Bruxism

Bruxism is a rhythmic motor behavior that can occur during sleep (sleep bruxism) and while awake (awake bruxism) (1). Although bruxism does not always cause painful symptoms, in some people, bruxism causes headaches, neck pain, and/or jaw pain. The most severe and extensive grinding and clenching occurs during sleep. People may be oblivious to their bruxism, but family members might notice it.

Bruxism is considered a multifactorial condition. Some risk or contributing factors for bruxism include sleep disorders, psychosocial factors (eg, stress or anxiety), and lifestyle factors (eg, alcohol consumption) (2, 3).

Bruxism can abrade and eventually wear down enamel and dentin in the crowns of teeth, damage metal or ceramic dental crowns, and cause teeth to become mobile. Bruxism can also cause temporomandibular myofascial pain syndrome, which can result in pain not only in the muscles of mastication but anywhere in the body, most commonly involving muscles in the neck, shoulders, and back.

Treatment requires that the patient consciously try to reduce bruxism while awake (4). Plastic oral appliances (night guards) that prevent occlusal contact by fitting between the teeth can be used while sleeping. When symptoms are severe, a guard can also be used during the day. Usually, such devices are custom-made and fitted by dentists. However, if the only problem is tooth wear, over-the-counter (OTC) heat-moldable devices fitted at home are available, but a dental evaluation should first be done to assess the severity of wear and determine whether an OTC device is adequate. Mild anxiolytics, particularly benzodiazepines, may help until a night guard is available but should not be used for extended periods.