Bruxism and TMJ Disorder

Bruxism is excessive clenching and grinding of teeth which is not a part of normal chewing movement. It can often lead to excessive wear of teeth and damage of the jaw joint, known as the temporomandibular joint (TMJ). Most of the time, it happens during sleep, when there is no conscious control over it.

Bruxism is excessive clenching and grinding of teeth which is not a part of normal chewing movement. It can often lead to excessive wear of teeth and damage of the jaw joint, known as the temporomandibular joint (TMJ). Most of the time, it happens during sleep, when there is no conscious control over it.

Causes of Bruxism

A combination of physical and psychological factors is believed to contribute to clenching and grinding of teeth. These may include physical stress such as illness, nutritional deficiencies or dehydration; as well as psychological stress, anxiety and tension.

Studies have shown that night bruxism is a sleep disorder. Bruxism can further cause muscle spasms in the chewing muscles. This can lead to overloading of the TMJs beyond their normal capacity, resulting in TMJ disorders.

A TMJ disorder can sometimes be provoked by degenerative disorders such as arthritis, which may cause significant TMJ dysfunction.

Signs and Symptoms

The signs and symptoms of bruxism and TMJ disorders vary according to its nature, frequency, duration and strength. Due to excessive wear, the teeth may display pain and sensitivity to cold, hot and sweet foods and drinks.

Teeth may also become flattened and worn, showing the underlying yellow dentine layer of the tooth once all of enamel layer is worn. Intense muscle contraction associated with bruxism can cause chronic facial pain with tension headaches, as well as earache or pain in the jaw joint. The noise is often noticed by partners or relatives that occurs as the teeth are ground together.

Over time, the teeth may become mobile, and may develop underlying fractures, causing frequent chipping and breaking teeth.

When severe TMJ disorder takes hold, there maybe limited jaw movement with pain and difficulty in opening the mouth wide. Often clicking, grating or popping noises are noticed from TMJ. Other symptoms may include pain in or around neck and shoulder.

Treatment

Treatment aims to relieve pain, restore jaw function, reduce or eliminate noises from TMJ. Simpler, non-surgical treatment are usually tried first.

Softer food enables to rest the jaw joints as less chewing is required. Hot and cold packs on the painful areas help to reduce inflammation in the TMJs and chewing muscles.

Stress management and relaxation techniques aims at targeting the cause of clenching and grinding of teeth. Furthermore, physiotherapy, jaw muscle exercises and acupuncture may help to reduce pain and stiffness in the jaw joint, and improve the strength, range of movement and posture of chewing muscles.

Short term use of sedative and muscle relaxant medication and anti-anxiety medications are sometimes used.

Occlusal splints may also be used for someone with mild to severe grinding behaviour. Worn at night, they are made from moulded harder plastic that fits over upper or lower teeth. They do not provide a cure but often help with symptoms. These appliances help to relax muscles and take pressure of TMJs and teeth, thus, preventing further wear of tooth surfaces, reducing sensitivity and pain in teeth.

TMJ surgery is sometimes indicated only after all conservative options have been assessed or a significant internal problem with TMJ exists.