Tooth grinding and clenching can cause many problems. The medical term for tooth grinding and clenching is bruxism. This can happen by night or day or both and many people are unaware that it is something they are doing.

The muscles involved in bruxism are the large cheek muscles, small muscles around the jaw joint and even the large muscle that spreads right from the face to the shoulder. The force used in bruxism causes these muscles to become tight and tense. The huge forces generated can cause tooth wear or even breakage, as well as pain to the surrounding tissues, joints and other muscles. The facial muscles are getting a real workout and can start to have a bulging appearance.

Bruxism is also a way of dealing with stress and many people notice their face is more tight and tense when times are stressful.

Effects on the face and head

The muscle tension involved can cause headaches, migraine, toothache, jaw and neck pain. Clicking jaw joints can also be a result of bruxism when one of the small muscles involved goes into spasm.

Effects on the teeth

The combination of active periodontal (gum) disease and bruxism can be extremely destructive as the forces on the teeth are dynamic-it’s like the forces involved in getting a post out of the ground, you move it by rattling it around in all directions, till it gets loose. This is not what we want to happen to teeth! The forces can also cause teeth to wear, chip, break or even split right through the middle.

What can be done

We advise our patients first to be aware of what their teeth are doing throughout the day. Once you can become aware that your jaws are generally clamped together, it can be possible to actively decide to relax! One active way to do this is set your phone alarm to go off at 15 minute intervals, then check where your teeth are. You can relax your jaw by saying “n-n-n-“. When your tongue goes to the roof of your mouth you can’t clench at the same time! Or just give your jaw a wiggle around to set it free. If there is pain we advise a course of ibuprofen as an anti-inflammatory which helps reduce the tension in the muscles. Take two 200mg tablets 3 times daily for 5-7 days, if you can take ibuprofen. Moist heat massage, using 2 pieces of facecloth or towel, with warm water and gently massaging the jaw joints is also helpful.

What else can we do?

Sleep Clenching Inhibitor

The sleep clenching inhibitor is a small dental splint which is worn on the front teeth. It separates the molars all night which switches off all the clenching activity and lets the muscles relax.

We highly recommend these as a way of treating bruxism related pain. We have used these successfully for many years and many of our patients can’t live without them. These splints have also helped people who have had other investigations, eg for throat pain and severe headaches.

Treatment with acupuncture helps break up the muscle tension.

A podiatrist or sports massage therapist can provide facial massages – which really helps.

General medical practitioners may prescribe amitriptyline as a muscle relaxant.

Botox treatment can deprogramme the large clenching muscles, which reduces the pressure on the teeth and allows the other muscles to relax. It can last 12-18 months and allow the habit to break.

In conclusion

If you are suffering from migraine, jaw and neck pain, morning headaches or pain from your teeth, it may be that you’re a bruxist!

For more information on bruxism or to make an appointment contact Dr. Ahmed J