Some of us will have had the experience of sleeping next to a person who grinds their teeth. Occasional teeth grinding is not a big deal, but if this happens regularly, it causes inconvenience for both the person and those around them.

Bruxism often occurs during sleep and it seems to be one of many known sleep disorders. The mechanism of bruxism is believed to be similar to that of kicking your leg during sleep.

There are several hypotheses to explain the possible causes of bruxism. Traditional views, for example, suggest that stress and anxiety cause teeth clenching and grinding. More recent studies have suggested that abnormalities in dopamine activities in basal ganglia cause abnormal sleep arousal from deep sleep stage to light one. The view that teeth grinding is caused by interferences of occlusion is not well supported. However, many investigators agree that stress and anxiety contribute to bruxism.

Bruxism can cause excessive wearing of dentition. This means that the surfaces of teeth become worn down as if by sandpaper, and the teeth become much more sensitive to small occlusal forces or cold stimuli. This can lead to small cracks in the teeth, which can eventually cause teeth fractures.

The periodontal bone and gums can also be damaged from excessive force on the teeth. Bruxism is also bad for the temporomandibular joints that allow movement of the lower jaw. The force delivered on the teeth during teeth grinding is three to four times larger than that from chewing food.

Prolonged teeth grinding can cause degenerative changes in jaw joints ― even in young people ― that are more commonly seen in the elderly. There can also be pain from fatigue of the chewing muscles. Clenching the jaws is a type of teeth grinding that occurs during the subconscious state. It is also harmful for the tissues surrounding teeth, jaw joints and the surrounding muscles, as well as the teeth.

The treatments for teeth grinding include pharmacological treatment and cognitive behavioral therapy. However, there is currently no treatment that can completely cure bruxism. Various dental protective equipments are being used to minimize any pathological symptoms from bruxism. This frequently used device looks like a mouthpiece used by athletes. It is a protective device that minimizes the harmful effects of teeth grinding and minimizes unpleasant sounds. Additionally, Botox treatment can sometimes be effective in preventing various complications from bruxism.

It is important to be wary of the jaw position to prevent jaw clenching. The patient should also try to minimize stress to prevent teeth grinding during sleep. Advice from a specialist dentist (oral and maxillofacial surgeon) can also be helpful. 

By Hong Jong-rak

Hong Jong-rak is a doctor at the Division of Dentistry at Samsung Medical Center and a professor of Sungkyunkwan University School of Medicine. ― Ed.