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Treatments and drugs
By Mayo Clinic staffIn many cases, no treatment is necessary. Many kids outgrow bruxism without special treatment, and many adults don't grind or clench their teeth badly enough to require therapy. However, if the problem is severe, treatment options include certain therapies and medications.
Therapies
- Stress management. If you grind your teeth because of stress, you may be able to prevent the problem with professional counseling or strategies that promote relaxation, such as exercise and meditation. If your child grinds his or her teeth because of tension or fear, it may help your child to talk about his or her fears just before bed or to relax with a warm bath or a favorite book.
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Dental approaches. If you or your child has bruxism, your doctor may suggest a mouth guard or protective dental appliance (splint) to prevent damage to the teeth.
Splints are usually constructed of hard acrylic and fit over your upper or lower teeth. Some dentists may make them right in the office, while others may send them to a laboratory to be made.
Mouth guards are available over the counter and from your dentist. Your dentist can make a custom mouth guard to fit your mouth. Mouth guards are less expensive than splints, but they generally don't fit well and can dislodge during teeth grinding.
Correcting misaligned teeth may help if your bruxism seems to be associated with dental problems. In severe cases — when tooth wear has led to sensitivity or the inability to chew properly — your dentist may need to use overlays or crowns to entirely reshape the chewing surfaces of your teeth. Reconstructive treatment can be quite extensive and though it will correct the wear, it may not stop the bruxism.
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Behavior therapy. Once you discover that you have bruxism, you may be able to change the behavior by practicing proper mouth and jaw position. Concentrate on resting your tongue upward with your teeth apart and your lips closed. This should keep your teeth from grinding and your jaw from clenching.
If you're having a hard time changing your habits, you may benefit from biofeedback, a form of complementary and alternative medicine that uses a variety of monitoring procedures and equipment to teach you to control involuntary body responses.
During a biofeedback session, electrical sensors are applied to different parts of your body. These sensors monitor your body's physiological responses to stress — such as teeth grinding — and then feed the information back to you via auditory and visual cues. These cues may take the form of a beeping sound or a flashing light. With this feedback, you'll start to associate teeth grinding or clenching with stress and learn to change your behavior. You may also be given a portable biofeedback device that you use at home.
Medications
In general, medications aren't very effective for treatment of bruxism. In some cases, your doctor may suggest taking a muscle relaxant before bedtime. If you develop bruxism as a side effect of an antidepressant medication, your doctor may change your medication or prescribe another medication to counteract your bruxism. Botulinum toxin (Botox) injections may help some people with severe bruxism who haven't responded to other treatments.
- What is bruxism? Academy of General Dentistry. http://www.knowyourteeth.com/infobites/abc/article/?abc=w&iid=292&aid=1137. Accessed Feb. 19, 2009.
- ADA Division of Communications. For the dental patient...do you grind your teeth? Journal of the American Dental Association. 2005;136:559.
- Lobbezoo F. Principles for the management of bruxism. Journal of Oral Rehabilitation. 2008;35:509.
- Huynh N. Weighing the potential effectiveness of various treatments for sleep bruxism. Journal of the Canadian Dental Association. 2007;73:727.
- Policy on oral habits. American Academy of Pediatric Dentistry. Policy on oral habits. Chicago, IL.: American Academy of Pediatric Dentistry. http://www.aapd.org/media/Policies_Guidelines/P_OralHabits.pdf#xml=http://pr-dtsearch001.americaneagle.com/service/search.asp?cmd=pdfhits&DocId=58&Index=F%3a%5cdtSearch%5caapd%2eorg&HitCount=12&hits=46+5f+ac+f8+104+109+28d+2fc+315+32c+38e+3a3+&hc=49&req=bruxism. Accessed March 10, 2009.
- Aloe F. Sleep bruxism treatment. Sleep Science. 2009;2:49.
- Lavigne GJ, et al. Sleep bruxism. In: Principles and Practice of Sleep Medicine. 4th ed. Philadelphia, Pa.:Elsevier Saunders; 2005:946.
- Lavigne GJ, et al. Bruxism physiology and pathology: An overview for clinicians. Journal of Oral Rehabilitation. 2008;35:476.
- Klasser GD, et al. Oral appliances in the management of temporomandibular disorders. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 2009;107(2):214.
