Bruxism: Difference between revisions
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{{SI}} | |||
{{Infobox medical condition | |||
| name = Bruxism | |||
| image = [[File:Deviated_midline_2.JPG|250px]] | |||
| caption = A person with bruxism showing a deviated midline due to teeth grinding | |||
| field = [[Dentistry]] | |||
| synonyms = Teeth grinding, teeth clenching | |||
| symptoms = [[Tooth wear]], [[tooth pain]], [[jaw pain]], [[headache]], [[earache]] | |||
| complications = [[Temporomandibular joint disorder]], [[tooth damage]], [[sleep disruption]] | |||
| onset = Any age, commonly in [[adulthood]] | |||
| duration = Can be [[chronic]] or [[episodic]] | |||
| causes = [[Stress]], [[anxiety]], [[sleep disorders]], [[malocclusion]], [[medications]] | |||
| risks = [[Stress]], [[smoking]], [[alcohol consumption]], [[caffeine]] | |||
| diagnosis = [[Clinical examination]], [[patient history]], [[sleep study]] | |||
| differential = [[Temporomandibular joint disorder]], [[toothache]], [[ear infection]] | |||
| prevention = [[Stress management]], [[mouthguard]], [[dental correction]] | |||
| treatment = [[Behavioral therapy]], [[dental splints]], [[medication]] | |||
| medication = [[Muscle relaxants]], [[botulinum toxin]] | |||
| frequency = Common, affects 8-31% of the population | |||
}} | |||
{{Infobox medical condition (new) | {{Infobox medical condition (new) | ||
| name = Bruxism | | name = Bruxism | ||
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| image = Deviated midline 2.JPG | | image = Deviated midline 2.JPG | ||
| caption = Attrition (tooth wear caused by tooth-to-tooth contact) can be a manifestation of bruxism. | | caption = Attrition (tooth wear caused by tooth-to-tooth contact) can be a manifestation of bruxism. | ||
| pronounce = {{IPAc-en| | | pronounce = {{IPAc-en|Àà|b|r| å|k|s|…™|z|…ôm}} | ||
| field = [[Dentistry]] | | field = [[Dentistry]] | ||
| symptoms = Tooth wear, jaw pain, headaches, sensitive teeth, [[temporomandibular joint dysfunction|TMJ]] pain, sleep disturbances | | symptoms = Tooth wear, jaw pain, headaches, sensitive teeth, [[temporomandibular joint dysfunction|TMJ]] pain, sleep disturbances | ||
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}} | }} | ||
[[File:Topviewtooth.jpg|left|thumb|View from above of an anterior (front) tooth showing severe [[Tooth wear|tooth wear]] exposing the [[Dentin|dentin]] layer. The [[Dental pulp|pulp chamber]] is visible.]] | [[File:Topviewtooth.jpg|left|thumb|View from above of an anterior (front) tooth showing severe [[Tooth wear|tooth wear]] exposing the [[Dentin|dentin]] layer. The [[Dental pulp|pulp chamber]] is visible.]] | ||
[[File:Gray382.png|thumbnail|left|The left [[Temporalis muscle|temporalis muscle]]]] | [[File:Gray382.png|left|thumbnail|left|The left [[Temporalis muscle|temporalis muscle]]]] | ||
[[File:Gray383.png|thumbnail|right|The left [[Medial pterygoid muscle|medial pterygoid muscle]] and [[Lateral pterygoid muscle|lateral pterygoid muscle]]]] | [[File:Gray383.png|left|thumbnail|right|The left [[Medial pterygoid muscle|medial pterygoid muscle]] and [[Lateral pterygoid muscle|lateral pterygoid muscle]]]] | ||
[[File:Gray378 (masseter highlight).png|thumb | [[File:Gray378 (masseter highlight).png|left|thumb|The left [[Masseter muscle|masseter muscle]] in red]] | ||
'''Bruxism''' is the excessive grinding of the [[teeth]] or clenching of the [[jaw]], often an unconscious habit. It is classified as a [[parafunctional habit]], meaning it serves no functional purpose such as eating or speaking. Bruxism can occur while awake (awake bruxism) or during sleep (sleep bruxism). | '''Bruxism''' is the excessive grinding of the [[teeth]] or clenching of the [[jaw]], often an unconscious habit. It is classified as a [[parafunctional habit]], meaning it serves no functional purpose such as eating or speaking. Bruxism can occur while awake (awake bruxism) or during sleep (sleep bruxism). | ||
== Types of Bruxism == | == Types of Bruxism == | ||
Bruxism is typically divided into two categories: | Bruxism is typically divided into two categories: | ||
* '''[[Sleep bruxism]]''' – occurs during [[sleep]] and is considered a [[sleep-related movement disorder]]. | * '''[[Sleep bruxism]]''' – occurs during [[sleep]] and is considered a [[sleep-related movement disorder]]. | ||
* '''Awake bruxism''' – occurs during [[wakefulness]], often in response to stress or anxiety. | * '''Awake bruxism''' – occurs during [[wakefulness]], often in response to stress or anxiety. | ||
== Causes == | == Causes == | ||
The exact causes of bruxism are not fully understood, but several contributing factors may include: | The exact causes of bruxism are not fully understood, but several contributing factors may include: | ||
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* [[Neurodevelopmental disorders]] (e.g., [[ADHD]]) | * [[Neurodevelopmental disorders]] (e.g., [[ADHD]]) | ||
* Substance use (e.g., caffeine, alcohol, tobacco, recreational drugs) | * Substance use (e.g., caffeine, alcohol, tobacco, recreational drugs) | ||
== Signs and Symptoms == | == Signs and Symptoms == | ||
Common signs and symptoms of bruxism include: | Common signs and symptoms of bruxism include: | ||
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* [[Scalloped tongue]] or [[linea alba]] on the inner cheeks due to cheek biting | * [[Scalloped tongue]] or [[linea alba]] on the inner cheeks due to cheek biting | ||
* Enlargement (hypertrophy) of the [[masseter muscle]] | * Enlargement (hypertrophy) of the [[masseter muscle]] | ||
== Tooth Wear and Damage == | == Tooth Wear and Damage == | ||
[[Tooth wear]] from bruxism often appears as: | [[Tooth wear]] from bruxism often appears as: | ||
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* Cracks and [[tooth fractures]] | * Cracks and [[tooth fractures]] | ||
* Compromised [[dental crowns]], [[fillings]], and [[veneers]] | * Compromised [[dental crowns]], [[fillings]], and [[veneers]] | ||
== Diagnosis == | == Diagnosis == | ||
Bruxism is diagnosed based on: | Bruxism is diagnosed based on: | ||
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* Observation by a partner (especially for sleep bruxism) | * Observation by a partner (especially for sleep bruxism) | ||
* Use of [[polysomnography]] in complex or uncertain cases | * Use of [[polysomnography]] in complex or uncertain cases | ||
== Complications == | == Complications == | ||
Untreated bruxism can lead to: | Untreated bruxism can lead to: | ||
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* [[Myofascial pain syndrome]] | * [[Myofascial pain syndrome]] | ||
* Sleep disturbances | * Sleep disturbances | ||
== Treatment == | == Treatment == | ||
While there is no single cure, treatments focus on symptom management and preventing further damage. | While there is no single cure, treatments focus on symptom management and preventing further damage. | ||
=== Dental Interventions === | === Dental Interventions === | ||
* '''[[Occlusal splints]]''' (night guards): Custom devices that protect teeth from grinding forces. | * '''[[Occlusal splints]]''' (night guards): Custom devices that protect teeth from grinding forces. | ||
* '''Occlusal adjustment''': Selective reshaping of tooth surfaces to balance the bite (used cautiously). | * '''Occlusal adjustment''': Selective reshaping of tooth surfaces to balance the bite (used cautiously). | ||
* '''Restorative dentistry''': Repairing damaged teeth with crowns or other restorations. | * '''Restorative dentistry''': Repairing damaged teeth with crowns or other restorations. | ||
=== Behavioral Therapy === | === Behavioral Therapy === | ||
* '''[[Stress management]]''' techniques such as [[biofeedback]], [[cognitive behavioral therapy]] (CBT), [[meditation]], and [[relaxation therapy]] | * '''[[Stress management]]''' techniques such as [[biofeedback]], [[cognitive behavioral therapy]] (CBT), [[meditation]], and [[relaxation therapy]] | ||
* '''[[Sleep hygiene]]''' improvements to reduce nighttime grinding | * '''[[Sleep hygiene]]''' improvements to reduce nighttime grinding | ||
* '''Awareness training''' to reduce daytime clenching | * '''Awareness training''' to reduce daytime clenching | ||
=== Medications === | === Medications === | ||
* '''[[Muscle relaxants]]''' before bedtime (short-term use) | * '''[[Muscle relaxants]]''' before bedtime (short-term use) | ||
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* '''Adjustment of antidepressants''' if they contribute to bruxism | * '''Adjustment of antidepressants''' if they contribute to bruxism | ||
* '''[[Botulinum toxin]] (Botox)''' injections in severe cases to reduce muscle activity | * '''[[Botulinum toxin]] (Botox)''' injections in severe cases to reduce muscle activity | ||
== Prognosis == | == Prognosis == | ||
The prognosis varies. Many individuals experience improvement with stress management and dental protection. In children, sleep bruxism often resolves without treatment. | The prognosis varies. Many individuals experience improvement with stress management and dental protection. In children, sleep bruxism often resolves without treatment. | ||
== See also == | == See also == | ||
* [[Temporomandibular joint dysfunction]] | * [[Temporomandibular joint dysfunction]] | ||
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* [[Dentistry]] | * [[Dentistry]] | ||
* [[Muscles of mastication]] | * [[Muscles of mastication]] | ||
{{SleepSeries2}} | {{SleepSeries2}} | ||
{{Mental and behavioral disorders|selected = physical}} | {{Mental and behavioral disorders|selected = physical}} | ||
Latest revision as of 19:29, 4 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics
| Bruxism | |
|---|---|
| File:Deviated midline 2.JPG | |
| Synonyms | Teeth grinding, teeth clenching |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Tooth wear, tooth pain, jaw pain, headache, earache |
| Complications | Temporomandibular joint disorder, tooth damage, sleep disruption |
| Onset | Any age, commonly in adulthood |
| Duration | Can be chronic or episodic |
| Types | N/A |
| Causes | Stress, anxiety, sleep disorders, malocclusion, medications |
| Risks | Stress, smoking, alcohol consumption, caffeine |
| Diagnosis | Clinical examination, patient history, sleep study |
| Differential diagnosis | Temporomandibular joint disorder, toothache, ear infection |
| Prevention | Stress management, mouthguard, dental correction |
| Treatment | Behavioral therapy, dental splints, medication |
| Medication | Muscle relaxants, botulinum toxin |
| Prognosis | N/A |
| Frequency | Common, affects 8-31% of the population |
| Deaths | N/A |
| Bruxism | |
|---|---|
| File:Deviated midline 2.JPG | |
| Synonyms | Teeth grinding, jaw clenching |
| Pronounce | |
| Field | Dentistry |
| Symptoms | Tooth wear, jaw pain, headaches, sensitive teeth, TMJ pain, sleep disturbances |
| Complications | Tooth fracture, temporomandibular joint dysfunction, tooth loss, periodontal disease, myofascial pain |
| Onset | Can occur at any age; often starts in childhood or early adulthood |
| Duration | Chronic or episodic |
| Types | Awake bruxism, sleep bruxism |
| Causes | Stress, anxiety, sleep disorders, malocclusion, side effects of certain medications |
| Risks | Emotional stress, caffeine or alcohol use, certain drugs (e.g. SSRIs), poor sleep habits, family history |
| Diagnosis | Clinical evaluation, patient history, observation, sometimes polysomnography |
| Differential diagnosis | Temporomandibular joint dysfunction, tooth erosion, occlusal trauma, myofascial pain syndrome |
| Prevention | Stress management, good sleep hygiene, behavior modification, limiting stimulants |
| Treatment | Occlusal splints, behavioral therapy, stress reduction, medications (e.g., muscle relaxants, botulinum toxin) |
| Medication | Muscle relaxants, benzodiazepines, anxiolytics, botulinum toxin |
| Prognosis | Good with treatment, but may recur with stress or sleep disruption |
| Frequency | Affects 8–31% of the population; more common in children and young adults |
| Deaths | Rare; not typically fatal |
Bruxism is the excessive grinding of the teeth or clenching of the jaw, often an unconscious habit. It is classified as a parafunctional habit, meaning it serves no functional purpose such as eating or speaking. Bruxism can occur while awake (awake bruxism) or during sleep (sleep bruxism).
Types of Bruxism[edit]
Bruxism is typically divided into two categories:
- Sleep bruxism – occurs during sleep and is considered a sleep-related movement disorder.
- Awake bruxism – occurs during wakefulness, often in response to stress or anxiety.
Causes[edit]
The exact causes of bruxism are not fully understood, but several contributing factors may include:
- Stress, anxiety, and emotional disturbances
- Malocclusion (misalignment of the teeth)
- Sleep disorders such as sleep apnea
- Certain medications (e.g., some antidepressants)
- Neurodevelopmental disorders (e.g., ADHD)
- Substance use (e.g., caffeine, alcohol, tobacco, recreational drugs)
Signs and Symptoms[edit]
Common signs and symptoms of bruxism include:
- Excessive tooth wear, especially attrition on the occlusal (biting) surfaces
- Tooth sensitivity due to worn enamel and exposed dentin
- Headaches, particularly in the temporal region
- Pain or tenderness in the TMJ and Muscles of mastication
- Tooth fractures or damage to dental restorations
- Trismus (limited mouth opening)
- Audible grinding or clenching sounds during sleep (reported by a partner)
- Scalloped tongue or linea alba on the inner cheeks due to cheek biting
- Enlargement (hypertrophy) of the masseter muscle
Tooth Wear and Damage[edit]
Tooth wear from bruxism often appears as:
- Attrition – enamel loss from tooth-to-tooth contact
- Abfraction – wedge-shaped defects at the gumline
- Cracks and tooth fractures
- Compromised dental crowns, fillings, and veneers
Diagnosis[edit]
Bruxism is diagnosed based on:
- Clinical examination of tooth wear and jaw muscle tension
- Patient-reported symptoms such as jaw pain or morning headaches
- Observation by a partner (especially for sleep bruxism)
- Use of polysomnography in complex or uncertain cases
Complications[edit]
Untreated bruxism can lead to:
- Damage to teeth and dental restorations
- Temporomandibular joint dysfunction
- Periodontal disease aggravation
- Myofascial pain syndrome
- Sleep disturbances
Treatment[edit]
While there is no single cure, treatments focus on symptom management and preventing further damage.
Dental Interventions[edit]
- Occlusal splints (night guards): Custom devices that protect teeth from grinding forces.
- Occlusal adjustment: Selective reshaping of tooth surfaces to balance the bite (used cautiously).
- Restorative dentistry: Repairing damaged teeth with crowns or other restorations.
Behavioral Therapy[edit]
- Stress management techniques such as biofeedback, cognitive behavioral therapy (CBT), meditation, and relaxation therapy
- Sleep hygiene improvements to reduce nighttime grinding
- Awareness training to reduce daytime clenching
Medications[edit]
- Muscle relaxants before bedtime (short-term use)
- Anxiolytics (for stress-related bruxism)
- Adjustment of antidepressants if they contribute to bruxism
- Botulinum toxin (Botox) injections in severe cases to reduce muscle activity
Prognosis[edit]
The prognosis varies. Many individuals experience improvement with stress management and dental protection. In children, sleep bruxism often resolves without treatment.
See also[edit]
- Temporomandibular joint dysfunction
- Tooth wear
- Sleep disorders
- Occlusal trauma
- Dentistry
- Muscles of mastication
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