what causes bruxism Archives - Holistic and Biological Dentistry

What Causes Teeth Clenching During Sleep

Teeth clenching is caused by a small mouth with not enough space for all the teeth and tongue to fit properly into the mouth. A small mouth leads to crowded teeth, a bad bite and trouble breathing during sleep.

Do you wake up with your teeth clenched? Or gasping for air? Do you feel like you never get enough sleep? If so this post is all about how to stop teeth clenching, TMJ pain and sleep apnea. All of these things are linked and related to having a small mouth and nasal passageways. Millions of people suffer from tooth grinding or bruxism. Sometimes it is a minor annoyance and a nagging pain. But at other times it can be debilitating and cause migraine headaches and very poor sleep.

What Causes Night Time Clenching?

Night time clenching is usually more related to mouth breathing and airway obstruction conditions. When the mouth space is too small, the tongue falls into the throat and it blocks breathing through the airway. Teeth clenching wakes you up (into light sleep) as apart of a defense mechanism to help people get enough oxygen and be able to breathe.

Clenching During the Day

Daytime clenching is caused by poor biomechanical function of the bite. If you have a bad bite and poor jaw alignment, you are at increased risk of clenching your teeth. Most people with this condition also have bad posture and sometimes neck, back and shoulder tension. When the jaws are misaligned it causes forward head posture and a lot of upper body tension.

Treatment Options for Teeth Clenching Video by Dr. Adams

How to Cure Teeth Clenching

The key to curing teeth clenching and TMJ pain is addressing to root cause of the problem. Dr. Adams has adult expanders that can create space in the jaws. Two such appliances are the Vivos DNA and the Homeoblock appliances. If used correctly, these appliances can improve the bite, airway, breathing and sleep. Needless to say, the value of palatal expanders in correcting TMJ pain, mouth breathing and sleep cannot be overstated.

Day Time Vs Night Time Clenching?

There are two types of clenching: day clenching and clenching during sleep. Most people clench their teeth at night during deep sleep. Day clenching is usually caused by a bite problem where teeth hit harder on one side of the jaw. Or in-other-words, when the jaw closes properly teeth hit on one side of the mouth before the other. People will usually close their jaw and try to steer around the area where the bite is off. The “steering around” is usually realized as popping and clicking of the TMJ and deviation of the jaw when opening. This problem creates an uncomfortable condition where the jaw muscles do not have a place to be stable and rest properly when the mouth closes. Sometimes people who have recently had a lot of dental work done or who have had a lot of orthodontics done have this problem with the bite. Most people who clench during the day also clench their teeth at night which is the bigger problem.

What Causes Teeth Clenching During Sleep?

People who clench and grind their teeth at night time have small mouths and upper airway spaces. When the mouth is small, there often is not enough room for the tongue to fit and function properly. When people get into deep sleep all the muscles in the body relax including the tongue (a very large muscle). If the tongue does not fit, it gets displaced into the throat where it partially blocks the airway. At this point oxygen levels start decreasing and the teeth clenching reflex is activated. Teeth clenching wakes people up into a lighter sleep where the tongue comes out of the throat and back into the mouth. This is the body’s defense mechanism to maintain proper breathing during sleep. The phenomena is part of upper airway resistance syndrome (UARS).

Treatments for Bruxism or Tooth Clenching?

protective – teeth grinding guards, protects teeth against getting worn down and lots of dental work
management – an appliance that manages and reduces clenching
corrective – an appliance that creates more space, balances the bite and corrects the underlying causes of clenching. For example curing airway and bite problems.

Protective Appliances

Night guard or occlusal guard. People will still clench, but they will just clench the plastic. Most people will not tolerate this treatment because the clenching usually gets worse because there is more clenching on the plastic guard. It really is not comfortable as there is more muscle tension. The appliance also takes up space in the mouth and further crowds the airway.

Management Appliances

Bite splint for splint therapy. Splint therapy is the use of a plastic appliance to put the patient into a more open and forward bite. A splint puts the jaws into a more restful position and is a great way to relax the jaw when sleeping. If a bite splint is made properly, it will typically reduce clenching by 30-70%. Occlusal splints do not correct the problem, but they can relieve a lot of symptoms if worn during the night. Splints work much better than night guards because they relieve muscle tension and decrease clenching. People usually clench more on night guards. Splint therapy used to be the only treatment for TMJ till corrective appliances became available a few years ago. Splints must be worn during sleep forever to keep you comfortable. Splints will also need to be adjusted from time to time. Splints will also need to be replaced every 3-5 years as they wear out and begin to discolor and smell badly.

Appliances That Can Cure Teeth Clenching

Appliances that correct the cause of clenching work by creating more space in the mouth so the tongue and teeth fit better. Effective treatments are available for adults and kids. Treatments uses special expanders that stimulate a small amount of growth in the mouth and jaw structure. The new space in the mouth allows:

optimization of the bite relationship and biomechanics of the jaw structure
improved tongue function
more space for airflow and breathing

One such appliance for adults is the Vivos DNA Appliance. The appliance therapy corrects upper airway restrictions and creates more space for the tongue and teeth to function optimally in the mouth. Corrective treatment will stop teeth grinding during sleep permanently by getting rid of the reason why people clench their teeth. Corrective treatment is the best permanent jaw clenching remedy. Other adult growth appliances exist for TMJ pain including the AGGA and the ALF. But Dr. Adams favorite appliance for adults is the Vivos appliance.

Anterior Growth and Expansion With Dental Appliances Video

Symptoms of Teeth Clenching

jaw muscle pain
neck and back pain
popping in the jaw joint
headaches
sinus pressure
ear pressure and the feeling of fluid in the ear
tight shoulder and neck muscles and many others

Conditions that Increase Teeth Clenching:

Stress
Change in schedule
Irregular schedule
Bad weather and changes in pressure outside
Poor work conditions such as sitting at a desk all day, or working bent over
Change in health status

Is it Normal for Kids to Grind Teeth at Night?

Absolutely not. Teeth clenching in children is a sign of pediatric sleep apnea and upper airway problems. This condition requires treatment. And not just braces. Other symptoms include poor nasal breathing, attention deficit, bed wetting and delayed development, tied tongue. Most kids problems can be corrected with growth stimulating appliances called expanders. The most popular expanders used by Dr. Adams are Schwarz appliance and ALF appliances. See our page about holistic orthodontics. The goal is to stimulate the proper growth and development in the mouth, nasal passageways for proper night time breathing and bite balance. Failure to treat this condition leads to adult sleep apnea, poor overall development, orthodontic problems and TMJ pain. Never pull teeth for braces and to get straight teeth.

How are Teeth Grinding and Clenching Different?

For starters, most people do not grind their teeth, but rather they clench. Clenching vs grinding. There is a difference. When grinding, there is a side to side or back and forth teeth rubbing action. Grinding makes a lot of noise typically and 90% people do not grind. Most people clench their teeth. Clenching is an action where the teeth are placed together and the jaw muscles tighten teeth down on one another top to bottom. Usually tooth clenching happens at night time. In fact 80% of people who clench their teeth, do so at night time and do not even know it.

Is Teeth Clenching a Sign of Sleep Apnea?

Yes. 77% of people who have been diagnosed with sleep apnea report tooth clenching in sleep and temporomandibular joint dysfuntion symptoms. Many TMJ specialists believe that teeth clenching is just a symptom of UARS and sleep apnea. Dentists who specialize in teeth clenching and use corrective treatment are in a position to help with not only symptoms from clenching but also solving UARS and sleep apnea. Sleep apnea is linked to TMJ problems.

How to prevent Bruxism and Clenching?

Why do people end up with small jaws and a tight upper airway? It is a combination of improper tongue function due to tongue tie, genetics and a soft diet. The biggest cause of the problem is a limitation of tongue range of motion caused by the tongue tie restriction how far the tongue can move. The tie also can deform the tongue causing it to taper or curl downward on extension. In these cases, the tongue may not be able to reach the palate. The key to prevention in growing kids is diagnosing and treating tongue tie, introducing tongue exercises and dental arch expanders.

Why do people clench their teeth at night?

During the night, the brain cycles through lighter and deeper stages of sleep. As the brain approaches deep sleep, all the muscles in the body have to fully let go and relax. This can cause trouble for the airway as the tongue and muscles in the throat and airway relax. The jaw is heavy and can easily reverse and block the main airway along with the tongue. The tongue, when fully relaxed can be displaced towards the throat and block the airway also. All these conditions can restrict air flow during breathing during sleep. This is called UARS or upper airway resistance syndrome. During UARS people will clench their teeth as a reflex. It is a defense mechanism to arouse someone from deep sleep to restore normal breathing patterns by opening and clearing the airway.

Orthodontic expanders and breathing exercises is the way to correct airway obstructions. Contact Dr. Adams for a complimentary appliance consultation

Options for treating TMJ pain and teeth clenching video

Teeth Clenching re-opens the airway during collapse

Researchers studied brain scans of people with airway resistance problems and what they noticed is that it was grinding (also called bruxism) that reopened the airway and got the study participants breathing again. As soon as they were given something to keep their airway open all night long like a CPAP machine or a dental appliance, the grinding stopped and so did the “sleep apnea” events.

Orthodontic Expanders can cure upper airway resistance

The DNA appliance therapy is a novel treatment that cures TMJ, sleep apnea and all the reasons why people grind their teeth at night time. The DNA or another adult orthodontic expander call the Homeoblock appliance is the best way to stop clenching and correct airway collapse?

Teeth clenching can cause a lot of damage

If grinding is what saves us, then what’s wrong with it? While grinding is effective at saving us at night, there are consequences to having interrupted sleep every night. You’re not sleeping well if you grind your teeth. Even with slight sleep apnea, you’re waking up in a damaged state. Tensing up the muscles to grind bounces the body out of deep sleep, and all the health benefits of sleep you read about come from deep sleep. This is where human growth hormone (HGH) is released, reversing the aging process, tightening skin, improving memory, burning fat, and building muscle, and potentially warding off diseases like Alzheimer’s. Untreated sleep apnea can have serious and life-shortening consequences like high blood pressure, heart disease, stroke, automobile accidents, diabetes, depression, anxiety, and weight gain. Don’t fall into the eight hour trap — just because you’re unconscious for eight hours, doesn’t mean it’s quality sleep.

Clenching causes cavities and teeth cracks

Teeth grinding causes people to need more dental work including fillings, dental implants, and crowns. The dental work just repairs wear and tear caused by clenching and not the cause of clenching. Later the dental work fails from more clenching and grinding and needs to be redone. Years of grinding and clenching can damage your teeth, cause tooth decay and tooth sensitivity, and lead to permanent jaw pain and damage to the TMJ.

Can night guards prevent clenching?

A mouth guard often makes things worse. A mouth guard is put in place to protect the teeth from grinding, but since it can reposition the jaw, it can actually make the obstruction of the airway worse.

Teeth clenching is a symptom of sleep apnea

If you grind your teeth, the new standard of care is that you get a sleep study because you are likely having episodes of interrupted breathing during the night and missing out on all the health benefits of deep stage sleep. Even if you’re otherwise healthy, sleep apnea is known to significantly increase your risk of high blood pressure, stroke, cancer, diabetes, depression, and obesity.

A Swedish study estimated that as many as half of women aged 20 to 70 suffer from some degree of sleep apnea which ranged from mild to severe. The old idea of an obese, middle-aged man who snores is no longer what we should think of when it comes to sleep apnea.

Who is most at risk of sleep apnea and clenching

Petite women
Children with ADHD and other learning disabilities
People with a long neck
People who did not breastfeed as infants
People with anxiety and depression
Anyone who grinds their teeth at night

Treating airway problems cures bruxism

To treat grinding, you have to treat the source of what’s causing it, and that’s a small airway. If you grind your teeth, you might have been told that you need to sleep with a mouthguard to protect your teeth from wear and tear and that’s based on the old standard of care. Neglecting teeth grinding can lead to excessive wear and tear on teeth, leading to tooth decay, periodontal tissue damage, jaw pain, and headaches. The new understanding is that, in order to treat teeth grinding, you have to treat the root cause that is causing you to grind your teeth. And that’s the obstruction of the airway.

Treating airway obstructions prevents teeth clenching

If you grind your teeth, it should be considered first due to its seriousness that you likely have a small airway and the reason you’re grinding is to open your collapsed airway while you’re sleeping.

In fact, wearing a mouth guard to protect your teeth from grinding may even make you grind more, since a mouth guard repositions the jaw in such a way that the airway could be getting blocked more than it would be without the mouth guard.

Mouth Guard can cause more harm than good

But how do you know if you grind your teeth if you’re asleep when you’re doing it? Most people don’t know that they grind their teeth until their dentist tells them. Unless the clenching is so frequent that TMJ pain commences.

How to Know If You’re Grinding Your Teeth

Wear on your teeth
Teeth that are worn flat
Abfractions or holes in your teeth by the gumline
gum tissue loss and “recession”
Sore jaw muscles
TMJ pain
A jaw joint that clicks when opening and closing your mouth

What to Do If You Grind Your Teeth

Talk to your dentist. Your dentist can’t make the diagnosis — she or he will leave that to the sleep medicine MD, but your dentist can screen you for teeth grinding and examine the beginning of your airway as you lie flat in the chair at your next appointment. There is an oral appliance your dentist can make for you that keeps the airway open while you sleep, which can work great in conjunction with a CPAP machine or even by itself in mild cases.

Get a Sleep Study Done

Find out if you grind your teeth. The telltale signs of a grinder are flat, worn teeth, jaw clicking, or jaw pain. Ask your dentist to be sure. Talk to your doctor about getting a sleep study. Ultimately, you will need a sleep study to get a diagnosis for sleep apnea from a sleep specialist.

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How to Stop Clenching Teeth at Night During Sleep