding (bruxism) – Causes. NHS.|
|14.||↑||Ahlberg, Kristiina, Jari Ahlberg, Mauno Könönen, Markku Partinen, Harri Lindholm, and Aslak Savolainen. “Reported bruxism and stress experience in media personnel with or without irregular shift work.” Acta Odontologica Scandinavica 61, no. 5 (2003): 315-318.|
|15.||↑||Causes Of Bruxism. The Bruxism Association.|
|16.||↑||Ahlberg, Jari, M. Rantala, Aslak Savolainen, T. Suvinen, Maunu Nissinen, Seppo Sarna, H. Lindholm, and Mauno Könönen. “Reported bruxism and stress experience.” Community dentistry and oral epidemiology 30, no. 6 (2002): 405-408.|
|17.||↑||Ohayon, Maurice M., Kasey K. Li, and Christian Guilleminault. “Risk factors for sleep bruxism in the general population.” Chest Journal 119, no. 1 (2001): 53-61.|
|18.||↑||Giannasi, Lilian Chrystiane, Israel Reis Santos, Thays Almeida Alfaya, Sandra Kalil Bussadori, and Luis Vicente Franco de Oliveira. “Effect of an occlusal splint on sleep bruxism in children in a pilot study with a short-term follow up.” Journal of bodywork and movement therapies 17, no. 4 (2013): 418-422.|
|19, 21.||↑||How Can I Stop Grinding My Teeth?. The Bruxism Association.|
|20.||↑||Thompson, B. A., B. W. Blount, and T. S. Krumholz. “Treatment approaches to bruxism.” American family physician 49, no. 7 (1994): 1617-1622.|
|22.||↑||Clarke, J. Henry, and P. J. Reynolds. “Suggestive hypnotherapy for nocturnal bruxism: a pilot study.” American Journal of Clinical Hypnosis 33, no. 4 (1991): 248-253.|
|23.||↑||Vanderas, A. P., M. Menenakou, T. H. Kouimtzis, and L. Papagiannoulis. “Urinary catecholamine levels and bruxism in children.” Journal of oral rehabilitation 26, no. 2 (1999): 103-110.|
|24.||↑||Grechi, Tais H., Luciana VV Trawitzki, Claudia M. de Felício, Fabiana CP Valera, and Wilma T. Alnselmo-Lima. “Bruxism in children with nasal obstruction.” International journal of pediatric otorhinolaryngology 72, no. 3 (2008): 391-396.|
|25.||↑||Children and Bruxism. The Bruxism Association.|
|26.||↑||Giannasi, Lilian Chrystiane, Israel Reis Santos, Thays Almeida Alfaya, Sandra Kalil Bussadori, and Luis Vicente Franco de Oliveira. “Effect of an occlusal splint on sleep bruxism in children in a pilot study with a short-term follow-up.” Journal of bodywork and movement therapies 17, no. 4 (2013): 418-422.|
|27.||↑||Restrepo, C. C., E. Alvarez, C. Jaramillo, C. Velez, and I. Valencia. “Effects of psychological techniques on bruxism in children with primary teeth.”Journal of Oral rehabilitation 28, no. 4 (2001): 354-360.|