Not Sleeping Well? Could Be You’re Bruxing

Today, we usually think of clenching and grinding teeth as a sign of stress or anger. And it often is. Consequently, we’ve seen quite a rise in this behavior since the onset of economic turmoil in 2008. But the phenomenon itself isn’t new at all. Our ancient ancestors did it, too, with the earliest records of it – via clay tablets found in the Mesopotamian Basin – dating back to about 3000 BC. Our modern word for the habit – bruxism – comes from the other side of the Mediterranean, though: from the Greek word ebruxya, which literally means “to gnash the teeth.”

Though statistics remain a little sketchy, estimates say about 5 to 20% of us are bruxers, with the higher number likely being closer to right. The habit is especially common during sleep. In fact, it’s the third most common sleep disorder after insomnia and snoring.

What’s more, those with another sleep disorder are more apt to be bruxers, too. Other risk factors include smoking, high caffeine intake, high alcohol intake, medication use and, of course, stress. But because bruxism is a habit, it can – and usually does – continue even after its cause has been dealt with. Among the problems it can lead to:

• Poor quality sleep
• Worn down teeth and fillings or other restorations
• Fractured teeth
• Inflammation and receding gums
• Loose teeth and premature tooth loss
• Persistent headaches and chronic jaw, face, neck and head pain
• TMJ disorder

TMJ stands for temporomandibular joint, and you have one on each side of your head. Together, they’re the hinge that lets you open and close your mouth – something than can be hard or painful to do if the joints are damaged or dysfunctional. (To see why this may be so, check out these videos showing what both healthy and dysfunctional TM joints look like in action.) You may experience clicking, grinding or pain in your jaw joints, or ringing or buzzing in your ears. “When the joint puts pressure on the nerves, muscles and blood vessels that pass near the head,” says Dr. Nigel Carter of the British Dental Health Foundation, “it can often result in headaches and migraines.”

Even so, adds Dr. Carter,

The cause of your headaches could actually be the way your teeth meet when your jaws bite together, otherwise known as dental occlusion. If you do suffer from continual headaches or migraines, especially first thing in the morning, pain behind your eyes, sinus pains and pains in the neck or shoulders, you should consider visiting your dentist, as well as a doctor, as soon as possible.

To check my patients’ occlusion, I use an imaging system called Tek-Scan, which shows how the teeth come together. It lets us see places where your bite may be “off” or where there’s an imbalance of force when you close your jaw. Once we’ve found these imbalances, we can determine the best solutions for correcting them.

For TMJ issues, we have another diagnostic tool: BioJVA (joint vibrational analysis). BioJVA lets us take fast, non-invasive and repeatable measurements of your TMJ function by determining the amount and kind of vibration at the joints. With it, we can diagnose dysfunction more specifically, and, because it’s repeatable, we can easily measure your progress through treatment.

Splint therapy is one of the most common and conservative measures taken to bring relief and readjust the jaw and related musculature. You may have seen or heard of over-the-counter “night guards” meant to cushion the forces of clenching and grinding, the main virtue of which is their low cost. Unfortunately, they’re often of little help to serious bruxers, who pretty quickly grind right through them. Their fit can often be poor, as well, causing problems such as discomfort, damaged gums or increased clenching.

A custom splint, on the other hand, will fit your mouth precisely and will normally last much, much longer than an over-the-counter device. Here’s what one of my patients had to say after just the first week of wearing a night guard we provided him:

But wait, you say. If I’m sleeping, how can I know if I’m grinding my teeth? Here are a few questions to ask yourself:

• Are your jaw muscles or neck achy when you wake up?
• Is it hard to open your mouth first thing in the morning?
• Do the biting surfaces of your teeth look worn down?
• Do you have frequent headaches?
• Has your bed partner ever complained about you making grinding noises while you sleep or told you about any mouth movements he or she has seen you make while sleeping?

As is the way with such questionnaires, the more “yesses,” the more likely it is that bruxing is an issue for you, in which case you should consult your dentist for help with remedies and relief…and a better night’s sleep.

Image by justin, via Flickr