Disorders of the temporomandibular joint (TMJ) can have many names. These include TMJ syndrome, TMJ dysfunction, and TMJ disorder, among others. Throughout this article, we’ll use these terms interchangeably. Regardless of the names, these conditions are often exacerbated by persistent teeth-grinding (bruxism). Before we talk more about TMJ problems, let’s review some background information about bruxism.
Definition | What is bruxism?
Bruxism is the involuntary or habitual grinding or clenching the teeth. “Sleep bruxism” (Bruxism that occurs during sleep) is a more pernicious variety. This is because damage from sleep bruxism is more challenging to detect, cure, and repair.
Symptomatology | How do I know if I have bruxism?
This is an important question. It’s usually not difficult to determine if you suffer from teeth grinding. You may be conscious of grinding your teeth while it’s happening. If not (for example, if you suffer from sleep bruxism), then you may only become aware of the habit by its symptoms.
- jaw pain
- mouth pain
- loose teeth
- teeth sensitivity
Even seemingly-unrelated conditions like sinus inflammation can result indirectly from “trigger point” compression of facial nerves effected by bruxism.
Only a healthcare professional can diagnose a medical condition, so for safe measure, it is recommended that you seek the input of a dentist or other oral health diagnostician.
Epidemiology | How common is bruxism?
Bruxism is not universal, but it is not uncommon. Epidemiological data shows that 1 in 10 people suffer from bruxism in their lives.
Pathophysiology | What is the physiological mechanism of bruxism?
Specialists have not yet agreed upon the root cause of bruxism, nor is it certain that one primary trigger exists at all. But there are several distinct factors associated with bruxism. Individuals exposed to these risk factors are more likely to develop the condition.
Such risk factors include stress, diet, anatomy, and pharmacology.
A person’s stress level or stress response has wide-ranging health impacts. Some of these impacts can have serious consequences. Vascular and psychiatric diseases are some of the more common outcomes. Typical stressors include interpersonal relationships, work, finances, and general health, among others.
Nutritional deficiencies can negatively impact every bodily system, from digestion to circulation. When the body is strained by inadequate nourishment, a cascade of destructive, self-reinforcing reactions can occur. For example, a diet low in potassium can lead to muscle cramping, which can lead to pain, which can in turn lead to emotional tension. Emotional tension then leads to musculoskeletal tension, which further exacerbates the initial pain. If not treated, this cycle may continue until the patient is partially or completely incapacitated.
Poor structural alignment of the teeth and jaws can result in an uneven bite. This means that the surface of the teeth come together in ways that are not conducive to efficient chewing. Such a condition can sometimes require increased effort and force during routine behaviors such as eating and chewing gum. When that happens, the afflicted individual is likely to experience the pain, discomfort, and dental damage associated with TMJ dysfunction and/or bruxism.
Just as poor nutrition can lead to myriad physiological consequences, so, too, can medicine, narcotics, and any other psycho-biological agents. In particular, substances that increase activation of the sympathetic nervous system should be carefully moderated. This sub-component of the larger nervous system is particularly sensitive to over-stimulation by way of coffee, sugar, tobacco, certain illicit substances (“uppers”), and some prescription medications.
Complications | Is bruxism serious?
As you may expect, bruxism can be quite serious if not treated with the right blend of interventional approaches.
For people who grind their teeth only occasionally, it is unlikely that significant damage or discomfort will occur. But for those who suffer from chronic or recurrent bruxism, it is vital that steps are taken to halt and counteract the possible complications. Methods to treat bruxism and control its damage generally include deliberate behavior modification (to reduce exposure to risk-factors) and custom-fit dental night guards meant to provide a protective barrier to the teeth, jaws, and the nearby structures, such as the tongue.
Without such measures in place, it is likely that a long-term “bruxer” will eventually develop a number of unpleasant symptoms. These symptoms can include wearing of the teeth, cracking of the teeth (craze lines), flattening of the teeth, headaches, ear pain, sleep disturbances, insomnia, painful aggravation of the facial nerves (most notably trigeminal neuralgia), tooth decay, inflamed and receding gums, and a cluster of troubling symptoms associated with the temporomandibular joint (where the jaw meets the skull). Many problems with this joint are grouped together and labeled as “TMJ syndrome”, “TMJ dysfunction”, “TMJ disorder”, etc. Much like bruxism, these conditions are not completely understood and documented, but they are strikingly common nonetheless.
Bruxism vs TMJ Dysfunction
|Is a behavior?||Yes||No|
|Is one distinct condition?||Yes||No|
|Is caused by another condition?||Sometimes||Yes|
|Can be treated with a night guard?||Yes||Yes|
This table summarized some of the conventional wisdom about teeth-grinding and TMJ dysfunction.
- characteristic clicking and popping sound
- associated with pain or discomfort in the juncture between the jaw and skull
- usually felt and heard inside or in front of the ear
- can be caused or exacerbated by bruxism
Ultrasound Therapy Used To Treat TMJ Syndrome
More About TMJ Syndromes
If you’ve spent a little time researching TMJ disorders, you may have noticed convoluted and even conflicting information. That’s because, as is the case with bruxism, TMJ disorders can present in a variety of ways. In addition, medical specialists, researchers, and patients are still discovering, correlating, and documenting the connections between the multitude of possible manifestations. Given this ever-increasing confluence of information, the traditional, singular epithet “TMJ syndrome” has been increasingly deprecated and superseded by the more general, plural form “TMJ syndromes”, along with other umbrella terms, most notably “TMJ dysfunction” and “TMJ disorder”.
These syndromes are generally recognized by a characteristic clicking or popping sound and an associated pain or discomfort in the juncture between the jaw and skull (again, the temporomandibular joint, so-named for its anatomical role as the union of the skull’s temporal bone with the attached mandible bone, better known as the jaw). This unpleasant clicking is usually felt and heard inside or in front of the ear, and is thought to be the result of dislocation, subluxation, inflammation, or other impairment of the cartilage disk that serves as a buffer between the two bones. Such impairment is frequently caused by…you guessed it: bruxism.
Treatment and Prevention | What can I do about my bruxism?
We’ll post another article soon focusing on treatment and prevention options. Whatever approaches you consider, be sure to consult a dental or orthodontic specialist. You may also want to speak with an orthopod. (That’s a medical doctor specializing in holistic care and treatment of the musculoskeletal system.)
You should strongly consider wearing a night guard (a mouth guard worn at night). These can be purchased online at much lower costs than you would pay a dentist, but with the same quality and customization options. If you do invest in a night guard, be sure that it is custom-molded to fit your unique dental anatomy.
Now, it should be noted that the mouth guards used for treating alignment disorders (a symptom of TMJ disorders) function differently than a typical night guard. This means that if your dental health provider has diagnosed you with an alignment issue, then a standard custom night guard is not recommended.
Night guards for alignment issues are always made of rigid acrylic material and sometimes incorporate metal clasps to help raise the bite and reposition the jaw. Because an alignment splint is fairly involved, the dentist may need to make multiple adjustments in order to achieve optimal position and results.
Again, for patients suffering from alignment issues, we do NOT recommend ordering a night guard bought online.
You should always consult a licensed specialist before using any medical device or treatment.
Bruxism, teeth-grinding, and TMJ disorders can be burdensome and destructive. But with the information in this article, we hope that you’re better-prepared to face the challenges head-on.