The jaw is a common place to store stress and anxiety. This is why some may find themselves grinding their teeth and clenching their jaw at night. This same response can happen repeatedly throughout the day, and throughout the night. It's known as bruxism when it's involuntary, or not on purpose. 

Bruxism can happen whether or not one is awake, but they are much less likely to know that they grind their teeth when they are sleeping. It's often not until a dentist appointment where one may discover that they actually are grinding their teeth down throughout the night. 

This habit can be pretty damaging to your teeth in the long run, so continue reading to learn more about bruxism, and what you can do about it. 

What is Sleep Bruxism? 

Sleep bruxism is teeth grinding that takes place during sleep. Sleep bruxism is different from bruxism due to the distinction of being asleep or not. Awake bruxism is much more common, however. 

A key challenge with sleep bruxism is that it is much more difficult for people to be aware that they are doing it because they are asleep. A sleeping person doesn't realize that their bite force is up to 250 pounds, all of which are going towards teeth. 

It is more common in children, adolescents, and young adults than middle-aged and older adults. However, it's hard to pin down the exact number because so many people are unaware that they grind their teeth. Anywhere from 6-50% of children experience nighttime teeth grinding. It can affect children as soon as their teeth come in, so even some toddlers and infants grind their teeth. 

Adolescents tend to have a smaller number of incidences, with 15% of them being teeth grinders. The prevalence continues to trend down the older one gets. 

Symptoms of Sleep Bruxism

The main symptom of sleep bruxism is jaw clenching or grinding. The motions resemble that of chewing, and don't happen constantly throughout the night. Instead, there are episodes where one is biting down, anywhere from a few to over 100. They also take place normally during stages 1 and 2 of NREM sleep. These are the lighter stages of sleep at the beginning of a sleep cycle. 

Some movement of the mouth is normal, also known as rhythmic masticatory muscle activity (RMMA). Up to 60% of people do this, and it's completely benign. However, in those with sleep bruxism, these episodes are more frequent and with more force.

It's normal for people to not be aware unless a family member tells them, or their dentists see evidence of it on their teeth. However, jaw and neck pain are two frequent signs of teeth grinding, mostly due to the constant tightening of the muscles during sleep. Morning headaches that feel like tension headaches are also symptoms that can be a sign that nighttime clenching and teeth grinding is happening. 

Consequences of Bruxism 

The main consequence is long-term and has to do with the health of one's teeth. Teeth may become more painful, eroded and mobile because of all the pressure being applied to them month after month. Any dental work, like crowns, fillings and implants, can also become damaged. 

Teeth grinding can also have negative consequences for the temporomandibular joint, or TMJ. This is the joint that allows your jaw to open and close. Issues with this joint can lead to chronic jaw pain, popping or clicking noises, locking of the jaw, chewing and other complications. 

Some people will not have consequences, as it depends on the severity of the grinding, the diet, the alignment of a person's teeth, and whether or not they have other issues that could affect teeth like GERD. 

Nighttime teeth grinding can also negatively affect your bed partner. The noise from clenching and grinding can be very bothersome, making it very annoying for your partner or difficult for them to go to sleep. 

Causes and Diagnosis of Sleep Bruxism

There are many factors that influence the risk of developing sleep bruxism. One of the major ones is stress. Clenching one's jaw or teeth is a natural response to a stressful situation. If stress is high, this behavior can carry over into sleep bruxism. Those with higher levels of anxiety are also thought to have higher levels of sleep bruxism. 

There is even a genetic component where having one family member that does it increases the risk of having another family member that does it. Episodes of teeth grinding are connected to changing sleep patterns or microarousals from sleep. There is even a link between bruxism and obstructive sleep apnea. 

Behavioral factors have also been linked to bruxism. These include activities like cigarette smoking, alcohol consumption, caffeine intake, depression or snoring. 

Diagnosing bruxism is normally done by a dentist or a doctor. An overnight sleep study - polysomnography - is the most conclusive way to diagnose sleep bruxism. However, these can be a bit cumbersome and are not always necessary to diagnose bruxism. Sleep bruxism is more of a clinical diagnosis with presenting symptoms like tooth damage, jaw pain, and reports from bed partners or observers. 

Treatment/Management of Sleep Bruxism 

There is no treatment that can completely eliminate teeth grinding during sleep. However, there are several approaches that can decrease episodes and limit the amount of damage done to teeth and the jaw. 

Stress reduction is very important for reducing the incidences of sleep bruxism. High levels of stress contribute to bruxism in both the awake and asleep states. So, finding ways to reduce stress or reduce exposure to stress will be the easiest ways to reduce these episodes. Therapies like cognitive behavioral therapy for insomnia (CBT-I) are great talk therapies for improving sleep that can decrease anxiety. Improving sleep hygiene and practicing good relaxation exercises before bed can help you release some of that tension. 

Mouth pieces or mouth guards are two other good options for intervening with sleep bruxism. These are plastic pieces that can be fitted to your mouth or general that you wear at night. These may not stop the bruxism, but can stop the teeth damage to the bruxism. There are various options for fitting, some may only cover areas of teeth while others cover the entire mouth. 

Finally, symptom management is another good option for symptom relief. Avoid chewing gum and hard foods that can irritate the jaw throughout the day. Hot compresses or ice packs can also relieve some of the muscle tension and damage. Facial exercises can help you reduce pain in your jaw and neck, while facial massages can reduce some of the inflammation and tightness. 

If you struggle with sleep bruxism and would like to speak with a sleep health expert, then please click the orange button below to take a free online sleep test. 

https://www.sleepfoundation.org/bruxism