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Clinician’s Corner: Teeth Grinding

Bruxism refers to repetitive jaw-muscle activity characterized by clenching or grinding of the teeth. Stress and anxiety seem to be often listed as the cause. The symptoms of teeth grinding include:

  • Clicking or popping jaw joints
  • Eating disorders
  • Insomnia
  • Enlarged jaw muscles
  • Earache
  • dull headaches
  • jaw pain and stiffness on waking
  • teeth that are painful or loose, due to wearing down of enamel and increasing sensitivity
  • fractured teeth and excessive tooth wear

Treatment may include mouth guards, and skeletal muscle relaxants.

German researchers did a small study of 69 patients, and concluded that participant’s significant teeth grinding during sleep tend to feel more stressed at work and in their daily life, and, according to the questionnaire, seem to deal with stress in a negative way. Teeth clenching is a dangerous dental problem that can not only wear down teeth, but also make them sensitive or loose or even fracture them. Besides worn tooth surfaces, which can lead to sensitivity, symptoms can include headaches and a sore jaw.

Causes of Bruxism (Teeth grinding):

May be traced to the use of tobacco, alcohol, caffeine, or medications for sleep and depression Mental disorders, anxiety, stress and adverse psychosocial factors are significantly related to tooth grinding during sleep. It has been found that nearly 70% of grinding occurs because of stress or anxiety.

Common antidepressants like citalopram (Celexa), Fluoxetine (Prozac) and Paroxetine (Paxil) being the biggest culprits causing teeth grinding.

DRUG TREATMENT (Pharmacotherapy) of BRUXISM

  • STOP the offending medication!
  • Buspirone (anxiolytic) may help with anxiety, without contributing to bruxism
  • Propranolol, Gabapentin, Botulism toxin have all been used.
  • Clonazepam has most evidence, and has the additional benefit of decreasing nighttime leg movements.

Mechanical treatment of Bruxism:

Mouth Guards

    • Premade Plastic Mouth Guards-flexible plastic- don’t always fit adequately over the teeth. May be an obstructive hazard
    • Boil and BiteMouth Guards OTC fit better than the pre-made but are more uncomfortable to wear.  May interfere with tongue movement.
    • CUSTOM FIT Mouth Guards: made by dental professionals, from soft rubber up to acrylic, for heavy grinding.
  • Occlusal splints (bite guards) have become first line therapy as they protect the teeth from premature wear, reduce jaw muscle activity and the noise of teeth grinding.

Your dentist and Thompson Pharmacist are great resources if you are experiencing teeth grinding.  At Thompson Pharmacy, it’s all for YOU!