Bruxism is a common condition that involves grinding the teeth or clenching the jaw, either while awake or asleep. People who have waking bruxism aren’t aware that they’re doing it, though it’s technically a conscious movement rooted in the cortex and can be treated with relaxation techniques, awareness training, stress management, and other behavioral approaches. Sleep bruxism, on the other hand, derives from the brainstem, bypassing all consciousness, and is related specifically to sleep. In most cases, people who have sleep bruxism also have other sleep disorders, like sleep apnea, and the tooth and jaw problems that arise because of sleep bruxism can help detect these larger issues. People with sleep bruxism who share a bed might have their bedmate screaming at them in frustration at the noise, though people who sleep alone might have sleep bruxism and not even know it until their teeth and jaws start screaming at them.
Thankfully, routine dental checkups allow your dentist to monitor your teeth for signs of bruxism and get to the bottom of things, figuring out the cause when it’s needed. Consistent monitoring helps dentists refer patients to sleep medicine specialists to determine whether sleep bruxism is paired with snoring or sleep apnea. These conditions require attention from other medical specialists, possibly including cardiologists, otolaryngologists, and even neurologists, and treatments could include mild interventions like weight loss or more moderate support like CPAP or BPAP machines, or even surgery.
Awake bruxism is likely due to a complex interplay of genetic and physical factors mingling with physical and mental health. It’s often triggered by intense frustration, tension, anxiety, or anger, especially in times of stress, and it can also indicate deep concentration, especially in young children. While the nuanced roots of waking bruxism are perplexing and the specific cause or causes of the condition aren’t fully understood, there are some clear triggers, including:
- Stress
- Anxiety
- Anger or frustration
- Hyperactivity
- Certain mouth habits, like biting the cheek or lip, or prolonged gum chewing
- Caffeine, tobacco, alcohol, and certain recreational drugs
- Family members with bruxism
- Sleep apnea
- Other medical conditions, including Parkinson’s disease, dementia, night terrors, and ADHD, to name only a few
It might be more challenging to treat sleep bruxism, but it’s easy to prevent the damage it wreaks by wearing a custom night guard while you sleep to reduce pressure on the bone and prevent the edges of the teeth from loudly sawing away at each other. Additionally, some sleep bruxism is an indicator of potentially deadly underlying conditions that require prompt attention from medical specialists.
Awake bruxism can often be effectively managed with mental health treatments, stress therapy, and behavior modification. Bruxism could be relatively harmless, mildly stressing out the jaw, or it could lead to headaches, severe pain in the face or jaw, damage to dental appliances or teeth, and other temporomandibular joint disorders. See your dentist regularly, but especially if you have any symptoms that could be caused by bruxism or if your bed partner has told you about your audible grinding and clenching. Pinpointing the cause is the best first step to stopping the destruction of your teeth and relieving the pain that comes with the prolonged, unaddressed stress and tension of bruxism.
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