Bruxism in Barcelona

Grinding your teeth at night can be treated

What is bruxism?

Bruxism is clenching or grinding your teeth without meaning to, almost always at night and without realising. People rarely work it out for themselves: it is their partner who hears the noise, or the dentist who sees it at a check-up, because the wear on the enamel leaves an unmistakable mark.

There is no single cause. Stress and anxiety are the most common, but sleep disorders, some medicines and a bite that does not meet properly all play a part. That is why the first job is working out what is driving it in your case.

And it is worth treating, because it does not stop at the noise: it wears teeth down until they chip, loads the muscles of the jaw and neck, and over time it can affect the temporomandibular joint, which is what suffers when opening your mouth starts to hurt or to click.

How it shows: the symptoms

Hardly any of these symptoms looks like a dental problem, which is exactly why many people live with them for years without connecting them to what their jaw does while they sleep. If several of them sound familiar at once, it is worth looking into.

You wake up with a headache. The most common symptom and the one least often blamed on teeth. A whole night of clenched muscles is paid for in the temples in the morning.
Your jaw aches or tires when you chew. Especially opening wide or biting something hard, and sometimes only on one side.
Your teeth have turned sensitive. Constant rubbing wears the enamel away and exposes the layer underneath, which does feel cold, heat and sweet things.
Your ear hurts with nothing wrong in the ear. The jaw joint sits just in front of it, so its tension is felt there and gets mistaken for an ear infection more often than you would think.
Teeth look flat, chipped or shorter. This is the sign the dentist sees even when you notice nothing, and the one that says how long it has been going on.
Your face feels heavy. A vague ache across cheeks and temples, like stiffness in muscles that never rested.
Stiff neck and shoulders. The tension does not stay in the jaw; it travels up and down the muscle chain.
You sleep badly without knowing why. Waking in the night, unrefreshing sleep and tiredness in the morning despite the hours.

What can be done

Treatment depends on what is actually happening: whether the urgent thing is protecting the tooth, whether what hurts is the muscle, or both.

A night guard made to fit you

This is the first option and it settles most cases. An impression or a scan of your mouth is taken and a rigid guard is made that you put in at bedtime: the teeth bite against it instead of against each other, so the wear stops there. It also spreads the load and usually lowers the tension you wake up with.

It does not cure bruxism, and that has to be said: you will still clench, but against a piece of plastic that can be replaced rather than against enamel that does not grow back. It is checked periodically to see how it is wearing, which is also the best measure of how hard you clench.

The ones sold at a pharmacy, the sort you soften in hot water, do not fit the same way: not being made on your own bite, they can spread the force badly and end up bothering you more than they protect.

Botulinum toxin for bruxism

Botulinum toxin is injected into the muscles that close the jaw, mainly the masseter, to reduce the force with which you clench. It does not act on the cause but on the power of the clenching, which is why it is considered when the main complaint is muscle pain, or when a night guard on its own has not been enough.

It is a medical treatment: a qualified professional assesses, prescribes and administers it after reviewing your case and your medical history, and not everyone is a candidate. The effect is temporary and wears off over the months, so maintaining it means repeating it; the assessment covers how often and what to expect.

It does not replace a night guard when what has to be stopped is wear on the teeth: they are different things and are often combined.

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Which one suits me?

It depends on what dominates. If it is the teeth that are being damaged, the night guard is the answer and it comes first. If what brings you in is pain in the jaw, the head or the ear, and a guard alone has not been enough, then adding the injection is considered.

And there is a third part that is not dental, without which the other two fall short: what is triggering the clenching. If there is a stretch of stress behind it, poor sleep or a new medication, that gets looked at too, because it is the only thing that can make bruxism decrease rather than merely be contained.

At the first appointment in Barcelona we examine the bite, measure the wear that is already there and check the joint, and out of that comes a specific recommendation for your case with its quote, not a list of options.