Bruxism: symptoms, causes and treatment

Clenching or grinding your teeth repeatedly can cause tooth wear, muscle pain, sensitivity and jaw discomfort. Bruxism is a common condition that many people suffer from without knowing it, especially when it occurs during sleep. At Clínicas Rincón Dental, we carry out a comprehensive evaluation of the teeth, muscles and bite to identify the source of the discomfort and establish a tailored treatment for each patient.

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What is bruxism and why can it go unnoticed?

Bruxism involves forcefully clenching or rubbing the teeth against one another without a functional purpose. It can occur during the day, usually associated with moments of concentration or stress, or while the person is asleep. In the latter case, it is common for patients to be unaware of the problem until symptoms appear or a partner hears the grinding sound.

Not everyone with bruxism grinds their teeth audibly. Some maintain a constant contraction of the jaw muscles without sideways movements. Therefore, the absence of nocturnal noise does not rule out the presence of muscle strain.

Symptoms that may indicate you are grinding your teeth

Symptoms vary depending on the intensity of the habit, how long it has been present and the adaptability of each patient. Among the most common signs are:

• Jaw pain or tiredness upon waking up: the muscles may feel stiff after remaining contracted for hours.
• Morning headaches: particularly in the temples or around the face.
• Tooth wear: the edges may flatten, shorten or lose their natural shape.
• Tooth sensitivity: progressive loss of enamel can increase discomfort when exposed to cold, heat or sweet foods.
• Cracks and fractures: repeated pressure can damage teeth, fillings, crowns or veneers.
• Discomfort in the jaw joint: clicking, limited opening or pain near the ear may occur.
• Marks on the tongue or cheeks: sustained pressure can leave visible marks on soft tissues.
• Apparently shorter teeth: in advanced cases, a noticeable reduction in length may occur.

These symptoms are not exclusive to bruxism. Facial or jaw pain can also be linked to other conditions, so it is important to avoid self-diagnosis and undergo a professional examination.

Daytime bruxism and sleep bruxism

Daytime bruxism

Daytime clenching usually occurs while working, driving, studying or coping with stressful situations. Many people keep their teeth in contact without realising it. In a normal resting position, the lips may be closed, but the upper and lower teeth should remain slightly apart.

Becoming aware of the habit is an essential part of treatment. Reminders, breaks, exercises recommended by professionals and correcting certain habits can help reduce muscle strain.

Sleep bruxism

Sleep bruxism occurs involuntarily during rest. As patients cannot consciously control it, treatment is mainly aimed at protecting the teeth, reducing the consequences of strain and identifying factors that may aggravate it.

Sleep quality, certain habits, stress levels and other personal circumstances can influence its intensity. This does not mean that all cases have a single cause or that there is a one-size-fits-all solution for every patient.

What are the consequences of untreated bruxism?

When pressure is severe and sustained over time, bruxism can progressively damage the teeth and previous dental work. Possible consequences include:

• Tooth wear and loss of dental enamel.
• Exposure of more sensitive inner layers.
• Fracture of weakened teeth or extensive restorations.
• Chipping or displacement of fillings, crowns and veneers.
• Persistent pain in facial and neck muscles.
• Strain on the temporomandibular joint.
• Aesthetic impairment due to reduced tooth length.
• Need to rehabilitate severely worn teeth.

Detecting it at an early stage allows the tooth structure to be protected before multiple teeth require reconstruction. Therefore, regular check-ups are important even when there is no pain yet.

How is bruxism diagnosed?

Diagnosis should not be based solely on observing worn teeth. Some people may show old wear that is no longer active, while others exert intense pressure without yet displaying obvious damage.

During a bruxism consultation, various elements can be evaluated:

• Wear patterns: we analyse which teeth are affected and how they come into contact.
• Condition of fillings and prostheses: recurrent fractures can indicate overloading.
• Masticatory muscles: we check for pain, tension or muscle enlargement.
• Temporomandibular joint: we assess joint noises, pain, deviations and movement restrictions.
• Bite and jaw movements: we study force distribution and potential interferences.
• Symptoms and habits: information regarding morning pain, sleep and daytime clenching is essential.

When symptoms suggest other conditions, it may be necessary to coordinate the evaluation with professionals from different fields. The aim is to avoid partial treatments and correctly understand the root cause of the discomfort.

Occlusal splint for bruxism

An occlusal splint is one of the most common solutions used to protect teeth during sleep. It is custom-made based on impressions of the patient's mouth and designed to distribute forces in a controlled manner.

Its main function is not to automatically eliminate the underlying cause of bruxism, but to reduce its consequences. A properly fitted splint can help to:

• Prevent direct contact and wear between teeth.
• Protect fillings, crowns, implants or veneers.
• Distribute the pressure exerted overnight more evenly.
• Reduce strain on specific muscles and joints.
• Monitor the intensity of the habit through the marks left on the splint.

Over-the-counter generic or soft guards bought without supervision are not equivalent to a professional splint. An ill-fitted device can be uncomfortable, shift during sleep or inadvisably alter dental contacts.

Other treatments that may form part of the approach

A splint is not always the only required measure. Treatment will depend on symptoms, the extent of wear and factors specific to each case. The plan may include:

• Education and control of daytime clenching: learning to identify when teeth remain in contact.
• Habit modification: avoiding biting objects, prolonged gum chewing or holding forced jaw postures.
• Exercises and muscle therapy: may be advised when facial tension, stiffness or pain is present.
• Correction of dental issues: defective restorations, fractured teeth or irregularities causing discomfort are evaluated.
• Rehabilitation of tooth wear: when a significant amount of tooth structure has been lost, rebuilding the teeth may be necessary.
• Multidisciplinary follow-up: some patients may require collaboration with other specialists depending on the origin and characteristics of the pain.

How to clean and care for an occlusal splint

A splint requires regular hygiene and care to prevent plaque buildup, unpleasant odours and deformation. After use, it should be rinsed and cleaned with a dedicated brush, cold or lukewarm water, and products recommended by a professional.

It should not be cleaned with hot water, as this could warp its shape. It is also important to store it dry and protected in a ventilated container. During routine check-ups, its fit, wear and any bite changes are reviewed.

Diagnosis and treatment of bruxism

Jaw pain, worn teeth and repeated fractures should not be normalised. The earlier muscle strain is identified, the greater the chances of preserving enamel and avoiding extensive restorative treatments.

At Clínicas Rincón Dental, we assess your bite, muscles, jaw joint and the condition of each tooth before recommending a splint or any other procedure. This allows us to propose a treatment based on the actual needs of your mouth and monitor your progress over time.

Do you wake up with jaw pain or notice your teeth becoming increasingly worn? Request a bruxism assessment and protect your smile before excessive pressure causes greater damage.