Brief overview
- Causes:Stress, misaligned teeth or jaws, too large crowns or fillings, too much alcohol or caffeine, certain medications, underlying conditions such as restless legs syndrome, nocturnal breathing pauses, circulatory problems, cerebral hemorrhage, epilepsy, Huntington’s disease, Parkinson’s disease.
- Symptoms: rhythmic, involuntary clenching of teeth, often with grinding, chewing-like movements. Usually at night, but sometimes during the day. Possible accompanying symptoms: Muscle tension with headache, neck pain, jaw pain, facial pain. Painful, porous teeth, severe tooth damage up to tooth loss.
- Treatment: depending on the cause, e.g. correction of excessively large crowns or fillings, bite splint, loosening and relaxation exercises for stress-related teeth grinding, physiotherapy and, if necessary, short-term use of painkillers and/or muscle-relaxing medication, psychotherapy for deeper-lying psychological stressors, biofeedback procedures.
- Prognosis: With early treatment, the prognosis is good. (Severe) subsequent damage to the teeth can then usually be avoided.
Teeth grinding: Causes
The main causes of teeth grinding (bruxism) are:
- Stress: Every second person reacts to professional or private overstrain with temporary teeth grinding. But only one in five develops a chronic problem.
- Disturbed occlusion: If the occlusion of the jaws is disturbed, teeth grinding can follow. Misaligned teeth as well as crowns or fillings that do not fit can trigger such jaw problems. Another cause is teeth growing out. This happens, for example, when one loses a tooth. The corresponding counterpart (in the opposite jaw) then no longer encounters resistance and can grow unhindered – the result is a disturbed bite between the upper and lower jaws, often accompanied by teeth grinding.
- Diseases: Sometimes behind teeth grinding are diseases such as restless legs syndrome (restless legs syndrome), obstructive sleep apnea (nocturnal breathing pauses), reduced blood flow (ischemia), brain hemorrhage, nocturnal epilepsy, Huntington’s chorea, Parkinson’s syndrome.
If no clear medical cause for teeth grinding can be found, the condition is primary bruxism. In this case, stress may play a role. Doctors speak of secondary bruxism when a specific trigger for teeth grinding can be identified, for example a neurological or psychiatric disorder, sleep disorders or medication.
Teeth grinding: Baby & Child
About half of all babies start grinding their teeth by the age of ten months. This is not a cause for concern, as this is how the new baby teeth are aligned or “ground in”. When the last milk tooth has fallen out, bruxism usually also disappears.
You can read more about this topic in our article “Teeth grinding in children and babies”.
Teeth grinding: symptoms
When people grind their teeth (bruxism), they involuntarily press the teeth of the upper and lower jaws together without pursuing a functional purpose (such as chewing). Rhythmic, grinding, chewing-like movements can also occur.
The fatal thing about teeth grinding: Very strong pressure is exerted on teeth and jaw joints. Up to 480 kilograms per square centimeter (kg/cm2) are possible – that’s ten times the pressure that occurs when chewing! And these enormous forces do not only stress the teeth and jaws for a short time – teeth grinding can last up to 45 minutes a day.
This enormous load permanently wears away the enamel and exposes the dentin (tooth bone) along with the nerve pathways. The result is pain-sensitive, increasingly porous teeth.
Teeth grinding during sleep and during the day
Most sufferers grind their teeth while they sleep. Doctors then speak of nocturnal bruxism or sleep bruxism.
Less common is diurnal bruxism (awake bruxism), i.e. teeth grinding during the day. In this case, the jaws are usually only strongly clenched without grinding the teeth.
Centric and eccentric bruxism
Some people unconsciously clench their teeth very hard. In this centric bruxism, extremely strong forces act on the teeth and jaw joints.
In eccentric bruxism, the teeth are rubbed against each other, which produces a more or less loud grinding noise.
Teeth grinding: What helps?
If none of this helps, you should consult your doctor or dentist. He will advise you on the choice of the appropriate therapy. If the cause of the teeth grinding is, for example, a crown or filling that is too large, the dentist can grind it down and thus easily eliminate the bruxism. A bite splint protects the teeth from abrasion and further damage. If teeth grinding is triggered by an underlying condition (such as restless legs syndrome), it must be treated accordingly.
Below you will learn more about important treatment options for teeth grinding.
Relaxation exercises
For stress-related teeth grinding, you should also try relaxation methods. This can reduce the inner tension and counteract teeth grinding. The exercises can also help against headaches and jaw pain associated with teeth grinding.
Proven methods to reduce stress include:
- Autogenic training
- Progressive muscle relaxation according to Jakobsen
Bite splint
A bite splint (occlusal splint) is individually fitted by the dentist. It prevents direct contact between the teeth when biting down, thus protecting the tooth structure and the periodontium, and contributes to a relaxed position of the upper and lower jaws.
Tip: Have your teeth checked regularly (every six months) by your dentist. In this way, any damage to your teeth can be detected at an early stage.
Physiotherapy
Medication
Under certain circumstances, pain-relieving medications or muscle relaxants are useful for teeth grinding. However, they should only be used for a short time.
Psychotherapy
Often stress triggers teeth grinding. If this stress has deeper psychological causes, psychotherapy can help, in addition to relaxation exercises such as autogenic training or progressive muscle relaxation according to Jakobsen.
Biofeedback procedures
Biofeedback methods are also effective for teeth grinding. With the help of electronic devices, people learn to become aware of unconscious physical processes such as teeth grinding. This allows them to be controlled voluntarily – for example, by consciously relaxing the jaw muscles.
Teeth grinding: Diagnosis
The dentist checks how pronounced the bruxism is and to what extent the teeth have already been damaged. Signs of bruxism include:
- pressure-sensitive chewing muscles
- tooth marks in the tongue and cheek
- smooth polished occlusal surfaces
- cracks and chips on the tooth enamel
- chipping of the tooth structure, the tooth necks and the incisal edges
- teeth sensitive to pain
Teeth grinding: prognosis
Most bruxism sufferers can be helped well. The prognosis is better the earlier the teeth grinding is treated. If you wait too long, severe tooth damage and accompanying symptoms such as pain and tension are usually unavoidable. That’s why you should do something immediately if you suspect teeth grinding. Sometimes simple relaxation exercises are enough to get teeth grinding under control. If not, you should contact your doctor or dentist.