Treatment

While the symptoms of bruxism in adults can be treated, the condition usually cannot be cured. Treatment focuses on relieving acute symptoms and limiting permanent sequelae. Treatment should be provided jointly by the patient’s physician and dentist.

A variety of treatments can be used deppending on what is causing the bruxism. The success of treatment is determined by symptoms resolution and improved mandibular range of motion.

The goals of treatment are to reduce pain, prevent permanent damage to the teeth, and reduce clenching as much as possible.

To help relieve pain, there are many self-care steps you can take at home. For example:

•Apply ice or wet heat to sore jaw muscles. Either can have a beneficial effect.

•Avoid eating hard foods like nuts, candies, steak.

•Drink plenty of water every day.

•Get plenty of sleep.

•Learn physical therapy stretching exercises to help restore a normal balance to the action of the muscles and joints on each side of the head.

•Massage the muscles of the neck, shoulders, and face. Search carefully for small, painful nodules called trigger points that can cause pain throughout the head and face.

•Relax your face and jaw muscles throughout the day. The goal is to make facial relaxation a habit.

•Try to reduce your daily stress and learn relaxation techniques. Stress reduction can be achieved by a number of techniques such as visual imagery and autosuggestion, aversive conditioning (such as awakening the patient during episodes of teeth grinding), massed negative practice (the patient voluntarily clenches the teeth for 5 seconds and then relaxes the jaw for 5 seconds), pharmacologic therapy to suppress REM sleep, changes in sleep position (lying supine with neck and knee support allows the lower jaw to rest), and a soft food diet.

To prevent damage to the teeth, mouth guards or dental appliances (dental splints) have been used since the 1930s to treat teeth grinding, clenching, and TMJ disorders. A splint may help protect the teeth from the pressure of clenching.

A splint may also help reduce clenching, but some people find that it makes their clenching worse. In others, the symptoms go away as long as they use the splint, but pain returns when they stop or the splint loses its effectiveness over time.

There are many different types of splints. Some fit over the top teeth, some on the bottom. They may be designed to keep your jaw in a more relaxed position or provide some other function. If one type doesn’t work, another may.

As a next phase after splint therapy, orthodontic adjustment of the bite pattern may help some people. Surgery should be considered a last resort.

Finally, there have been many approaches to try to help people unlearn their clenching behaviors. These are more successful for daytime clenching, since nighttime clenching cannot be consciously stopped.

In some people, just relaxing and modifying daytime behavior is enough to reduce night-time bruxism. Methods to directly modify nighttime clenching have not been well studied. They include biofeedback devices, self-hypnosis, and other alternative therapies.