TMJ Help Program

Bruxism, or Teeth Grinding, Can Cause Facial Pain, Infection.

Sophie may seem like an otherwise carefree 25-year-old, but one look at her worn-down teeth proves otherwise.

“I grind my teeth at night because of stress,” said Sophie, who asked that her real name not be used to protect her privacy.

And Sophie is not alone — dentists told ABCNews.com that they often see signs of bruxism, or teeth grinding, and treat the cracked teeth and jaw pain from people who clench their teeth too much.

“The past four or five months have been so stressful,” said Sophie, who said her dentist recently pointed out the damage she’s done to her teeth from grinding. “It’s no coincidence that I grind.”

Judy LaRosa, 51, knows how Sophie feels. She says she’s been grinding her teeth for as long as she can remember.

“I wake up in the morning and my mouth is killing me,” said LaRosa. “My teeth ache and my jaw hurts.”

Studies have found that between 5 percent and 12 percent of people suffer from facial pain, known as tempormandibular joint and muscle disorder (TMJD), which is often caused by teeth grinding, according to the National Institute of Dental and Craniofacial Research.

Dr. Harold Menschel, whose Florida-based dental practice The TMJ & Facial Pain Institute specializes in oral face pain, said that he’s convinced the rising levels of stress have increased the number of cracked teeth he mends.

“People today don’t have cavities anymore, and we have gum disease under control,” said Menschel. “People instead [are] losing their teeth by wearing them down and cracking their teeth.”

“It’s a huge problem,” said Menschel.

Grinding Your Teeth Can Cause Earaches, Headaches and Jaw Pain

The related muscles and joints in the face, said Menschel, are affected by the pressure that grinding teeth produces, often resulting in earaches and jaw pain.

“When you grind your teeth you’re putting force on the system,” said Menschel. “That can result in tooth pain and even headaches because they are all related to the nerve that governs the face.”

At Dr. Kimberly Harms’ private dental practice outside of Minneapolis, some of her baby boomer patients complain of symptoms that have resulted from a lifetime of grinding.

Stress, Harms said, is a “huge factor” of bruxism.

“From experience, when I had two teenage daughters at home I needed a high number of root canals,” said Harms, who added that root canals are necessary when a cracked tooth — in her case caused by grinding — gets infected.

“Stress definitely causes bruxism to be more prominent,” said Harms, who also acts as the American Dental Association’s consumer adviser.

“I just had a patient who came in with a major crack say that she’s been under a lot of stress,” said Harms. “Patients recognize how stress causes them to grind.”

And it’s not just adults who are so stressed out that they ruin their teeth, said Harms. Children too have been known to grind down their baby teeth.

“There is some thought that ear infections and colds can cause kids to grind their teeth,” she said. Children may deal with the pain by taking it out on their teeth.

To Cure Grinding, Dentists Suggest Relaxing

Some patients get a plastic mouth guard made to prevent grinding during the night.

“Night guards do protect the teeth and put the jaw in the good position while the person grinds,” said The TMJ & Facial Pain Institute’s Menschel, who also recommends relaxation therapy and even hypnosis.

Harms said that many dentists who can’t get their patients to stop grinding and clenching will adjust the patients’ bite to decrease the impact on their teeth.

“It’s a very hard habit to break,” said Harms.

Sophie says that her grinding problem has opened her eyes to how stressed she actually is and just how hard it is to stop.

“It’s crazy to think that I’m that stressed,” said Sophie. “I can’t even control it — especially if I’m doing it at night I’m doing damage to myself but I don’t even realize it. It’s frustrating.”

LaRosa says her doctor’s advice was nearly impossible to follow.

“He told me to avoid stress,” she said, laughing.

Teeth grinding in children is otherwise known as bruxism and happens when children clench their upper and lower teeth, rubbing them together. Commonly children grind their teeth whilst sleeping and are not aware of what they are doing.

What are the causes of bruxism in children?

It is not known for certain why some children start grinding their teeth and some children don’t. There are many theories to suggest that it could be down to the fact that the sets of top and bottom teeth do not fit together comfortably due to the fact that children’s teeth and jaws grow in phases leading to unpleasant sensations in the area. The natural response of the child is to grind their teeth to soothe themselves which often later develops into a habit. It has also been shown that both children and adults grind their teeth when they feel anxious in some way, or even as a response to facial pain such as an earache or teething. It has also been shown that hyperactive children have developed bruxism.

More recent research has suggested that sleep disturbances may be a cause for bruxism in children as well as causing a number of other problems such as bed-wetting, drooling and sleep-talking. Interruptions in the rapid eye movement (REM) patterns due to dehydration during sleep can be the underlying cause of many of these problems, though your dentist will be able to advise you more on this matter.

What are the effects?

Children do not usually experience ill effects from grinding their teeth. Even when their milk teeth show wear it usually does not cause any pain or damage, yet if this wear gets severe, or if your child has already lost their milk teeth, then it is advisable to seek treatment from your dentist as dental problems such as tooth infections can occur. In most cases of teeth grinding in children they will usually outgrow the problem.

What can be done to help?

Whilst the problems will most likely go away you may want to try some methods to help the child stop grinding their teeth in the meantime. Your dentist would be the best source of advice, and will be able to make sure that there are no problems regarding the alignment of the child’s teeth.

The most common remedy recommendation is usually a mouth guard. Wearing a mouth guard at night will prevent the child from grinding their teeth and night, and has a very high success rate in reducing the habit. However, your child may feel uncomfortable wearing a mouth guard and for this reason it is wise to look into other treatment options. In many cases hypnosis has been shown a successful way to get people of all ages out of the habit of grinding teeth.

In children whose grinding appears to be down to stress or anxiety it is extremely important to discover the underlying cause for these feelings. Try ways to relax your child before they go to sleep, such as a warm bath and a massage of the jaw. These methods will help to ensure that your child has a deep, relaxing and uninterrupted sleep.

The most important thing is that you needn’t be alarmed by a child’s grinding as it is extremely common. If your child already has their adult teeth then it is more of a worry, though there are many options available so seek advice from your dentist.

Sleep problems are frequent among healthy school going children seen at general pediatric practice. Sleep related problems were reported in 42.7% children that included nocturnal enuresis (18.4%), sleep talking (14.6%), bruxism (11.6%) nightmares (6.8%), night terrors (2.9%) snoring (5.8%) and sleepwalking (1.9%). Bruxism is a destructive habit. It is defined as the nonproductive diurnal or nocturnal clenching or grinding of the teeth.

Bruxism happens in about 15 percent of youngsters and in as many as 96 percent of grown-ups. The etiology of bruxism is unclear. It has been linked with stress, occlusal disorders, allergies and sleep positioning. In addition, type A personality behavior combined with stress is more predictive of bruxism. Because of its nonspecific pathology, bruxism may be difficult to diagnose.

Beside complaints from sleep partners, clenching-grinding, sleep bruxism, myofacial pain, craniomaxillofacial musculoskeletal pain, temporomandibular disorders, oro-facial pain, fibromyalgia, and chronic fatigue spectrum disorders are linked. The main clinical signs of bruxism comprise tooth wear, tooth mobility, hypertrophy masticatory muscles, and tender joints. Other symptoms of bruxism are multiple and diverse. They include temporomandibular joint pain and dysfunction, head and neck pain, erosion, abrasion, loss of and damage to supporting structures, headaches, oral infection, tooth sensitivity muscle pain and spasm, disturbance of aesthetics, and interference and oral discomfort.

Treatment for bruxism may be simple or complex, depending on the nature of the disorder. Severe bruxism disorders are difficult to treat and their prognoses also may be questionable. Children with bruxism are generally managed with observation and reassurance. Most of the children’s bruxism habit will disappear naturally as they grow up. Adults may be managed with stress reduction therapy, modification of sleep positioning, drug therapy, biofeedback training, physical therapy and dental evaluation. Correction of the malocclusion with orthodontic procedures, restorative procedures, or occlusal adjustment by selective grinding will not control the bruxism habit.

What about prevention? Researchers have found only a weak correlation between different types of morphologic malocclusion such as Class II and III molar relationship, deep bite, overjet, and dental wear or grinding. Moreover, there is no correlation between periodontal disease and bruxism in children. Because the malocclusions’ status in children does not increase the probability of bruxism, early orthodontic treatment (braces) to prevent bruxism is not scientifically justified.

Bruxism is a destructive habit that may result in severe dental deterioration. Bruxism in childhood may be a persistent trait. The occlusal trauma and tooth wear in childhood bruxism can be succeeded by increased anterior tooth wear 20 years later. If your child has significant tooth attrition, dental mobility or tooth fracture may happen. Therefore, it is mandatory to take your child to your dentist for evaluation of bruxism.