The root of the problem: teeth grinding, bruxism and TMD
When it comes to jaw pain, headaches and ear ringing, teeth grinding could be the root of the problem. 1300SMILES dentist Dr John Kotaidis explains symptoms, causes and treatment options for bruxism and temporomandibular joint disorder (TMD).
Do you ever wake up to find your teeth hurt? Perhaps you have unexplained headaches during the day, or a ringing in your ear for no reason? Maybe you awaken with pain in your cheeks or tightness in your temple? Or you’ve developed a painful clunk in your jaw when you chew?
Teeth grinding could be the culprit. It’s a common condition, known as bruxism, that many of us will experience at some point in our lives. It can be disruptive to both sleep and day-to-day living – and you may not even realise you do it.
“Often, people who grind their teeth don’t even know they do it until their grinding wakes their partner and the partner tells them, or until their dentist notices fractures in their teeth,” says Dr John Kotaidis, who practices at 1300SMILES’ Belgian Gardens practice.
“Some people experience all the symptoms of teeth grinding, some people get only some, some people get no symptoms other than what the dentist can see during a regular check-up.”
Signs you grind your teeth
• You wake yourself or your partner with the sound of grinding teeth
• Jaw pain, clicking jaw, locked jaw, limited opening of the jaw, or pain or discomfort when chewing
• Cracks, chips or fractures in your teeth
• Referred pain – headaches, migraines, ear aches, tinnitus (ringing in the ear), jaw aches, facial pain, tightness in your temple or cheeks in the morning
Bruxism – teeth grinding
As mentioned, teeth grinding is common, and for many of us the condition will end as quickly as it began. In children, it can be an occlusion issue (how the teeth make contact) due to new or lost teeth. In adults, bouts of bruxism can be triggered by stress or anxiety, medications, sleep apnoea or an abnormal bite.
How could you possibly have bruxism for decades without even knowing? It is the involuntary action of grinding or clenching teeth, and often happens at night during sleep.
“We all have times of stress in our lives, and that’s when teeth grinding can come and go. The grinding can be a stress release; when the brain finds a spot it likes, the grinding goes into overdrive.
“It is not uncommon to find people in their 60s, who have worn their teeth down almost to the gum line,” says Dr John. “Grinding causes dentine exposure and acid erosion of dentine can accelerate the wearing down of the tooth surface.”
If left untreated, chronic bruxism can wear down teeth to the point of breaking or loosening teeth, can lead to jaw pain, tinnitus, migraines or temporomandibular joint disorder (TMD). One treatment for chronic bruxism is a night splint, worn on the teeth like a mouthguard, which protects the teeth and prevents the jaw from over-closing.
“When we see patients who have used a night splint, we can see the areas where the grinding is forceful, because the acrylic is worn down. In many cases, the grinding will stop with the splint because the teeth can’t find a good spot to grind.”
TMD – temporomandibular joint disorder
While bruxism is the condition of grinding teeth, TMD is a condition that occurs when the jaw is misaligned or not functioning properly. Chronic grinding or clenching can lead to TMD.
An accurate diagnosis is important, to ensure your treatment is effective. Be sure to see your dentist if you suspect you could be experiencing bruxism or TMD.
Methods to manage teeth grinding
• Break the cycle. Often, simply stirring a teeth grinder from deep sleep is enough to stop them grinding. Obviously, this is only viable for short bursts of bruxism.
• Avoid excessive chewing. Modify your diet to avoid tough or chewy foods like steak, nuts, sticky lollies and chewing gum.
• Limit extreme jaw movements.
• Medicate. Take an anti-inflammatory, like Nurofen, just one tablet a day, for a few days, to ease the pain.
• Relax. Find a bedtime ritual to help you enter sleep in a calm state, not worry about the day gone or the day ahead. White noise can help ease you into a peaceful sleep.
• Stress management methods. If bruxism is brought on by stress or anxiety, treating those conditions will
• Splint. For chronic bruxism, your dentist can give you a mouthguard made of clear acrylic with a rubber insert.
• Surgery. In extreme cases, surgery is an option.
