What is the difference between bruxing, clenching and grinding?

Teeth grinding and clenching teeth together is a common behaviour that all of us do at some point during the day and night. However, when this becomes a regular habit that is hard to give up, it is called bruxism.

 

Bruxing is usually categorized into sleep bruxism and awake bruxism. As the name suggests, sleep bruxism occurs at night time or whenever the affected person is sleeping, in periods of light sleep and REM (rapid eye movement). On the other hand, awake bruxism occurs primarily when the person is awake.

 

Bruxing is generally described as clenching or grinding of the teeth, but these are distinct activities that sometimes have different causes and impact on the patients wellbeing. Clenching is characterized by the bracing of the jaws, involving no movement. In grinding the lower jaw is tightened and moved sideways against the upper jaw. Therefore people who clench their teeth are more likely to report aching jaws with hardly any wear marks on the teeth. On the other hand, grinding is likely to leave distinct patterns of tooth wear. However, this can become clear only during a dental examination.

 

Grinding is more likely to occur in sleep bruxism or at night. For the layman, the most prominent symptom would be the sounds of gnashing and grinding while asleep. Grinding is probably related to the central nervous system with disturbances in neurotransmitters and is thought to be related to sleep disturbances. Though the affected person may remain unaware, bed partners or parents are the first ones to hear the sound. Additionally, night grinders would feel discomfort in their jaws first thing in the morning which gradually decreases during the day. 

 

On the other hand, clenching is more commonly observed during awake bruxism when the person is either under some sort of work pressure, working with intense concentration or feeling stressed. The person is likely to be symptom free in the morning but may begin to feel worse as the day passes. Clenching is thought to be semi-voluntary and is often accompanied by other oral habits like cheek biting, tongue thrusting and nail biting. 

 

Generally speaking, dental treatment focuses on minimizing the impact on the teeth as well as repairing any damage that may have occurred. Oral appliances like the occlusal splint or dental guards which may be of hard acrylic or of soft rubber are sometimes used to minimize damage to the teeth. These may be partial, that is, cover some of the teeth or may cover all of them. However, these bruxing appliances have a limited effect on bruxing itself. 

 

Besides this, botox injections can be given to reduce the activity of the muscles involved in bruxism. Certain medications, such as muscle relaxants, may also prove beneficial for treating the habit of bruxing though again it has limited effectiveness. If bruxing is a result of any medicines, then these may need to be changed.

 

Other measures include psychotherapy and meditation to reduce stress. Besides, steps like reducing caffeine and alcohol intake may also prove helpful.