Why Do I Grind My Teeth ?
The technical term for grinding your teeth, is Bruxism. According to the Mayo Clinic:
"Bruxism (BRUK-siz-um) is a condition in which you grind, gnash or clench your teeth. If you have bruxism, you may unconsciously clench your teeth when you're awake (awake bruxism) or clench or grind them during sleep (sleep bruxism). Sleep bruxism is considered a sleep-related movement disorder."
They go on to list the most common symptoms of Bruxism: Teeth grinding or clenching, which may be loud enough to wake up your sleep partner. Teeth that are flattened, fractured, chipped or loose. Worn tooth enamel, exposing deeper layers of your tooth. Increased tooth pain or sensitivity.
A nice review article in the Journal of the Indian Prosthodont Society broke Bruxism down into three main categories:
- Peripheral factors such as tooth interference in dental occlusion,
- Psychosocial influences such as stress or anxiety
- Central or pathophysiological causes involving brain neurotransmitters or basal ganglia
Bruxism is often separated into Awake and Sleep Bruxism. Sleep Bruxism (night grinding) is associated more often with a Central Nerve System causation and Awake Bruxism (daytime clenching) more with Psychosocial causation.
Central or pathophysiological causes involving brain neurotransmitters or basal ganglia can be related to some types of sleep disturbances and as a by-product of certain medications and chemical substances (some anxiety medications, stimulants and Parkinson's medications). In addition Bruxism can be seen as a secondary symptoms of neurological diseases like Parkinson's.
Psychosocial Influences makes common sense, people who are stressed out clinch more. This does happen both during the day and at night. Research is ongoing to determine just how linked these are, ie does one cause the other. There is also the potential that the bruxism starts due to stress, but the becomes "habituated" and remains even when the initial cause has left.
Peripheral Factors has been around since the 1960's. It was originally thought that malposition of the teeth caused a stimulus that caused the grinding. This has since been shown often not be the case.
How Does This Relate to My TMJ Issue ?
At this point in time evidence for addressing a TMJ Issue for bruxism (especially sleep bruxism) is indirect at best. Day time "clenching" as opposed to bruxism (night grinding) is probably better correlated, likely due to pain. TMJ Issues may play a role indirectly in impacting the Central Nervous System -brain, brainstem and spinal cord- and thus Sleep Bruxism through the Cranial Nerve 5 (The Trigeminal) as this sits right behind the TMJ and may be inflamed and irritated with irritation of the joint.
I tell patients that Day time "clenching" may respond well to addressing their TMJ issue (and those of the neck and shoulder for that matter). We usually take a "wait and see" approach to true Night Grinding. If the day time clenching gets better and the TMJ Issue resolves and the Night Grinding goes away then we know they were related. If everything clears but the Night Grinding, another approach is in order!
If you have are dealing with Day Time "clenching" or Night Grinding, and have questions, please feel free to give me a call. I would be happy to let you know if we think we can help or to point you in the right direction if I can.
Yours in Health,
Doug Williams, D.C.
TMJ Relief Center at Care Chiropractic
134 Executive Drive #3
Lafayette, Indiana 47905
(765) 448-6489
