You may be surprised to hear that what you do in your sleep can impact your oral health. Sleep bruxism is a condition that causes the teeth to clench or grind involuntarily while you’re asleep, which can cause serious problems in your mouth regardless of your waking oral care habits.

Bruxism is a threat to your oral health 

Over the long term, bruxism causes significant permanent damage to the teeth, which eventually become worn down from excessive, repeated force. Grinding your teeth against one another can cause the enamel to erode, resulting in tooth sensitivity and pain. As symptoms worsen, the teeth can start to wear away and shorten, making them more vulnerable to cracking or breaking. Eventually, teeth may even need to be removed. Bruxing can also damage existing fillings or crowns, which will need to be replaced or repaired. Since Covid-19 lockdowns began in March of 2020, fractured and broken teeth due to bruxism have become a North American dental epidemic. 

What causes bruxism?  

Bruxism can be related to a wide range conditions such as:

• stress and anxiety
• sleep apnea
• TMJ disorder and malocclusion (overbite or underbite)
• misaligned posture or spinal problems
• psychiatric conditions
• neurological disorders such as Huntington’s and Parkinson’s
• consumption of tobacco, alcohol, caffeine, or other substances
• a side-effect of some medications, especially antidepressants
• hereditary indicators

How to tell if you are grinding your teeth at night  

Symptoms of sleep bruxism can vary greatly—it may be obvious and severe, or so subtle that it goes undetected until damage is already done. Bruxism can also occur while awake when it is more easily noticed by the bruxer. 

Unlike waking bruxism, many people are grinding their teeth at night without realizing—and they may never know they are doing it until they visit their dentist. More acute cases might be overheard  by a parent, roommate, or partner. The bruxer may also find they wake up regularly with tension or soreness in the face muscles. 

Not only will a sleeper be unaware that they are grinding, they also will not be able to regulate the amount of force used—studies have shown some sleepers can employ up to 250 pounds per square inch of force while grinding.  Regular dental visits can ensure that the behaviour is caught before too much damage is done. Any muscle soreness or reports from those around should you be taken seriously and brought to your doctor or dentist right away.

Bruxism treatment 

Treatment is assessed  based on the severity and resulting symptoms of each case. Some cases are mild and might never show symptoms or need treatment, while others are severe and require intervention to prevent severe damage. 

Some treatment options include: 

• Stress reduction and lifestyle changes 
• Facial massage and other relaxation techniques
• Facial physiotherapy or chiropractic care 
• Custom mouthpieces such as dental splints or mandibular advancement devices (MAD) 
• Invisalign or orthodontic treatment for malocclusion correction
• Muscle relaxant medications
• Botox injections

What’s happening with your teeth while you sleep?

If you think you might have sleep bruxism, there is a good chance you could be right—this condition is very common, preventable, and treatable! Yet, it often goes undetected until it’s too late. The best way to protect yourself against the damage of habitual or subconscious bruxing is to see your dentist twice annually for a routine checkup, and schedule an appointment as soon as you experience any symptoms even if they seem mild.