Bruxism is the chronic clenching of the jaw and grinding of the teeth, and can appear during sleep or while people are awake. The causes for sleep bruxism and waking bruxism differ just as broadly as the specific causes within these two categories, and the treatment approach for each specific case will vary accordingly.
Sleep bruxism is a sleep-related movement disorder characterized by muscular activity in the jaw that occurs between sleep stages as people transition from one sleep stage to another. This is caused by activity in the brainstem, meaning it’s not consciously controllable, though it is often exacerbated by waking stress. Because it sometimes indicates other underlying conditions, it may be possible to prevent sleep bruxism by treating these underlying conditions. Otherwise, the best way to treat it is to prevent damage to the teeth and bone by protecting the teeth with a mouth guard or a splint. It is estimated that up to 15% of adults experience this condition, with the highest rates in young adults. Some stress-reduction, awareness, and behavior-modification approaches have also helped reduce, though not fully eliminate, sleep bruxism.
Waking bruxism is a chronic habit that tends to appear during times of significant stress or concentration, often appearing as a coping mechanism. While the condition is unconscious, because it involves higher brain functions, it is possible to modify waking bruxism with awareness and behavior training. It is often the case that people with waking bruxism don’t realize they’re clenching their jaw, but once informed, they are able to relax; sometimes, this level of mindfulness requires additional support, which can come in the form of yoga, exercise, massage, talk therapy, or whatever else helps you relax and feel less stress. Studies suggest that up to 30% of adults experience waking bruxism, though this may be due to the increased need for coping mechanisms during the waking hours.
Many people have both waking bruxism and sleeping bruxism, which requires more comprehensive treatment approaches. If your sleep partner hears your teeth grinding at night, or if you notice that your jaw is especially sore in the mornings, these are signs you might have sleep bruxism. If you notice yourself clenching your jaw while concentrating or during emotional or stressful times, you might have waking bruxism. Your dentist can help you determine which type or types of bruxism might be affecting you with consistent monitoring at your dental appointments, along with more intensive observation, like sleep studies when needed.
The most effective way to manage bruxism is to first determine whether it’s conscious or unconscious. Awareness techniques can work for both waking and sleep bruxism, though they function very differently. Night guards and splints protect against symptoms but have no effect on the condition of sleep bruxism itself, while waking bruxism can most often be managed by awareness, feedback, and other behavior modification approaches. The causes of bruxism are often more complex than simply what is reported by patients, however. A comprehensive evaluation, along with routine monitoring by a dental professional, can help pinpoint causes and fine-tune the best treatment approach or approaches for each unique case.
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