Teeth grinding / Clenching

What is it

Teeth grinding, also known as bruxism, is a condition where a person grinds, or clenches their teeth unconsciously and often unknowingly. It usually happens during sleep, but it can also happen during the day. Teeth grinding can occur in both adults and children, and can cause a range of dental and health problems if left untreated.

I was taught very little about tooth grinding and clenching in school. The main treatment  prescribed is an occlusal guard so you don’t wear down or break teeth. Which is very common especially these days. But Occlusal guards treat the symptoms not the cause. 

I now know the causes of teeth grinding are not fully understood, but it is believed to be related to stress, anxiety, and certain lifestyle factors such as alcohol consumption, smoking, or caffeine intake. However,  since becoming a myofunctional therapist I realize it is a symptom of myofunctional disorders and an airway issue. It is the body’s way of compensating to get more oxygen by moving the jaw forward to open the airway.  It may also be related to certain medical conditions such as sleep disorders, TMJ disorders, or gastroesophageal reflux disease (GERD).

All of which have been seen to improve with opening the airway,  breathing and functional exercises to strengthen the muscles of the face and tongue.

Tooth grinding and clenching are the body’s way of compensating while trying to get more oxygen.

 What are the symptoms?

Symptoms of teeth grinding may include:

1. Grinding, clenching, or gnashing of teeth, often loud enough to be heard by others
2. Flattened, chipped, or worn down teeth
3. Breaking teeth
4. Headache or earache
5. Jaw pain or stiffness
6. Neck, Shoulder or facial muscle pain
7. Sensitive teeth
8. Difficulty sleeping or waking at night

If you suspect that you may be grinding your teeth, it is important to see a dentist, airway orthodontist, doctor or even a myofunctional therapist for an evaluation. They can help identify the cause of the teeth grinding and recommend appropriate treatment to prevent further damage to the teeth and alleviate symptoms. Treatment may include lifestyle changes, relaxation techniques, or the use of a mouthguard,  splint to protect the teeth during sleep or a myofunctional therapy  to evaluate tongue position, tongue tie or mouth breathing, palatal expansion or surgery.

Again an occlusal guard helps protect your teeth from damage, however it does not address the root cause.

What is the root cause of teeth grinding?

We are being told the exact root cause of teeth grinding, or bruxism, is not fully understood. Nevertheless, it is believed to be related to a combination of factors and the exact cause can vary from person to person. 

Physical factors that may contribute to teeth grinding include misaligned teeth or jaw, and other dental problems, such as missing or damaged teeth. Certain medical conditions, such as sleep apnea, TMJ disorders, or gastroesophageal reflux disease (GERD) may also contribute to bruxism.

Psychological factors, such as stress, anxiety, and tension, are also believed to be a major contributor to teeth grinding. It is thought that when an individual is stressed or anxious, they may clench or grind their teeth unconsciously as a way to relieve tension or to get more oxygen.

In many cases, the root cause of teeth grinding may be multifactorial, with a combination of physical, psychological, and lifestyle factors playing a role. Identifying and addressing the underlying cause(s) of teeth grinding is important in preventing further damage to the teeth and alleviating symptoms. 

Here are some of the most common causes of teeth grinding some mentioned above:

1. Stress and anxiety: Stress and anxiety are common triggers for teeth grinding. Many people grind their teeth as a way of coping with stress, tension, or anxiety.
2. Sleep disorders: Sleep disorders, such as sleep apnea, can cause teeth grinding. When the airway is obstructed during sleep, the body may respond by clenching or grinding the teeth.
3. Malocclusion: Malocclusion, or an improper bite, can cause teeth grinding. When the teeth do not align properly, the muscles of the jaw may compensate by grinding the teeth.
4. Not being able to breathe through your nose. Tongue down blocking the airway, not functioning properly or not having enough space for the tongue. So it is not in the proper position.
5. Medications: Certain medications, such as antidepressants, can cause teeth grinding as a side effect.
6. Lifestyle factors: Lifestyle factors, such as smoking, caffeine or alcohol consumption, can also contribute to teeth grinding.

It is important to identify the root cause of teeth grinding in order to develop an effective treatment plan. Myofunctional therapy, along with other treatments such as stress reduction techniques, orthodontic treatment, or addressing sleep disorders, can be effective in addressing the underlying causes of teeth grinding and reducing its frequency and severity.

Treatment of teeth grinding

The most common treatments may include lifestyle changes, relaxation techniques, and the use of a mouthguard or splint to protect the teeth during sleep.

There are other treatment options for teeth grinding besides dental splints or night guards. However, the most appropriate treatment option will depend on the underlying cause of the teeth grinding and the severity of the symptoms. Some common alternative treatment options for teeth grinding include:

1. Stress management techniques: As stress and anxiety are a common cause of teeth grinding, relaxation techniques such as meditation, yoga, deep breathing exercises, or counseling can help reduce stress levels and prevent teeth grinding.
2. Behavioral therapy: This type of therapy helps individuals identify and change the behaviors that contribute to teeth grinding. Techniques such as habit-reversal training, biofeedback, or cognitive-behavioral therapy may be used.
3. Muscle relaxation exercises: Stretching or massaging the jaw muscles before bed can help reduce tension in the jaw and prevent teeth grinding.
4. Acupuncture: This alternative therapy involves the insertion of fine needles into specific points on the body to stimulate nerve and muscle function. Some people find acupuncture helpful in reducing stress and tension that contribute to teeth grinding.
5. Medications: In some cases, medications such as muscle relaxants, anti-anxiety drugs, or antidepressants may be prescribed to help manage teeth grinding.
6. Myofunctional therapy: can help with teeth grinding, by addressing the underlying muscle and breathing patterns that contribute to the behavior. This is a less common treatment option. It may not solve the root cause. A myofunctional therapist can help identify what is happening and get you to the airway providers that can help address the underlying cause. It may take  collaboration of several providers to get the best results.

There are 4 goals of Myofunctional Therapy:

Here are some ways that myofunctional therapy can be helpful for teeth grinding:

1. Tongue positioning: One of the goals of myofunctional therapy is to help patients learn to properly position their tongue at rest, which can help to reduce tension in the jaw muscles that contribute to teeth grinding.
2. Muscle relaxation: Myofunctional therapy exercises can help to relax the muscles in the face and jaw, which can help to reduce the severity and frequency of teeth grinding.
3. Breathing: Myofunctional therapy can also address breathing patterns that may contribute to teeth grinding. Improving breathing patterns can help to reduce stress and tension in the body, which can in turn reduce teeth grinding.
4. Posture: Myofunctional therapy can help patients to improve their overall posture, which can also help to reduce tension in the jaw muscles and reduce teeth grinding. A body worker can also help with posture. 

Overall, myofunctional therapy can be an effective approach to addressing teeth grinding by targeting the underlying muscle and breathing patterns that contribute to the behavior. By improving these patterns, patients can often experience significant reduction in the frequency and severity of teeth grinding, and improve their overall oral health and well-being.

Botox, which is derived from the botulinum toxin, is a treatment option that has been explored for relieving tooth grinding.. While Botox is commonly associated with cosmetic procedures, it can also have therapeutic applications for various medical conditions, including bruxism. 

Why Botox is a potential treatment for tooth grinding:

 

• How it works: Botox works by temporarily relaxing or paralyzing muscles. When injected into the muscles responsible for jaw movement, Botox can help reduce the intensity and frequency of teeth grinding and clenching. By inhibiting muscle contractions, Botox can provide relief from the symptoms associated with bruxism allowing the muscle to relax.
• Treatment process: Botox treatment for bruxism typically involves a series of injections into the masseter muscles, which are the primary muscles involved in jaw movement. The procedure is generally performed in a dental or medical office setting and does not require anesthesia. The effects of Botox may take a few days to become noticeable and can last for several months before additional injections are needed.
• Effectiveness: Studies have shown that Botox injections can effectively reduce the severity of bruxism symptoms. By weakening the muscles involved in grinding, Botox can help prevent excessive tooth wear, jaw pain, headaches, and other associated issues. However, it’s important to note that Botox does not address the underlying causes of bruxism and is considered a temporary solution rather than a permanent cure.
• Considerations and side effects: Botox injections for bruxism should be administered by a qualified healthcare professional experienced in this treatment. Potential side effects can include temporary muscle weakness or soreness at the injection site, difficulty chewing certain foods, and changes in facial expression. It’s crucial to discuss potential risks and benefits with your healthcare provider before undergoing Botox treatment.
• Multidisciplinary approach: Botox treatment for bruxism is often combined with other therapies. This may include the use of occlusal splints or mouthguards to protect the teeth, chiropractor, body worker, stress management techniques, behavior modification, and addressing any underlying dental or medical conditions contributing to bruxism.

 

I had this done 4 months ago. I have been a mouth breather all of my life, my premolars were removed at 15 for braces saying I did not have enough room which led to TMJ issues. The stress of the last few years had me grinding more than usual. I was in so much pain I could not relax my jaw muscles. I would have done just about anything to relieve the tension. It took about four days after the injections to get full relief but it was a game changer. I would highly recommend it for temporary relief. Addressing the underlying cause is always best. For me I would have to wear braces and get implants to open my bite back to where I was before wearing braces. That is not something I am choosing to do at the moment so addressing the symptoms where my mindset is currently at. 

As with any medical procedure, it’s essential to consult with a qualified healthcare professional, such as a dentist or oral and maxillofacial specialist, to determine if Botox is a suitable option for your specific case of bruxism. They can evaluate your symptoms, discuss potential treatment options, and provide guidance based on your individual needs.

Like many things in healthcare these days, this is a symptom of a bigger health concern and more than the symptoms should be treated. Not all providers are aware of or treat airway related problems. Follow your instincts. Get as much information as you can so you can make an informed decision on what treatments are best for you. 

It is important to consult with multiple  healthcare professionals to determine the most appropriate treatment option for teeth grinding. In some cases, a combination of therapies may be needed to effectively manage this condition. 

The key takeaway is to be aware that teeth grinding, clenching, snoring are all signs of an airway, breathing and possible space issue in individuals. Our bodies are amazing and great and compensating for our survival. 

According to Maslow’s theory of hierarchy we need to meet our basic need of survival before we can thrive. 

Your mouth is connected to your body and this is one of the warning signs your mouth gives you to let you know it is struggling.

You get to choose to ignore the signs and symptoms or listen and take action. 

I ignored the signs for years.  I like many felt it was not a priority I had so many other things that were more important. Don’t wait until your body gives you another option. 

No pain does not mean no problem. If you wait, trust me it will cost you more money, more time and more pain.

Medical and dental insurance are for healthy people or really sick people. Our insurance does not always cover things that can prevent the issue from happening or early intervention.  

Traditional healthcare failed me. I had no option if I wanted to feel better. The alternative treatments I needed to help me were not covered by insurance at all. I work more days now to pay for these treatments. I am lucky to have this option. I realize not everyone can seek these treatments or afford them.  But everyone can learn about these signs and symptoms and address them before they get to the point of you being out of options for treatment. 

Knowledge is power. You only get one body. It is your greatest investment. If you are not healthy you miss out on so much in life and you spend more time and money getting your health back.

You get to choose where you spend your time and  money.

What will you choose?