Article by Dr Angela Ngauw, General Dental Surgeon, BDS (S’pore)
Do you frequently wake up in the morning with jaw discomfort and fatigue, or with achy, sensitive teeth?
Do you have headaches or stiffness and pain of the facial muscles on waking up?
Does your partner or family member complain of being awoken by loud, unpleasant grating noises coming from your teeth when you are sleeping?
If your answer is yes to any of these, you may be suffering from night grinding, also known as sleep bruxism.
Night grinding involves the clenching and grinding of teeth during sleep. It is a fairly common disorder, and some studies have shown that up to 1 in 6 people suffer from it 1. As it is a jaw movement that happens during sleep, it is not under a person’s conscious control. Studies have shown that night grinding tends to occur during the transition from a deeper stage to a lighter stage of sleep, peaks in the minutes before rapid eye movement (REM) sleep, and can repeat multiple times throughout the night.
What causes night grinding?
The exact cause of night grinding is not known. However, there are several factors which are strongly associated with this destructive habit. Daytime stress and anxiety, obstructive sleep apnea, certain types of antidepressant medications, excessive alcohol or caffeine consumption, smoking, and illegal stimulant drugs such as cocaine and methamphetamine, have all been linked to an increased chance of night grinding.
What are the effects of night grinding?
There are varying degrees of severity of grinding: it can range from a very mild, occasional grinding, to a severe regular nightly gnashing. Occasional mild grinding usually does not give problems. However, if it happens on a regular basis, it can lead to a whole host of problems. The human jaw muscle is one of the strongest muscles in the body, and very high forces can be generated by the jaws during grinding. Some of these damaging effects include:
- Wearing down of teeth enamel, leading to exposure of the inner dentine layers. In severe cases, teeth can even be worn right down to the gums
- Flattened, fractured or chipped teeth
- Increased sensitivity of teeth to cold and hot food, or on chewing
- Loosening of teeth
- Loss of teeth
- Tight and painful jaw joint and facial muscles
- Damage to the temporomandibular joint, leading to temporomandibular joint disorders (TMD), which may cause pain on chewing, speaking or opening the mouth
- Headaches and/ or earaches
If you suspect that you suffer from night grinding, it is important to consult your dentist for a thorough check. Night grinding, if allowed to continue untreated for prolonged periods, will lead to severe damage to the teeth, which may eventually require treatments such as root canals, crowns, or even extractions. Jaw joint damage resulting from the excessive pressure exerted during grinding may require medications or even surgery. It is, therefore, best to consult your dentist, as he would be able to detect early signs of bruxism from examining your teeth and jaws. An appropriate treatment can then be worked out to prevent or lessen the damaging effects of grinding.
How is night grinding treated?
Night guards, or mouth splints, can be fabricated by your dentist to protect your teeth from the grinding during sleep. Night guards are customised dental appliances which fit over either the upper or the lower teeth. They are worn while sleeping and create a barrier between the upper and lower teeth, thus preventing contact with the opposing teeth and reducing the stresses of grinding on the teeth.
If the bruxism is stress-related, relieving stress and anxiety by finding ways to relax, such as exercising, practising yoga, or listening to soothing music, will help. If there is pain from the jaw muscles, certain anti-inflammatory drugs may be prescribed to reduce the inflammation. Muscle relaxants may also be recommended to be taken before bedtime to relax the jaw and ease stress and anxiety.
As the saying goes, prevention is better than cure. The importance of early diagnosis and treatment of night grinding cannot be stressed enough. Taking the time to visit your dentist for a check may save you from a lot of dental problems in future.