Tension and Your Teeth: Parafunction & Bruxism

Have you ever been woken up by the dull crunch of your own gnashing teeth? Did you simply shrug it off only to find that, come morning, you had an awful pain in your jaw? You could be suffering from Bruxism, or teeth grinding.

Bruxism is a form of Occlusal Parafunction, which is a term given to oral behaviours that serve no function. Unlike most other parafunctions (such as nail-biting, thumb sucking, cheek-biting etc.) bruxism normally takes place in your sleep, and is not a learned behaviour.

Is it deadly? Thankfully no. Even so, Bruxism’s side effects can be much more drastic than other parafunctional behaviours.

 

Why am I grinding my teeth?

Some bruxism activity is rhythmic, quick and repetitive. When you’re chewing, for example, your bite force pulses are very minute, often only accounting for a fraction of a second. Other activities result in longer bite force pulses of 1 to 30 seconds, such as clenching and releasing your jaw.

A major cause for this second type of bruxism is stress. Tension and anxiety can cause people to unwittingly clench and unclench their jaws for several seconds at a time. If you’ve ever caught yourself biting hard in concentration, or tensing up your jaw while you focus on an important task, you’re familiar with how easily we can manipulate our jaw muscles involuntarily.

Work, stress, and active worry aren’t the only causes for bruxism however, since a great deal of tooth- grinding occurs while we sleep. Disturbed sleep habits and a misaligned bite can increase grinding and clenching, inviting bruxism activity even when you’re completely unconscious. For this reason researchers will often classify bruxism as a sleep disorder, as well as a parafunctional habit.

A disturbed sleep habit is not only unhealthy for your teeth. It can have an impact on your health in general. So what’s disturbing your sleep?

 

Computer/Tablet/Phone Screens 

In our modern world, it is not uncommon to spend the remaining minutes before bedtime sitting on your (insert electronic device here) checking emails or aimlessly surfing the web. This pre-sleep ritual could be affecting your ability to sleep properly.

The artificial light that emits from your device suppresses the release of the hormone melatonin. A hormone that helps you sleep, making your body more alert and more awake.

Plan to put away your device(s) at least an hour before bed. Spend the last minutes before you hit the sheets winding down.

 

Caffeine

 You’ve managed to reduce your caffeine intake to help with your sleep. The last cup of coffee you’ve consumed was four hours before bed. Unfortunately, that’s still going to disrupt your sleep.

Caffeine has been found to be just as potent when consumed six hours before bed, as three hours before bed. That means that that cup of coffee you had with dinner will stay with you.

Do your best to limit any caffeine to at least 8 hours before you sleep.
 

The Effects of Bruxism

Bruxism can have unpleasant and harmful effects on both your jaw and teeth. Since grinding and clenching overwork your jaw muscles, these behaviours can result in discomfort, headaches and earaches, in addition to slowly eroding your teeth. Severe grinding can also be so loud that it has the disagreeable habit of waking you or a partner repeatedly in the night.

Other effects of bruxism include:

  • Gum recession
  • Insomnia
  • Malocclusion, or misalignment of the teeth
  • Temporomandibular joint problems (TMJ): discomfort and poor functioning of the chewing muscles in the lower jaw
  • Disk derangement
  • Severe bruxism can result in pulpal exposure, or even pulpal death
  • Trauma to the teeth and tooth loss
  • A disturbed sleep habit can result in sleep apnea, which is not only worsens your quality of sleep, but also your quality of life [hyper link to sleep apnea blog]

Bruxism, Teeth Grinding

Effects of severe Bruxism: Image via http://en.wikipedia.org/wiki/File:Topviewtooth.jpg

Treatment

If you suffer from bruxism, a visit to an oral health care specialist is necessary. Your practitioner will help determine the best course of action to target the habits underlying your clenching and grinding. The primary goals of treating bruxism are to reduce discomfort, improve sleep, and prevent long-term damage to the jaw and teeth. Common treatments for the condition include:

Visiting a sleep lab: Sleep labs perform the most reliable diagnostic technique for diagnosing bruxism. They’ll be able to establish how severe your bruxism is, giving your oral health specialist the information they need to appropriately treat it.

Wearing a mouth guard: A dental guard is effective at reducing tooth abrasion and muscle strain. Your oral health care practitioner will create a mold of your mouth to ensure that the instrument is completely customized for your bite. The guard works by allowing the upper and lower jaw to move easily and independently of each other. This will provide a protective barrier and prevent the repeated, grinding contact that erodes the teeth and exhausts the jaw muscles.

 

Biofeedback device and Cognitive Behavioural Therapy:

Biofeedback devices work by sending out a signal when your jaw clenches beyond a pre-set threshold. This “signal” might be an unpleasant taste, sound, or mild electric shock, depending on the biofeedback mechanism. The purpose of these devices is to interrupt the grinding behaviour and thereby provide the wearer with a subconscious awareness of it.

This works on a deeply psychological level. It’s called classical conditioning. Every time the biofeedback device recognizes a negative behaviour, it immediately jolts you out of your sleep. It provides a negative consequence to dissuade your body from continuing. Most professional have found that reinforcing this classical conditioning with a positive behaviour (I.E. Brushing teeth) strengthens the whole process.

Certain other treatments believed to improve bruxism, such as Botox and dietary supplements, are still undergoing research to determine their effectiveness. If bruxism has damaged a person’s teeth visibly, dental procedures can replace the worn and damaged crown of a tooth with a prosthetic alternative.

Of course this is an end-scenario fix. With timely preventative treatments and diagnostic assessments, you can manage and contain the effects of bruxism, and simultaneously improve other symptoms you may not have realized were related to this condition.