Tooth Clenching (Bruxism)

Stress is a common cause of teeth clenching

Teeth clenching can occur not only during sleep but also when the person is awake. If there is no pain, patients may not be aware that they are clenching their teeth. They become aware of the situation with the realization and warning of this situation by their physician or with the information given by the person they share the same room with if they grind their teeth loudly while sleeping. Otherwise, bruxism is only recognized in advanced stages when tooth and bone loss occurs.

Causes of tooth clenching

In research, many factors are mentioned as possible causes of bruxism, but the most effective of these is stress. Studies have also determined that the stress sensitivity of cleners is higher than those who do not clench their teeth.

In the patient who clenches teeth, anatomical structures tolerate these excessive forces for a certain period. However, muscle force increases over time. The increased force exceeds the tolerance limit of the tissues and symptoms begin to appear in the patient.

Studies also mention that bruxism may be genetically related. When patients with bruxism are interviewed, they usually mention that someone in their family also clenches their teeth.

Other causes of teeth clenching (bruxism)

In addition to these; fillings/restorations that have poor harmony in the mouth and prevent the jaw from closing in a balanced way may also have effects. Likewise, bruxism can also be observed in patients with malocclusion and crowding. Not all people with crooked teeth clench their teeth, but the effects of clenching are more destructive in individuals with such a tooth structure. For this reason, after the complaints caused by clenching are resolved, patients are referred to an orthodontist and their bite is balanced by the orthodontist.

Another reason for the imbalance in the bite is tooth deficiencies. Especially if there are missing molars, which play an active role in chewing, it is recommended that these teeth be completed immediately because these deficiencies cause the forces in the jaw to be unbalanced while eating and clenching teeth.

There are studies showing that the use of certain antidepressant medications, alcohol and smoking can also cause bruxism.

Damages that bruxism can cause to oral and dental health

The habit of clenching has negative effects on the existing restorations on the teeth and on the masticatory muscles. These effects include;

– Fractures and abrasions on teeth and restorations,

– Sensitivity of the teeth,

– Recurrent gum problems,

– Fatigue and pain in the jaws in the morning,

– Sleepiness the next day due to poor quality sleep,

– The corners of the chin become increasingly prominent and the face appears wider,

– In the long term, it can be listed as problems in the jaw joints.

When patients clench their teeth, the load on the teeth is higher than normal and therefore abrasions, cracks and fractures occur. The same effects can also be seen in fillings and prostheses. This leads to toothache and sensitivity for unknown reasons. Patients wake up in the morning with pain in their jaws and a feeling of fatigue. Patients experience sleepiness the next day due to poor quality sleep.

Recurrent gingival problems can also be observed in patients who clench their teeth. When clenching teeth, there is much more pressure on bone structures than normal, and since bone tissues cannot tolerate this force, losses and resorption (melting) may occur in the jawbone. This manifests itself as progressive gingival recession and, in advanced cases, can lead to complete loss of teeth. Injuries and bruises can occur on the inside of the cheeks and on the edges of the tongue.

In addition, due to overdevelopment of the masticatory muscles, the corners of the jaw may enlarge and the face may appear angular. Since this increase in force causes higher forces than normal in the jaw joints, problems in the jaw joint begin to occur in the future.

Bruxism is more common in women

Bruxism is more common in women than in men. In today’s city life, everyone is at risk of bruxism. Those who work in professions that directly address people, where stress and risk factors are present, are more at risk. The majority of patients who apply to physicians are bankers, finance sector workers, call center workers, doctors and teachers. In addition, teeth clenching is also common in soldiers and police officers.

How is bruxism understood and diagnosed?

In the diagnosis of bruxism, the physician first interviews the patient and learns his/her medical history and performs an intraoral and extraoral examination. If necessary, radiological methods such as X-ray, MRI and tomography are used or sleep laboratory examinations are performed.

When patients with bruxism findings are asked during the examination, most of them say that they do not clench their teeth. Therefore, the first important thing is to make the patient realize their condition. “Raising awareness” is the first treatment option to be applied to the patient. Thus, the person starts to monitor himself/herself in his/her daily life.

Teeth clenching while sleeping

Since consciousness is inactive during sleep, the force of chewing during sleep is beyond the person’s control. For this reason, a different solution is used for teeth clenching and grinding that occurs during sleep.

Teeth clenching apparatus

In cases of teeth clenching during sleep, this condition is taken under control by making personalized dental protective dental plates (occlusal splints). Thanks to these aligners, the load is distributed to the entire jaw by ensuring balanced closure of the teeth. Thus, the patient is protected from the harmful effects of clenching.

When there is pain in the chewing muscles, relief can be provided with hot applications to the muscles. In advanced cases, physical therapy methods can also be used.