When you stop to think about it, bruxism – habitually clenching and grinding your teeth, often during sleep – is kind of a weird behavior. It doesn’t seem to have an obvious physiological purpose and can cause a lot of dental damage over time: enamel erosion and subsequent tooth sensitivity; chipped or cracked teeth; gum recession; TMJ disorders; and more.
One popular hypothesis is that bruxing is part of the body’s attempt to restore breathing when it stops due to obstructive sleep apnea (OSA) – an unconscious attempt to reopen a blocked airway by repositioning the jaw and tongue muscles to allow for better airflow. If so, bruxism could actually be seen as a survival mechanism.
While this may be true in some cases, a new study in Sleep Medicine Reviews suggests otherwise.
Its authors started by searching three major medical databases for relevant research published before February 2024. Fourteen studies made the cut. Despite a thorough investigation and careful analysis, the research team found no strong evidence that people with OSA are more likely to have sleep bruxism.
Rather, they found that the overall chance of having sleep bruxism was similar in people with and without sleep apnea. For those with apnea, its severity (mild, moderate, or severe) didn’t make a difference either; nor did the sex of the participant. There was no significant difference in the rates of sleep bruxism between men and women with OSA.
That said, the authors also noted that the quality of the studies they reviewed was quite low, so these findings are far from conclusive.
Still, we share them ecause they highlight a fundamental concept in the holistic, biological approach we take here at the Laguna Hills Center for Sleep Apnea & CPAP Intolerance – where we offer a full range of dental services in addition to specialized treatment of both OSA and TMJ disorders, which often go hand-in-hand.
That concept? The best long term results come from identifying and addressing the root cause of any given problem. Otherwise, you’re just chasing symptoms.
With bruxism, for instance, the usual treatment is simply to provide a nightguard – an oral appliance similar to a sports mouth guard that you wear during sleep. While a nightguard is great for protecting the teeth from the damage of clenching and grinding, it does nothing to address the cause, which could be one of any number of things other than OSA or other sleep disordered breathing. These include
- A misaligned bite (malocclusion).
- Chronic stress or anxiety.
- Lifestyle factors, including tobacco, alcohol, and/or caffeine use.
- Certain neurological conditions.
- Certain medications, including some antidepressants and antipsychotics.
While a nightguard may be part of the treatment plan, it’s only that: one part.
That’s why, when you come in for your first visit, you’ll find that we gather far more information about your health than your average dentist. We want to know about your medical history, as well as your dental history, not to mention your diet, exercise, and other lifestyle habits, and much more.
All of this information gives us the necessary context for understanding what we learn from your dental exam, imaging, and other diagnostic testing we do. We want the biggest, clearest view possible of your current oral health and how it intersects with your whole body health and well-being so we can pinpoint the cause of your current concerns.
At that point, we can develop a fully customized treatment plan for you so you can get long-term relief and resolution using the most natural, holistic, and least invasive modalities possible.
Think about it this way: When something goes wrong with your car and the “check engine” light turns on, you don’t solve the problem by covering up or otherwise disabling the light. You take your car to a mechanic to determine what made the light go on in the first place and then address the cause.
Dentistry should be no different.