Bruxism, also referred to as teeth grinding or clenching, is a common issue affecting between eight and 31% of all people in the U.S. A little tension in the jaw may be normal during stressful situations or an episodic bad dream or two, but people suffering from bruxism experience near constant, reoccurring jaw clenching and teeth grinding at some point every day. But, what causes bruxism and how can you fix symptoms related to it?

What is bruxism?

There are two types of bruxism. Sleep bruxism occurs when a person sleeps, causing symptoms upon awakening. Awake bruxism occurs over the course of a day, resulting in symptoms that get worse as the day progresses. Some unlucky people even have both varieties to varying degrees.

Although a patient’s partner might point out nighttime tooth grinding, a dentist most often diagnoses bruxism when wear and tear on the teeth becomes apparent in a regular dental exam. Identifying the problem is only half the battle; figuring out what causes bruxism is the other half.

What causes bruxism in adults?

Bruxism is, in most cases, an involuntary response. During the day, our teeth come in contact with each other for less than 20 minutes total (including chewing and talking). The muscles of the jaw must be specifically engaged in order to bring the teeth together.

Awake bruxism’s causes may be a more straightforward combination of stress and muscle tension that causes a patient to clench their jaw (more often than actually grinding it). Sleep bruxism causes, when all of our muscles are relaxed, are more complicated.

The most common causes of bruxism, in adults, include:

  • Medications
  • Stress and anxiety
  • Sleep apnea

Medications that cause bruxism

It seems a cruel irony that some medications designed to help relieve stress and promote a sense of well-being could cause bruxism, but it’s true. Many anti-depressants, including, selective serotonin reuptake inhibitors (SSRIs) like Prozac (fluoxetine), Zoloft (sertraline), and Paxil (paroxetine), are linked to an increase in bruxism. Antipsychotics are also linked to an increased chance of bruxism.

Because bruxism is related to disturbances in the central nervous system (CNS), it stands to reason that any medication that affects the CNS would affect the incidence of tooth grinding. Changes to the dopaminergic system, the neurotransmitters in the central nervous system that regulates the release of dopamine, may also result in an increase in bruxism. Any medications that stimulate this system can lead to this condition.

Anxiety, stress, and bruxism

Anxiety and stress may play a larger role in awake bruxism than sleep bruxism, but it is still present as a cause for both types of bruxism. During waking hours, women have a higher incidence of bruxism that involves mainly jaw clenching. However, both men and women have an equal incidence of sleep bruxism. This may casually suggest that women experience more stress and anxiety during the day than men, but that is difficult to determine.

Regardless of gender, the presence of stress or anxiety may cause an involuntary physical reaction in the body. “Bruxers” have been found to be more hostile and less resilient when it comes to stress. They also tend to handle depression and challenging situations in a much less adept manner than those who don’t experience chronic bruxism.

It’s a chicken-and-egg conundrum – does bruxism cause these types of anxiety, stress, and depression, or does the presence of these conditions mean that bruxism will be present? The answer is complicated. The presence of anxiety or extra daily stress doesn’t necessarily mean that you will develop bruxism, but it certainly doesn’t help!

Sleep apnea and bruxism

Sleep apnea is a serious disorder that can lead to a host of serious health issues. Those with sleep apnea stop breathing for a period of time, five to ten times every hour, all night long. The brain realizes that it has stopped receiving oxygen and will wake the sleeper, often with a sharp intake of air.

Because sleep bruxism is related to periods of lighter sleep (or changes in sleep in general), sleep apnea and bruxism also go hand-in-hand. In some cases, tooth grinding while experiencing a period of apnea may cause the sleeper to wake up. A person’s partner is also likely to notice these two disorders first.

What causes bruxism in children?

An estimated two or three children out of ten experience some level of sleep bruxism. It is difficult to determine exactly why children experience sleep bruxism, but anxiety is a common cause. This can be from something as simple as an upcoming test or as complicated as changes in the household (e.g., a new sibling or a troubled parental relationship).

Poor alignment of teeth and any pain that it causes may also lead to bruxism in children. They may involuntarily move their jaws at night (or during the day) as those pain levels fluctuate.

Children who struggle with sleep due to hyperactivity may also experience an increased rate of bruxism. Some of the medications used to treat hyperactivity may have a rebound affect in the evening, just as children should be winding down for bed.

Fortunately, most children will grow out of sleep bruxism as anxiety decreases, tooth alignment is resolved, and better sleep habits develop.

What bruxism symptoms should I be aware of?

Symptoms of bruxism may vary depending on the severity, but most people experience one or more of the following symptoms:

  • Uneven or accelerated tooth wear
  • Fractured or broken teeth
  • Increased tooth sensitivity to hot and cold due to worn enamel and exposed dental pulp
  • Grinding or chattering noise at night
  • Pain in the ligaments of the jaw
  • Difficulty opening the mouth upon awakening
  • Issues with the temporomandibular joint (e.g., clicking, popping, pain)
  • Headaches
  • Potential for tooth loosening

Some of these bruxism symptoms may not be immediately present but develop over time.

If you think you might be grinding your teeth or clenching your jaw, give your Phoenix area dentist a call for a full evaluation.

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