Twin Cities TMJ and Facial Pain Clinic

Sleep Bruxism

Sleep bruxism is defined as "clenching or grinding of the teeth during sleep." This is an involuntary muscle activity occurring when the person is asleep and therefore unaware of their actions. Clenching the teeth and other jaw behaviors that occur while we are awake (tooth tapping, jaw protruding, gum chewing, etc.) are voluntary actions or habits.   


Your dentist is usually able to tell if you have been bruxing by the severity and patterns of wear on your teeth. A spouse or bed partner may also be able to confirm nighttime tooth grinding, although often the jaw clenches (without grinding), which may not be heard or observed by others. 


Sleep bruxism can negatively impact the jaw area in a number of ways. Continual grinding, clenching and other repetitive contractions of the muscles of the jaw can lead to fatigue, aching of facial muscles, tooth pain and headaches. Bruxers often notice these symptoms predominantly in the early morning and complain of pain interfering with their normal daily activities, such as brushing their teeth, talking, eating breakfast or yawning. This pain may fade as the day progresses, although for some people it can last throughout the day. Daytime clenching or other habits (caffeine, gum chewing, nicotine) may be contributing factors to the lingering daytime pain. It is important to be aware that sleep bruxism can be affected by what we do and how we live our lives during the day. Unmanaged stress and anxiety have a direct effect on how often and hard a person grinds and clenches day and night. Therefore, it is very important to learn to manage stress and anxiety. 


It is still not known if bruxism can cause TMJ disorders (structural defects in the jaw joint). However, what is clear is the negative impact that bruxing, clenching and other habits have on a vulnerable TMJ, causing pain and inflammation in an otherwise comfortable jaw. Excessive tooth wear or damage to dental work can also be an effect of hyperactive jaws. 


A number of approaches have been developed to manage jaw hyperactivity and sleep bruxism. An oral splint or appliance, customized to your bite and worn in the mouth while sleeping, is a very effective way of preventing strain to the TMJ and can also reduce muscle tension and tension headaches as well as protect the teeth from further damage. If needed, additional treatment options are also available, including: medications, behavior modification therapy, biofeedback and other therapies to help reduce or eliminate these problems. Although none of these treatments represent a "cure" for sleep bruxism or hyperactivity of the jaw, they can be effective tools in controlling or minimizing these problems.