Teeth Grinding in Sleep - Featured

Teeth Grinding in Sleep: Causes and Treatment

by Dr. Lina Velikova, MD

Teeth grinding in sleep, called bruxism, is a common complaint—up to one-third of people experience it at least once in their lives. Mild forms of the condition can be due to temporary nervousness or overwork, which pass quickly and leave no consequences. Moderate and severe forms of bruxism, however, may be the sign of an underlying disease or health problem.

In most cases, this habit is entirely unconscious. It can occur both during the day and at night. When this phenomenon occurs accidentally, there’s no need to worry. But if it continues for an extended period, it can damage your teeth and disturb your sleep.

Statistics on Grinding Teeth in Your Sleep

Data on this problem is quite controversial. Some sources report that between 1% and 3% of people suffer from it, and others account for between 5% and 10%. Of these, around half of the cases are related to children.

According to a study published in the Journal of Dentistry for Children, about 38% of them grind their teeth. Teeth grinding in babies has also been documented. It’s been found that the average age at which this habit occurs is just three and a half years. Typically, the average age at which the child stops grinding their teeth is around six years.

However, the problem can occur in people of all ages, genders, and ethnicities.

What Does Grinding Your Teeth in Your Sleep Mean?

Teeth Grinding in Sleep - Bruxism

The term bruxism refers to a state whereby a person presses and scrapes their teeth together. These actions, however, are never associated with normal teeth functions such as eating or speaking.

The gnashing is mostly unconscious and linked to the clenching of the chewing muscles at night, which causes teeth to grash together. When your jaw slides left and right, you can hear it makes the typical teeth grinding sound.

Bruxism can lead to fractured teeth, the development of deep caries, and even the loss of teeth. The habit can also damage bridges, root canals, and crowns. When these happen, you might end up needing dentures. If left untreated, the condition can cause cracks in your tooth enamel or lead to a painful sensation in your teeth, jaw muscle pain, headaches, etc.

Additionally, toothaches caused by the recurrent use of your chewing muscles also accompany bruxism. It’s important to watch out for this symptom because it sharpens the jaw clenching symptoms and typically precedes tooth damage.

Most people learn that they have this problem accidentally during a routine dentist visit. The dentist notes that the teeth are worn down to varying degrees—the dentin might be affected, chewing surfaces have become flat and smooth, there’s more tooth sensitivity, or perhaps some obturations have broken.

Very often, people learn about their problem from their sleeping partner, who can hear the grinding. As for younger patients, a child coughing and grinding their teeth at night sometimes go hand in hand.

If, for example, you wake up in the morning with pain in your jaw—specifically your chewing muscles—or your teeth feel numb or have increased sensitivity, then it’s more than likely that you suffer from bruxism. In more alarming cases, you might find a piece of tooth or a whole tooth on your pillow when you wake up.

Why Do I Grind My Teeth in My Sleep?

Bruxism is not a disease in itself. It’s most often the result of another health problem, which could include any of the following:

  • An abnormal bite
  • Malpositioned single teeth or misaligned contacts between upper and lower teeth
  • Broken teeth
  • Diseases of the temporal-mandibular joints
  • Stress

According to the specialists, however, tooth removal and the associated problems in the temporal-maxillary joints are rather a consequence of the pressure exerted on the teeth while gnashing. The clamping force between the two jaws is 150–180 kg, which is six times stronger than that of chewing food.

Bruxism in Children

Teeth Grinding in Sleep - Children

When a toddler has a problem with teeth grinding, it’s often associated with earaches or teething. In children who are more sensitive and prone to emotional stress, the condition appears relatively more frequently. The reasons may be purely domestic, perhaps from watching a terrible movie at bedtime, enthusiasm from playing computer games, stressful upcoming exams or other appointments, or conflicts with parents, teachers, or classmates.

In the past, one of the more widespread claims was that when we had a child grinding teeth in their sleep, worms were the cause. However, there was no significant correlation between the two. In fact, despite the many studies, the exact causes of bruxism still aren’t fully understood.

It’s assumed that there is an individual genetic predisposition. For a large percentage of children who clench their teeth, one of the parents had a similar problem at some point in their lives.

Teeth Grinding in Seniors

For elderly patients who find themselves grinding teeth in their sleep, the causes may also be an emotional event. This could involve the loss or illness of a loved one, separation from a partner, participation in a serious conflict, or feelings of personal failure, not to mention the use of some antidepressants.

Other Causes

According to modern medical studies, bruxism can also be associated with diseases such as Huntington’s disease or Parkinson’s disease. It may even be directly caused by a meningococcal blood infection or a brain injury. Some doctors connect bruxism during the waking hours with low blood sugar (hypoglycemia), which may be associated with decreased adrenal gland function. Teeth grinding is often found in people who have teeth that are particularly sensitive to warm and cold.

How Do I Know if I Have Bruxism?

In mild cases, clenching doesn’t cause any particular problem. In severe cases, however, unpleasant symptoms such as headaches, jaw tenderness, or even excessive wear on the teeth are observed.

When bruxism becomes a chronic problem, over the years the abnormal actions of the temporal-mandibular joints contribute to localized muscle pain and headaches. If the grinding isn’t controlled, you might end up developing microcracks and tooth abrasions, leaving the teeth permanently damaged. In children whose jaws are still forming and developing, the teeth may come out of the tooth row deformed.

Most teeth grinding symptoms are among the following:

Teeth Grinding in Sleep - Headaches

  • Fracturing and loss of teeth
  • Tooth wear—the teeth become flattened, fractured, and have broken edges
  • Increased sensitivity in the teeth due to worn enamel and root trauma
  • Tooth prints on the tongue
  • Pain in the temporal-mandibular joint area
  • Pain in chewing muscles
  • Headaches and neck pain

If you notice one or more of these symptoms, seek help from a specialist.

The signs of grinding teeth in one’s sleep are more often seen in people who are competitive and hyperactive, are under increased stress, or display strong emotions (anxiety, anger, tension). Bruxism may also be associated with other problems, such as sleep disorders, gastric disease, or Parkinson’s disease, as mentioned above.

If the grinding is accidental, then there are almost no consequences. In sporadic cases, it’s possible for one or two teeth to fracture. Gradually, the enamel becomes thinner, and in more advanced cases, the tooth dentin can also be affected.

Teeth Damage Due to Bruxism

Since it’s the enamel that protects your teeth, losing it from grinding teeth in your sleep leads to the usual symptoms: hypersensitivity or toothache from external irritants like hot or cold, as well as those caused by sweets or acidity. There may even be an unpleasant feeling when brushing your teeth, which often leads to worse oral hygiene.

All these are prerequisites for developing caries, periodontal diseases, and poor oral health. These teeth clenching symptoms can even change a patient’s facial appearance and smile. Also, as the height of your teeth (and bite) decreases, wrinkles around the mouth develop, prematurely aging the face’s appearance.

Some of these symptoms can become so severe that sleep quality becomes a major problem, so much so that suicidal tendencies have been observed.

How Do I Stop Grinding My Teeth in My Sleep?

Most medical treatment directly focuses on a condition’s leading cause. But in the case of bruxism, it’s often difficult to identify what the cause is, especially when there might be more than one.

Episodic bruxism caused after dental work and crowning, for example, isn’t dangerous, passes quickly, and doesn’t lead to permanent damage to the teeth. However, when the condition is chronic, it leads to abnormal wear and fractures. If the problem isn’t diagnosed in time, severe pain in the gums and teeth may occur. Most often, these are the first symptoms patients notice before consulting a specialist.

Dental Options for Teeth Grinding Treatment

It’s best to consult with a dentist when you first notice any symptoms so that you can get an accurate diagnosis with the most appropriate therapy. If the patient is a child, it’s better to have treatments that protect their teeth from rubbing against each other.

The best option for that is having them wear a teeth grinding mouth guard to sleep. They can be made of rigid or soft plastic, or a combination of both. That’s why it’ll need to be replaced periodically, but it’s still a better option than further damaging the teeth.

Teeth Grinding in Sleep - Mouth Guard

If the teeth have been damaged, you’ll need to visit your dentist. Orthodontic correction can make a big difference, as well. It might correct a problematic bite or curved teeth, or it might help the upper and lower teeth align more uniformly. Also, there’s always the option of a teeth grinding guard or you can turn to one of the great technological innovations. No matter the method, evenly distributing your chewing pressure helps treat bruxism.

In some cases, bruxism can lead to morphological changes in the teeth, jaws, mandibular joint, and chewing muscles. When this happens, prosthetic therapy becomes imperative. The goal of prosthetic treatment is to restore the standard shape and function of the chewing apparatus—bite height, tooth morphology, normal joint function, and chewing muscles.

How Do You Treat Bruxism Pain?

Sometimes patients who grind their teeth also report tooth pain or sore jaw muscles in the morning. In some cases, doctors prescribe a muscle relaxant at bedtime to relieve the pain. However, muscle relaxants can only be taken for a limited time—they aren’t effective for long-term use.

Other medications that can be used include Botox injections or medications that decrease anxiety or stress. While botulinum toxin may help some people with a severe form of teeth grinding who don’t respond to other therapies, short-term use of antidepressants or anti-anxiety medications may help deal with the stress or any other emotional issues causing bruxism.

Treating Any Underlying Bruxism Causes

The essential thing when treating bruxism is to eliminate the cause. Once a specialist identifies an underlying medical condition causing bruxism, such as gastroesophageal reflux disease, sleep apnea, or anxiety, then it becomes possible to treat bruxism.

In some cases, bruxism is developed as a side effect of a prescribed drug. In that case, you’ll need to talk to your doctor about switching to something different.

How to Stop Grinding Teeth: Lifestyle and Home Remedies

Teeth Grinding in Sleep - Stress

First of all, try to analyze your stress factors and do what you can to minimize them. Bruxism’s causes are often psychological. In these cases, psychological therapy may help control your teeth grinding. Seek a specialist whenever your stress becomes too much. Adults may also want to consider a stress management program that includes meditation or yoga exercises. Even simple things like listening to music or taking a warm bath can reduce stress.

Exercising before going to sleep or actively relaxing your chewing muscles should help. And finding the best sleeping position for a great night’s rest also makes a difference. Alcohol and teeth grinding are mutually connected, so avoid alcohol use before going to bed, as it may worsen bruxism.

If a sleep disorder is causing your bruxism, you’ll need individual therapy. Start practicing good sleep habits, such as getting enough sleep, and avoid drinking stimulating beverages, such as coffee or tea, in the evening. If you have a sleeping partner, ask for help—they’ll be the first to spot any grinding or clicking sounds while you’re asleep.

No matter what, regular dental exams are the best approach to recognize bruxism. So if you’ve been having problems, schedule a visit to your dentist now.

Can Bruxism Be Cured?

Although the symptoms of adult bruxism can be overcome, its treatment may be prolonged and challenging. Methods such as blocking your nose at night and breathing through the mouth aren’t considered effective, nor do orthodontists and dentists recommend it. For that reason, stick to the above-listed approaches if you’re trying to cope with teeth grinding.

FAQ

What vitamin deficiency causes teeth grinding?

In some cases, a deficiency in some minerals (but not vitamins), such as calcium or magnesium, might be associated with teeth grinding. If you adhere to a well-balanced and healthy diet that’s rich in all nutrients and take a multivitamin and mineral supplements when needed, you might overcome bruxism.

Is grinding teeth a sign of autism?

Yes, grinding teeth can be a sign of autism in children. Repeating motor activities over and over again, such as teeth grinding, is typical in autistic children. This could be a form of self-stimulatory behavior that children do to calm themselves and cope with stress or other challenging emotions. However, not all children with bruxism also have a disorder that falls on the autistic spectrum.

If you suspect your child has autism based on teeth grinding, it’s essential you contact your doctor and schedule a screening.

Is teeth grinding a sign of sleep apnea?

Nearly 25% of people with obstructive sleep apnea gnash their teeth at night, and men are more often affected. If left untreated, grinding teeth can in turn lead to trouble sleeping, as well as tooth decay, headaches, etc.

Fortunately, managing sleep apnea may help you avoid bruxism at night. Remedies for sleep apnea, including losing weight, quitting smoking, and treating nasal allergies, can help alleviate teeth grinding symptoms.

What stage of sleep does bruxism occur in?

Bruxism can occur during any sleep stage, even when your body transitions between sleep stages. It’s more common in the first and second stages of non-REM sleep, and it’s much rarer in REM. The International Classification of Sleep Disorders recommends audio monitoring during sleep along with recording the movement of at least one masseter muscle in order to diagnose bruxism, which is where this data comes from.

Does a mouth guard stop teeth grinding?

Since mouth guards and splints are made specifically to reduce teeth grinding, they are the most effective way to stop any gnashing while also reducing the symptoms and consequences of the condition. However, it’s important to identify the underlying cause, because once that’s addressed, the grinding should stop.

Conclusion

Bruxism is a condition that shouldn’t be ignored. Teeth grinding in sleep can be due to both high levels of stress or an underlying medical problem. However, the symptoms of this condition can be alleviated by taking the appropriate measures.

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