Bruxism: FAQs

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Grinders chew, bite and grind their teeth at night – and usually wake up the next morning with a sore jaw.

If your jaw is tight and sore when you wake up, you might unconsciously grind your teeth at night. In an interview, dental expert Prof. Dr. Natalia Oesterreich, how harmful the unconscious crunch really is – and what you can do about it.

Do you wake up in the morning and don’t feel relaxed at all, the muscles in the jaw area hurt and feel stiff – and that almost every morning? Or you may even suffer from tension headaches? Then it is likely that you are a grinder, that is, clench your teeth while you sleep and push and bite each other with strong pressure. The effects of these unconscious dental activities, which are scientifically referred to as bruxism and can also take place during the day, are tough: the teeth of the upper and lower jaw are sometimes loaded with ten times the weight of the normal chewing process – up to 480 kilograms per square centimeter. When the habit becomes the norm, signs of wear and tear on the bit are just one of the unpleasant consequences. Incidentally, women are more often affected by teeth grinding than men.

bruxism

What are the causes of teeth grinding? Can there also be serious illnesses behind it?

This can be psychological stress such as excessive stress. In addition, breathing disorders during sleep, increased consumption of stimulants such as alcohol or coffee, and certain medications. Disturbances in the clenching of the rows of teeth can also lead to increased muscle activity in the jaws.

When does harmless crunching end – and where does the clinical picture of so-called craniomandibular dysfunction (CMD) begin?

If, in addition to pain in the masticatory muscles, there are also disorders in the movement of the temporomandibular joint. These are expressed, for example, by a restricted ability to open the mouth. Joint noises and tinnitus can also occur in this context. A free CMD self-test is available on the Internet – but this does not replace a visit to the dentist!

What happens if bruxism is not treated? In the worst case, can the teeth be so badly damaged that only dentures can help?

When grinding, hard tooth substance is removed by abrasion. In massive cases, this can affect the aesthetics, chewing function and pronunciation and change the position of the jaw. In addition, existing dentures, such as crowns and bridges, but also dental fillings, can be damaged when grinding. In extreme situations, extensive dental prosthesis treatment is necessary.

To what extent is grinding related to the psyche or stress?

Emotional stress and psychological tension, for example stress in the family or at work, are now the main causes of bruxism in the waking state (awake bruxism). In contrast, the cause of the crunch in sleep (sleep bruxism) has not been conclusively clarified. This bruxism is discussed in connection with certain medications, stimulants, breathing disorders and in connection with sleep-arousal reactions.

Can an occlusal splint help with stress-related crunching at all – or should the stress trigger be treated as a priority? And how effective is therapy with the splint actually?

Therapy should always focus on the causes of bruxism. So, if strong stress is in the foreground, psychotherapy or a psychological procedure to cope with stress makes sense. Cooperation with specialists is necessary here. But also, self-observation and thus the possible influence of bruxism is an option. Hard, customized bite splints (occlusion splints) are suitable as long-term therapy. If there is a craniomandibular dysfunction, further therapeutic methods are used.

Are there methods to “condition” the jaw differently or to counteract the excessive activity through special training?

The so-called self-observation to make you aware of grinding phenomena is important in order to recognize when you are grinding your teeth. This can also be done with the help of devices that use acoustic signals or vibrations to indicate muscle tension (biofeedback).

Can the grinding of teeth go away all by itself?

As with other behavior-related disorders, the most varied forms of progression occur when grinding teeth, depending on the causes. On the one hand, there are cases in which patients stop grinding after the end of an acute period of stress. On the other hand, there are also cases in which the initial “bad habit” grows into a disease that is difficult to control. Then it can no longer be overcome without dental help.

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