Bruxism Treatment Options

Bruxism treatment is designed to help you reduce the tendency to clench and grind your teeth. As a result, you should feel relief from symptoms such as jaw pain and tooth sensitivity. Long term management of nighttime grinding may prevent substantial damage to your teeth over time, reducing your need for dental restorations and limiting your risk of tooth loss. Bruxism treatment usually involves a combination of lifestyle adjustments and dental treatment (depending on what’s causing your tooth grinding problem).

Immediate Relief

Some patients find that warm or cold compresses help relieve muscle and tendon soreness in the jaw. Soaking a rag in warm water and applying it to your jaw joint (the point where your cheek meets your ear) for 10-20 minutes prior to going to bed may help you relax your jaw.

If your tooth clenching is causing painful muscle spasms in your jaw and face, your dentist may prescribe a muscle relaxer for initial relief as part of a more extensive bruxism treatment plan. This type of medication is not an effective solution over the long term. It may lessen the immediate pain symptoms of bruxism but does not address the underlying cause.

Preventing Tooth Grinding

In many cases, a dentist will prescribe a mouth guard or splint to reduce the harmful effects of nighttime grinding. A mouth guard is a flexible thermoplastic tray that can be purchased over the counter for $20-40 and molded to fit your mouth after the plastic is softened in boiling water. These guards vary in their level of comfort and effectiveness. Some patients find the bulkier versions make breathing difficult. Smaller mouth guards often have a tendency to shift around in the mouth, reducing their protective effect during sleep. They must usually be replaced after a few months of wear since they bear the brunt of tooth grinding rather than actually preventing it. Some dentists also offer custom-molded mouth guards that may be more comfortable and effective.

A bite splint or nocturnal bite plate is a harder, acrylic type of night guard that is custom crafted by a dental lab to fit your mouth. A splint is more expensive (it may cost $500 or more). However, it may be a more appropriate choice for bruxism treatment:

• For severe nighttime grinding and chronic pain
• When tooth damage has already begun
• If the goal is to reposition the jaw over time rather than just keep the teeth from touching
• In preparation for orthodontics treatment to correct a misaligned bite
• To help resolve TMJ symptoms as well as tooth grinding

Many patients try an over-the-counter night guard first to see if it helps. However, it is possible for a cheap mouth guard to actually trigger more tooth grinding. It’s always a good idea to check with your dentist for a recommendation on what device to use.

Retraining Muscles

Bruxism treatment for daytime tooth grinding is generally easier than treatment for nighttime grinding since you can become consciously aware of the habit and take steps to change it. This may include physical therapy exercises (like those used to treat TMJ) to help your jaw, face and neck muscles relax. Facial massage can also be helpful if you tend to have specific areas that are painful.

Your dentist will probably advise you to practice placing the tip of your tongue against the roof of your mouth where your front teeth meet your gums (keeping your lips closed and your teeth slightly apart). This tongue position automatically relaxes the jaw muscles and keeps your teeth from clenching or grinding. The more you practice, the faster you can break the habit of daytime bruxism. Retraining your jaw in this way could potentially help reduce nighttime grinding since your muscles may remember what you are learning even when you are asleep.

Biofeedback is a more advanced technique for muscle retraining to reduce daytime bruxism. It involves using equipment to measure the movements in the jaw and facial muscles that signals the patient when they need to stop and relax their jaw. This treatment is still in the investigational stages and may not be effective for all patients.

Lifestyle Changes

In cases of stress-induced bruxism, any steps you take to reduce stress may lessen your tendency to grind or clench your teeth during sleep. This area of bruxism treatment varies widely since every person has to find the stress reduction strategies that work best for them. Many people find the following tips helpful:

• Practice meditation or other relaxation techniques every day (especially before sleep) to reduce anxiety
• Stop chewing gum, ice, pencils or other items that train your jaw to grind
• Reduce caffeine, nicotine and alcohol consumption

Dental Correction

After bruxism treatments such as those above have helped limit your grinding, you may be a candidate for corrective dental work. Bruxism treatment for tooth grinding that is linked to bite malocclusion (where your teeth don’t line up properly) may be treated with orthodontics (braces). If only the bite surfaces need correction and not the actual position of the teeth, you may be treated with crowns or porcelain onlays to reshape the individual teeth. In cases where ongoing bruxism has worn down or fractured your teeth, you may need extensive crowns or other restorations throughout your mouth. This is one reason that you should discuss any symptoms of bruxism with your dentist during your annual checkup. The sooner you address the warning signs, the less damage your teeth will sustain.