Teeth Grinding and Clenching (Bruxism)

What Is Bruxism?

Bruxism refers to involuntary or unconscious clenching and grinding activity.

It may occur during sleep or during waking hours, sometimes in association with concentration, stress or habitual muscle activity.

The severity varies between individuals. Some people have few noticeable effects, while in others considerable forces may be placed on the teeth and chewing system.

What Are the Signs of Bruxism?

Possible signs and symptoms include:

• Flattened or worn tooth surfaces
• Cracked or fractured teeth
• Repeated damage to fillings or crowns
• Jaw muscle fatigue or pain on waking
• Tooth sensitivity
• Tight or tender jaw muscles
• Discomfort around the jaw joints
• Morning facial or head discomfort
• Grinding sounds noticed by another person during sleep

These symptoms are not specific to bruxism and may have other causes. A clinical evaluation is therefore important.

What Causes Teeth Grinding and Clenching?

Bruxism may not have a single cause. Sleep-related factors, stress, behavioral factors and individual habits may all be involved.

For this reason, management should include not only protection of the teeth but also consideration of factors that may contribute to the condition.

Can Bruxism Damage the Teeth?

Repeated high clenching or grinding forces may gradually wear the chewing surfaces of the teeth.

More advanced cases may be associated with cracks, fractures, sensitivity or damage to existing restorations.

Evaluation of biting forces may be particularly important in patients with ceramic crowns, zirconia restorations or implant-supported prostheses.

Can Bruxism Affect the Jaw Joint?

Prolonged clenching and increased activity of the chewing muscles may occur together with muscle or temporomandibular joint symptoms in some patients.

Bruxism is not the only cause of temporomandibular joint disorders. Joint symptoms therefore require a separate and comprehensive assessment.

How Is Bruxism Evaluated?

Assessment includes the patient's symptoms and habits together with an examination of the teeth, restorations, chewing muscles and jaw joints.

Findings that may be evaluated include:

• Tooth wear patterns
• Cracks or fractures
• Damage to existing restorations
• Tenderness in the jaw muscles
• Mouth opening and jaw movements
• Bite relationship
• Jaw joint symptoms

How Is Bruxism Managed?

Management is individualized according to the patient's symptoms and clinical findings.

The treatment plan may include:

• A custom-made protective night guard
• Restoration of worn or fractured teeth when indicated
• Assessment of existing fillings and prosthetic restorations
• Evaluation of jaw muscles and joint function
• Strategies to increase awareness of daytime clenching
• Referral for additional evaluation when another discipline is required

What Is a Night Guard?

A night guard is a removable appliance individually made to fit the patient's teeth and is commonly worn during sleep.

One of its main purposes is to reduce direct contact between opposing teeth during clenching and grinding and help protect natural teeth and restorations.

A night guard should not be considered a treatment that removes every underlying cause of bruxism. Its purpose and duration of use are determined according to the individual clinical situation.

Custom Night Guard or Over-the-Counter Guard?

Fit, bite relationship and material properties are important when an appliance is used for bruxism.

A custom-made appliance is produced from records of the patient's teeth and its fit and bite relationship can be clinically evaluated and adjusted.

Can Worn Teeth Caused by Bruxism Be Restored?

Different restorative procedures may be considered depending on the amount of tooth wear.

Conservative restorations may be sufficient for limited loss, while more extensive wear may require a broader restorative treatment plan.

Assessing the cause of the wear and the forces affecting the teeth before restoration is important for long-term planning.

What Happens if Bruxism Is Not Managed?

The progression and effects of bruxism differ between individuals.

Persistent excessive forces may contribute in some patients to progressive tooth wear, damage to restorations or continued muscle and joint symptoms.

Regular monitoring is therefore important when clinically significant signs are present.

Bruxism Treatment at DrKuyumcu

Bruxism management is not limited to simply providing a night guard.

At DrKuyumcu, tooth wear, existing restorations, bite, chewing muscles and the temporomandibular joints are evaluated as a whole.

The treatment plan is individualized to help protect existing tooth structure and restorations, reduce the effects of excessive forces and support long-term health of the chewing system.

Frequently Asked Questions About Bruxism