Alternative names
Teeth grinding and clenching

What is Bruxism?
Bruxism is when you clench or grind your teeth. The term clenching means you tightly clamp your top and bottom teeth together, especially the back teeth. The stressful force of clenching causes pressure on the muscles, tissues, and other structures around your jaw. This can lead to jaw joint disorders, jaw pain and soreness, headaches, earaches, damaged teeth, and other problems.

Many people who clench also grind their teeth. Grinding is when you slide your teeth over each other, generally in a sideways back-and-forth movement. This action may wear down your teeth and be noisy enough at night to bother sleeping partners. Like clenching, grinding can lead to jaw pain and other problems.

Causes, incidence, and risk factor
People can clench and grind subconsciously during both the day and night, although sleep-related bruxism is often the bigger problem because it is harder to control.

The cause of bruxism is not completely agreed upon, but daily stress may be the trigger in many people. Some people probably clench and never feel symptoms. Whether or not bruxism causes pain and other problems may be a complicated mix of factors -- how much stress you are under, how long and tightly you clench and grind, whether your teeth are misaligned, your posture, ability to relax, diet, sleeping habits, and other factors. Each person is probably different.

Symptoms
teeth grinding, which may be loud enough to annoy sleeping partners
sore or painful jaw
headache or earache (the perception of an earache is because the TMJ is so close to the ear canal)
anxiety, stress, and tension
insomnia, depression, eating disorders
Signs and tests
Examination will rule out other disorders that may cause similar jaw pain or ear pain, including ear disorders such as otitis media, temporomandibular joint (TMJ) dysfunction, and dental disorders. Detailed history may reveal abnormal stress or tension.

Treatment
The goal of treatment is to prevent permanent damage to the teeth and reduce pain.

Mouth guards, or splints, have been used since the 1930's to treat teeth grinding, clenching, and TMJ disorders. Many people have found them to be useful, but the benefits vary widely. In some people, the symptoms go away as long as they use the splint, but pain returns when they stop. In others, the splint loses its effectiveness over time. Still others may feel worse pain when they wear the splint. Furthermore, there are different types of splints. Some fit over the top of the teeth, some on the bottom. They may be designed to keep your jaw in a more relaxed position or provide some other function. If one type doesn't work, another may.

For example, a new type of splint is called the TNI-tss. It fits over just the front teeth. The idea is to keep all of your back teeth (molars) completely separated, under the theory that most clenching problems is done by these back teeth. with the TNI splint, The only contact is between the tiny splint and a bottom front tooth.

What you can do:

Relax your facial and jaw muscles throughout the day . The goal is to make it a habit.
Avoid eating hard foods like nuts, candies, steak.
Drink plenty of water every day
Try to reduce your stress and learn relaxation techniques. Overall stress and muscle tension in your back, neck and body may make TMJ pain worse.
Maintain good posture while working at a computer, watching TV, reading, etc.
Get plenty of sleep.
Other home-care therapies are very useful for some people, such as heat or cold, deep breathing, vitamins, or massage. Read as much as you can, as opinion varies widely in the management of TMJ disorders. It is important to get as many clinical perspectives as you can. Most people eventually find something that helps.

Orthodontic adjustment of the occlusion or bite pattern may be beneficial for some people.

Psychotherapy or counseling may help the afflicted person to express anger and deal with anxiety or stress. Relaxation or techniques can be beneficial in reducing anxiety or stress.

Expectations (prognosis)
Bruxism is not a dangerous disorder. However, it can cause permanent damage to the teeth and uncomfortable jaw pain or ear pain.

Complications
If clenching leads to jaw pain, this in turn can lead to insomnia, depression, and eating disorders. Clenching and grinding can worsen existing dental or TMJ problems. Nightly grinding can awaken roommates and sleeping partners.

Calling your health care provider
Grinding, clenching, and TMJ disorders tend to fall "in between" medical specialties -- they are tradionally addressed by specilty dentists, but ENT doctors or orofacial pain neurologosts often provide help. Try to find someone who focuses their entire practice on TMJ doisorders. Surgery is now considered a last resort by the vast majority of TMJ experts. Always get multiple opinions.

Call your dentist if bruxism occurs, especially if it is associated with pain in the jaw or ear, or if teeth appear misaligned or there is difficulty with the bite.

Call your health care provider if other symptoms accompany bruxism.

Prevention
Stress reduction/anxiety management may reduce bruxism in persons prone to the condition.