Do you ever wake up with sore teeth and a headache?

If so you could be grinding your teeth. Clenching and grinding, also know as bruxism, is often caused by stress and in many cases, although not all, it happens during the night while a person is asleep. It can cause severe damage to your teeth, jaw pain, earache and headaches.

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The problem is controlled by the muscles in your cheek that also happen to be incredibly powerful and can exert up to a massive 600 pounds of force per square inch in the back of your mouth, near the molars. So as you can imagine, this strong muscle can have a serious impact on your teeth.

As many as one in 10 people experience teeth grinding on a daily basis, with the condition being most at its peak between the ages of 25 and 44, and on top of this, many others do it periodically. Because it often occurs during sleep, most people are totally unaware that they grind their teeth. However, a dull, constant headache or a tender painful jaw is a definite symptom of bruxism.

Just like snoring or sleep apnoea, people often first learn that they grind their teeth from their partner who hears the grinding at night, although the most reliable way to diagnose bruxism is during a sleep study. It is often also associated with other sleep disorders such as obstructive sleep apnoea and you may suffer from both.

In addition to being detrimental to oral and dental health, the noise from bruxism is often disturbing for others. It can lead to headaches, jaw pain and daytime tiredness caused by the disruption to normal sleep brain-rhythms.

If left undetected, dental damage will usually occur, leading to tooth loss and gum disease. In some cases, chronic teeth grinding can result in a fracturing, loosening or even loss of teeth. The chronic grinding may wear teeth down to stumps. When these events happen, bridges, crowns, root canals, implants, partial dentures and even complete dentures may be needed as a result.

Not only can severe grinding damage teeth and result in tooth loss, it can also affect your jaw and jaw joints, result in earache, cause or worsen jaw joint disease (TMJ), and even change the appearance of your face.

Bruxism frequently occurs due to psychological factors including anxiety, stress and emotional problems. However it can be caused by a variety of other medical disorders (neurological and psychiatric disorders, substance abuse, and as a side-effect of medications). Bruxism can occur at any age, is often noted in children and adults, and there are no significant differences in bruxism rates between males and females.

Patients with bruxism usually experience cycles of improvement and worsening in their symptoms over time and although complex sleep testing in a clinic is not essential to diagnose sleep bruxism, a simpler form of sleep study is often very helpful to assess whether the bruxism is associated with another sleep or movement disorder such as sleep apnoea, restless legs syndrome, or periodic limb movement disorder.

In many cases, your oral healthcare provider can provide you with an occlusal appliance, like a sports mouth guard, to be worn at night in order to protect your teeth from damage, and these occur in several forms.

One of the most common ways to protect your teeth from wearing down and even fracturing due to constant grinding and clenching, and reduce the subsequent pain, is to wear an ‘occlusal appliance’ which is simply a name for a protective night guard.

These are normally custom-made so that they fit perfectly over either your top or your bottom teeth. Simpler versions also occur that are suitable for milder, infrequent episodes of bruxism. Both are quite inexpensive and the custom-made version comes in several helpful options to suit you.

Other more advanced mouthpieces, called mandibular advancement devices, or MAD’s, are also regularly used to stop teeth grinding.

However, these are most commonly used when a sleep disorder like sleep apnoea is the most likely cause. They’re also bespoke made specifically to fit your jaw and are usually worn over both the top and the bottom teeth. The purpose of this is to bring your bottom jaw forward and this keeps the airway open, preventing snoring and episodes of sleep apnoea, as well as stopping you grinding your teeth.

John Redfern