There are many misconceptions about bruxism. Everyone has bruxism to some extent, so it is important to get the facts. Perhaps you have been told by a bed partner or dentist that you grind your teeth at night. Maybe you clench your teeth, or perhaps you are “fortunate” to experience no symptoms of bruxism. Whatever your experience with bruxism, here are the facts.
Fable: Bruxism is grinding teeth at night.
Fact: Bruxism experts from around the world came to an international consensus that bruxism is masticatory muscle activity (MMA), which is the contraction of jaw muscles. Teeth grinding is a symptom of MMA and may indicate bruxism. Tooth wear from grinding, jaw pain, headaches, and filling or implant breakage are all possible symptoms of MMA.
Often bruxism happens while asleep, but it can also occur while awake.
Fable: Bruxism is a sleep disorder.
Fact: Bruxism is regular muscle activity that is widely experienced, it is not considered a disorder as previously thought. Studies have shown a high correlation between bruxism and obstructive sleep apnea (OSA), which is a sleep disorder. At the end of many OSA events, jaw muscles contract to open the upper airway. Research suggests that if bruxism is treated, it might intensify OSA.
Fable: I have bruxism because my teeth are misaligned. If I get braces, it will be cured.
Fact: Bruxism is caused by muscle contractions in the jaw, not the structure of the mouth or teeth. Stress and lifestyle factors like smoking and alcohol usage are more likely to contribute to bruxism. Oral appliances may help the negative effects of bruxism but will not “cure” it.
Fable: My child is ruining his or her teeth by grinding them while asleep.
Fact: Parents may hear their child grind his or her teeth while sleeping and be concerned about what it is doing to the child’s teeth, or the noise it is making. Up to 40% of children grind their teeth. It is a normal behavior, usually does not cause pain, and should not be treated except in extreme cases. Sleep bruxism in adults occurs in about 12%, suggesting that many children will outgrow grinding, although currently, no studies have followed children with MMA to adulthood.
Fable: Bruxism is affecting my sleep.
Fact: While people have self-reported on questionnaires that their quality of sleep suffers due to bruxism, sleep studies have shown no change in sleep quality with people who experience bruxism.
Fable – Bruxism is bad and should be treated.
Fact: Studies suggest that bruxism may improve salivatory flow. It stimulates the glands and increases saliva which keeps the mouth moist and maintains the necessary humidity levels in the mouth. It all adds up to a healthier mouth.
It is only when complaints arise that bruxism should be addressed. Treatments are available for the symptoms of bruxism including pain, aesthetically displeasing teeth, or destruction to teeth and dental work. If clenching, grinding, or bracing during the day, counseling may help to “unlearn” these behaviors. If done at night, an oral splint may be prescribed to lessen tooth wear, damage to dental work, and jaw pain. If there are no adverse effects, bruxism is best left untreated.
Frank Lobbezoo, DMD, PhD is a Professor and Chair of the Department of Orofacial Pain and Dysfunction at the Academic Centre for Dentistry Amsterdam, the Netherlands (ACTA), and a member of the Royal Netherlands Academy of Arts and Sciences (KNAW). His specialties are TMD, Orofacial Pain, Oral Movement Disorders, and Dental Sleep Medicine.