There is a newer version of this article, check it out here: https://getsovn.com/how-to-diagnose-teeth-grinding-and-clenching-when-to-seek-help/
Teeth grinding and clenching can have a significant impact on our day-to-day lives, so it’s an extra challenge that getting a bruxism diagnosis isn’t straightforward. A definitive diagnosis for sleep bruxism is only possible if you’re studied while you sleep (polysomnography) in a lab, where complex equipment can track your sleep stages and muscle activities. There is currently no definite diagnostic criteria for awake bruxism, although sometimes an electromyography (EMG) sensors that are worn on your face all day can measure your jaw muscular activities and help track your subconscious bruxism behaviors.
The expense and time these diagnoses take means they’re not accessible to most people, unless your physician thinks you have a more serious underlying medical condition. So most bruxism diagnosis relies on a combination of self-report and clinical examination. Most people find out they have bruxism from their dentist if they notice tooth wear, but it only indicates that you may have experienced bruxism at some point, not whether you still do or how severe it is [Cassett et al. 2017].
But can you have it and not know it? You might, but you’ll almost definitely recognise the effects, which commonly include:
- Sound of grinding teeth while you sleep – this symptom relies on sleeping in the same room as someone else, and them being a light enough sleeper that the sound wakes them up! The sound is often repetitive, loud and pretty unpleasant to hear, so it’s hard to miss.
- Jaw pain or discomfort – known clinically as masticatory muscle symptoms, it can range from a feeling of fatigue or soreness in your jaw muscles in the morning, or painful and tender jaw muscles during the day.
- Temporomandibular joint (TMJ) pain – this is pain around your jaw, ear and temple which can make it difficult and painful to do things like chew or yawn.
- Sore or sensitive teeth – there are other causes for this, like overconsumption of acidic food and beverages, but it may also be a sign of bruxism.
- Dental damage or deterioration – a history of broken/fractured teeth or restorations, as well as the appearance of deterioration, functional problems and teeth pain.
- Headaches, migraines and other orofacial pain
- Tense or sore neck and shoulders – if you work long hours at a desk, you may already have issues with sore neck and shoulders, but bruxism could be contributing too.
- Hypertrophy of jaw muscles – essentially growth of the jaw muscles. Something you may want to achieve for other muscles in your body, but less desirable in your jaw where they can become bulky and create a square-shaped jawline or asymmetrical face shape.
- Intermittent locking of the jaw joints
If you’re worried about whether you have bruxism and the impact it might be having on your health or your teeth, there are some steps you can take:
Seek professional advice – if you think you may have bruxism, ask your healthcare provider to ensure that it doesn’t stem from a serious, underlying medical condition.
Find out if you’re still actively bruxing – there are apps that can record the sounds you making during sleep, or if you sleep in the same room as someone, you can ask them if they’ve heard you grinding recently. However, this is not a foolproof method as teeth clenching tend to be silent.
Tackle awake bruxism – although sleep and awake bruxism are considered different behaviors with different etiologies, studies indicate that there’s a carryover effect – what you do during the day carries into the night. So check if you frequently clench or tense your jaw during the day: set random timers (every 5-15 minutes) during the day and when it goes off, check if you are clenching or tensing your jaw muscles. The positive side of the carryover effect means that if you’re able to unlearn clenching habits during the day, it will also help with reducing bruxism at night [Sato et al., 2012].
Review your sleep hygiene – fragmented sleep with frequent arousals during the night can increase the likelihood of bruxism activities, so taking stock of your sleep hygiene factors can help improve the impact of sleep on your bruxism. Good practice is a quiet, dark bedroom with comfortable temperature, avoiding disruption from your electronic devices and large meals, caffeine or alcohol close to bedtime.
Reflect on your diet and dental care habits – acidic foods (like citrus fruit and tomatoes) and sugary and carbonated drinks are prime culprits when it comes to tooth wear. Avoid where you can, and rinse your mouth with water after meals.
If you want to get to know bruxism even better, check out our content hub.
References
Casett E, Réus JC, Stuginski‐Barbosa J, Porporatti AL, Carra MC, Peres MA, de Luca Canto G, Manfredini D. Validity of different tools to assess sleep bruxism: a meta‐analysis. Journal of oral rehabilitation. 2017 Sep;44(9):722-34.
Sato M, Iizuka T, Watanabe A, Iwase N, Otsuka H, Terada N, Fujisawa M. Electromyogram biofeedback training for daytime clenching and its effect on sleep bruxism. Journal of Oral Rehabilitation. 2015 Feb;42(2):83-9.
