Are Your Teeth Grinding All Night? What To Do?

Most of us only want to “bite the bullet” occasionally, but a disturbing number of people bite the bullet, or their own teeth, all night long. 

The common medical opinion is that grinding your teeth is all in your mind. It’s called bruxism, and the Mayo Clinic defines it as ” when you grind, gnash or clench your teeth.” I love it when we give something a Latin name and pretend that means we know anything about it. 

In the same breath that the Mayo clinic says bruxism is due to stress,they also say it can be associated with a whole host of medical conditions. So don’t worry, or really worry, and grind your teeth some more. At any rate, there isn’t much to be done for it besides seeing a shrink, getting a dental guard (a plastic bullet to bite instead), or trying out botox injections. So much for conventional treatments. 

We need another plan for treating teeth grinding. Let’s start by asking if bruxism, grinding, is the same as chewing or sucking. This is a behavior we develop in childhood, called rhythmic masticatory muscle activity (RMMA). Isn’t it great when you can make thumb sucking sound clinical? According to researchers,”No relationships were found between RMMA (presence/absence) and clinically assessed tooth wear or reports of tooth clenching or grinding or craniofacial complaints.” Except that by the time we get to be adults with bruxism, more RMMA is associated with more tooth wear. Keep in mind that most adults have RMMA, 60%, and only 8% have bruxism. So suck away, or gurgle and coo to your heart’s content. Just don’t bite down.

If mouth movements don’t necessarily cause grinding, what does? Maybe micro-arousals? Someone jostling you in your sleep, a noise that partially wakes you, these are micro-arousals. “Although post-arousal RMMA occurred in all SB (sleep bruxism) patients, it was seen in only one normal subject. Moreover, tooth-grinding occurred during 71% of the evoked RMMA in SB patients.” Other researchers playing around in brains found that during sleep RMMA does not occur, so the process is associated with waking

Since bruxism has nothing to do with sleep, but with waking, my thoughts for possible treatments would include some obvious things like melatonin. In uncontrolled epileptic children, adding melatonin reduced bruxism. Another herb, Lemon balm, didn’t help with muscle movements, and the researchers didn’t measure if the bruxism was worse or better. 

There are various drugs that have been tried for bruxism, and most decrease it while sedating the person. But most have side effects from that sedation. One “drug” listed was L-tryptophan, which again was measured against motion rather than grinding.

Massage combined with splinting was more effective than splinting alone. In patients who received counseling and massage, “After 6 weeks, a mean of 60% pain decrease was reported.”

So, in the end, the alternative approach to bruxism would be, get better sleep, get counseling and massage, and use a mouth guard if you can.