We’ve all heard about the common causes of tooth damage, right? Sugar, poor hygiene practices, neglect. But there’s one that can affect up to 80% of people that is woefully underacknowleded: tooth grinding.

Despite the number of people affected by it, tooth grinding is one of the most under-diagnosed issues in dentistry, and a major contributor to headaches, facial pain, dental damage, and even sleep problems.

So what is it, exactly?

It is, essentially, what it sounds like. Tooth grinding is the act of involuntarily grinding or rubbing your top teeth against your bottom teeth. Most people won’t notice they’re doing it, because they’ll do it whilst sleeping, or when preoccupied with something else. It’s an unconscious activity. Chronic grinding, to the point of damaging your teeth, is known as bruxism – this only affects 8-10% of adults, but its estimated that over 10 million adults in the UK are affected, and a third of those aren’t even aware they have it. 

Symptoms might include:

Regular headaches and facial pain – because grinding your teeth puts a lot of strain on the muscles in the top of your jaw, you might experience a pain that radiates around your head, particularly at the sides. You may also experience pain in the cheeks and mouth, and because it can damage the tissue inside your mouth, you may even feel pain in the lips and the cheeks. If this is a pain you feel regularly, especially in the morning, it might be a sign that you’re grinding your teeth.

Making loud noises at night – even if you do not notice it yourself, your partner may notice a very loud, perhaps unpleasant, crunching or creaking noise, which could be indicative that you grind your teeth.

Tooth wear – perhaps the most unfortunate effect of tooth grinding is that it wears down your teeth over time. This can have a poor effect on the aesthetics of your smile, as shorter teeth can make for a gummy smile, but more importantly it puts you at greater risk of cracking or chipping teeth. Worn down teeth, particularly in people who are not elderly, are almost always caused by tooth grinding, so if its something you notice, see your dentist.

Tooth sensitivity – Tooth sensitivity can have a number of causes, so this is not a definite sign of bruxism, but tooth grinding can wear away the protective enamel layer on your teeth. 

Sleep problems – The discomfort caused by grinding can wake you up intermittently at night. These periods of wakefulness may only last a few moments, and go unnoticed and unremembered, but they disrupt the sleep cycle, and can cause tiredness during the day.

TMJ (Temporomandibular Joint) Dysfunction – TMJ is characterised by chronic stiffness and pain in the joints of the jaw. In severe cases it can prevent you opening your mouth properly. Tooth grinding puts strain on the TMJ and damage the soft tissue, and this makes it the most common cause of the dysfunction. Serious TMJ may require medical intervention or even surgery to be righted.

What causes it?

The extent to which someone grinds their teeth is down to both environmental and genetic factors. A big genetic factor is how straight our teeth are – essentially, the less straight they are, the more likely you are to grind them. You’re especially likely to grind if you have a misaligned bite, such as an underbite, overbite, or crossbite. 

Natural resting levels of activity in the jaw muscles can also play a role; hyperactive jaw muscles can increase the chance of tooth grinding. 

As far as environmental factors go, the leading cause is, unsurprisingly, stress. It’s a link that’s been very well established in clinical studies.

Its thought the reason behind the link is the effect of the hormones adrenaline and norepinephrine, which are secreted at a higher level in stressful situations, have on our reflexes, increasing the frequency of reflexive actions. For some people, stress might be fleeting, and tooth grinding with it – only during stressful times like exam season, or difficult periods at work, but for some stress is a chronic issue. Chronic stress is an especially high-risk factor, because it can lead to an imbalance in adrenaline and norepinephrine.  

Another leading environmental cause is stimulant use. This doesn’t necessarily mean illegal stimulants, either – though those can contribute to bruxism – caffeine and nicotine can both promote the body’s reflexive movements.  People who smoke or/and have more than 6 cups of caffeine a day are reported to be more likely to suffer from bruxism. Alcohol also plays a part, as dehydration can contribute to tooth grinding.

In fact, dehydration is big factor in tooth grinding in children, so keep an eye on how much water your little ones are drinking.

So how do we fix it?

There’s no known cure for tooth grinding as yet, but there are ways of managing the condition to get relief from symptoms.

Common treatments include:

Occlusal splints – you might know of them as night guards, and generally they’re considered the most effective treatment for bruxism. They’re designed to prevent inadvertent tooth movement, and they have the added bonus of reducing grinding noises – which helps limit disruption to sleep – and protect your teeth from premature wear and damage.

Botox – botox isn’t only for wrinkles. Botulinum toxin has muscle relaxing properties, and when a small amount is injected into the muscles of your jaw, it reduces clenching and thus helps relieve symptoms. Results can last anywhere from 3 to 6 months.

Behavioural approaches – Also included in management options are hypnosis, meditation, stress-management techniques, and muscle relaxants. If stimulant use is part of the issue, reductions in caffeine or nicotine may also be advised. You can also cut out habits that promote jaw tension, like chewing gum. 

Tooth grinding is no laughing matter, but it is readily manageable if you catch it. So, if you’re at all concerned, why not book in for a consult, and find out how you can get the help you need?