Bruxism typically follows transient arousals, too brief to recall, and happens while the person is drifting back into a sounder sleep. Anything that can make a person more arousable can aggravate it such as:
- Nasal congestion, from allergies, upper respiratory infections, “sinus trouble”, etc.
- Sleep apnea — when the patient arouses repeatedly from inability to breathe.
- Caffeine, stimulants, decongestants, diet pills and other medications that fragment sleep.
- Stress, as well as a tense, hard-driving personality style. Some individuals with bruxism have a history of anxiety attacks.
Other sleep disorders that provoke repeated arousals, including seizures, can increase bruxism.
Chronic bruxism may gradually damage the teeth and temporomandibular joints (“TM joints”, “jaw joints”) accelerating dental occlusion abnormalities (tooth and jaw misalignment) which in turn may increase bruxism.
Symptoms vary. Some people have none at all, and their problem is recognized first by someone else (either a dentist or bed partner who finds the grinding noises objectionable). However, other patients experience pain in the face or TM joints, more generalized headaches, restless sleep or biting of the tongue or inside of the cheek.
Treatment must be tailored to the patient. Underlying sleep disorders should be evaluated by a sleep medicine specialist, and dental occlusive problems should be assessed by a dental practitioner who may prescribe a “bite plate” to protect the teeth from further wear. Avoidance of aggravating factors that may increase arousals and hence, bruxism, should be avoided. Good relaxation/ stress management training proves invaluable in many cases.