Waterford, MI Dentist
Lloyd H. Alpert, D.D.S.
4025 Highland Road
Waterford, MI 48328
(248) 682-6010

Posts for tag: Ear Pain

The Dangers of Teeth Grinding

Bruxism (BRUK-siz-um) is a condition in which you grind, gnash or clench your teeth. If you have bruxism, you may unconsciously clench your teeth together during the day, or clench or grind them at night (sleep bruxism).

Sleep bruxism is considered a sleep-related movement disorder. People who clench or grind their teeth (brux) during sleep are more likely to have other sleep disorders, such as snoring and pauses in breathing (sleep apnea).

Mild bruxism may not require treatment. However, in some people, bruxism can be frequent and severe enough to lead to jaw disorders, headaches, damaged teeth and other problems.

Because you may have sleep bruxism and be unaware of it until complications develop, it's important to know the signs and symptoms of bruxism and to seek regular dental care.

Signs and symptoms of bruxism may include:

•Teeth grinding or clenching, which may be loud enough to awaken your sleep partner

•Teeth that are flattened, fractured, chipped or loose

•Worn tooth enamel, exposing deeper layers of your tooth

•Increased tooth sensitivity

•Jaw or face pain or soreness

•Tired or tight jaw muscles

•Pain that feels like an earache, though it's actually not a problem with your ear

•Dull headache originating in the temples

•Damage from chewing on the inside of your cheek

•Indentations on your tongue

When to see a doctor

See your doctor or dentist if:

•Your teeth are worn, damaged or sensitive

•You have pain in your jaw, face or ear

•Others complain that you make a grinding noise while you sleep

•You have a locked jaw that won't open or close completely

If you notice that your child is grinding his or her teeth — or has other signs or symptoms of bruxism — be sure to mention it at your child's next dental appointment.


Doctors don't completely understand what causes bruxism. Possible physical or psychological causes may include:

•Emotions, such as anxiety, stress, anger, frustration or tension

•Aggressive, competitive or hyperactive personality type

•Abnormal alignment of upper and lower teeth (malocclusion)

•Other sleep problems, such as sleep apnea

•Response to pain from an earache or teething (in children)

•Stomach acid reflux into the esophagus

•An uncommon side effect of some psychiatric medications, such as phenothiazines or certain antidepressants

•A coping strategy or focusing habit

•Complication resulting from a disorder such as Huntington's disease or Parkinson's disease

Risk Factors

These factors increase your risk of bruxism:

•Stress. Increased anxiety or stress can lead to teeth grinding. So can anger and frustration.

•Age. Bruxism is common in young children, but it usually goes away by the teen years.

•Personality type. Having a personality type that is aggressive, competitive or hyperactive can increase your risk of bruxism.

•Stimulating substances. Smoking tobacco, drinking caffeinated beverages or alcohol, or taking illegal drugs such as methamphetamine or Ecstasy may increase the risk of bruxism.


In most cases, bruxism doesn't cause serious complications. But severe bruxism may lead to:

•Damage to your teeth, restorations, crowns or jaw

•Tension-type headaches

•Facial pain

•Disorders that occur in the temporomandibular joints (TMJs), located just in front of your ears, which may sound like clicking when you open and close your mouth


Preparing for your appointment

It's usually best to see your dentist first, though you also may see your primary care provider if your dentist feels it's necessary. In some cases when you call to set up an appointment, you may be referred to a sleep specialist.

Because appointments can be brief, it's a good idea to be well-prepared.

To get ready for your appointment:

•Gather relevant medical records, for instance, if you've been seen for bruxism-related problems in the past.

•Make a list of any symptoms you're experiencing, including any that may seem unrelated to the reason for the appointment. If you experience pain, make a note of when it occurs, such as when you wake up or at the end of the day.

•Make a note of key personal information, including any major stresses or recent life changes.

•Make a list of all medications, vitamins or other supplements you're taking and the dosages.

•Prepare questions to ask your doctor or dentist.

For bruxism, some basic questions to ask include:

•What's likely causing my symptoms or condition?

•Are there other possible causes?

•What kinds of tests do I need?

•Is my condition likely temporary or long-term?

•What's the best treatment?

•What are the alternatives to the primary approach you're suggesting?

•I have other health conditions. How can I best manage them together?

•Are there any restrictions I need to follow?

•Should I see a specialist? Will my insurance cover that?

•Is there a generic alternative to the medicine you're prescribing?

•Are there any brochures or other printed material that I can have? What websites do you recommend?

What to expect from your doctor or dentist

Your doctor or dentist is likely to ask you a number of questions, such as:

•When did you first begin experiencing symptoms?

•Have your symptoms been continuous or occasional?

•How severe are your symptoms?

•What, if anything, seems to improve your symptoms?

•What, if anything, seems to worsen your symptoms?

Tests and diagnosis

At Mayo Clinic, we take the time to listen, to find answers and to provide you the best care.

Learn more. Request an appointment.

During regular dental exams, your dentist likely will check for signs of bruxism. If you have any signs, your dentist will look for changes in your teeth and mouth over the next several visits to see if the process is progressive and to determine whether you need treatment.

If your dentist suspects that you have bruxism, he or she will try to determine its cause by asking questions about your general dental health, medications, daily routines and sleep habits.

To evaluate the extent of bruxism, your dentist may check for:

•Tenderness in your jaw muscles

•Obvious dental abnormalities, such as broken or missing teeth or poor tooth alignment

•Damage to your teeth, the underlying bone and the inside of your cheeks, usually with the help of X-rays

A dental exam may detect other disorders that can cause similar jaw or ear pain, such as temporomandibular joint (TMJ) disorders, other dental problems or an ear infection.

If your dentist suspects a significant psychological component to your teeth grinding or a sleep-related disorder, you may be referred to a therapist, counselor or sleep specialist. A sleep specialist may conduct more tests, such as assessment for sleep apnea, video monitoring and measuring how often your jaw muscles tighten while you sleep.


Appointments & care

At Mayo Clinic, we take the time to listen, to find answers and to provide you the best care.

Learn more. Request an appointment.

In many cases, treatment isn't necessary. Many kids outgrow bruxism without 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 dental approaches, therapies and medications. Talk to your doctor about what may work best for you.

Dental approaches

If you or your child has bruxism, your doctor may suggest ways to preserve or improve your teeth. Although these methods may prevent or correct the wear to your teeth, they may not stop the bruxism:

•Splints and mouth guards. These are designed to keep teeth separated to avoid the damage caused by clenching and grinding. They can be constructed of hard acrylic or soft materials and fit over your upper or lower teeth.

•Dental correction. Correcting teeth that aren't properly aligned may help if your bruxism seems to be related to dental problems. In severe cases — when tooth wear has led to sensitivity or the inability to chew properly — your dentist may need to reshape the chewing surfaces of your teeth or use crowns. In certain cases, your dentist may recommend braces or oral surgery.


Certain therapies may help relieve bruxism, such as:

•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 or meditation.

•Behavior therapy. Once you discover that you have bruxism, you may be able to change the behavior by practicing proper mouth and jaw position. Ask your dentist to show you the best position for your mouth and jaw.

•Biofeedback. If you're having a hard time changing your habits, you may benefit from biofeedback, a form of complementary medicine that uses monitoring procedures and equipment to teach you to control muscle activity in your jaw.


In general, medications aren't very effective for treatment of bruxism, and more research is needed to determine their effectiveness. Examples of medications that may be used for bruxism include:

•Muscle relaxants. In some cases, your doctor may suggest taking a muscle relaxant before bedtime, for a short period of time.

•OnabotulinumtoxinA (Botox) injections. Botox injections may help some people with severe bruxism who don't respond to other treatments.

If you develop bruxism as a side effect of a medication, your doctor may change your medication or prescribe a different one.

Lifestyle and home remedies

These self-care steps may prevent or help treat bruxism:

•Reduce stress. Listening to music, taking a warm bath or exercising can help you relax and may reduce your risk of developing bruxism.

•Avoid stimulating substances in the evening. Don't drink caffeinated coffee or caffeinated tea after dinner, and avoid alcohol and smoking during the evening, as they may worsen bruxism.

•Practice good sleep habits. Getting a good night's sleep, which may include treatment for sleep problems, may help reduce bruxism.

•Talk to your sleep partner. If you have a sleeping partner, ask him or her to be aware of any grinding or clicking sounds that you might make while sleeping so that you can report this to your doctor.

•Schedule regular dental exams. Dental exams are the best way to identify bruxism. Your dentist can spot signs of bruxism in your mouth and jaw with regular visits and exams.


October 30, 2015
Category: Jaw
Tags: TMJ   TMD   Jaw Pain   Jaw Discomfort   Facial Pain   Ear Pain  

The Great Imposter: TMJ Dysfunction (The following article is a great tool in understanding your jaw, what a powerful force it is, and what happens when it's strained or not functioning properly)

For about 3 years, Sally heard clicking when she opened her mouth. It wasn't painful, so she didn't worry. But then the sides of Sally's face started to ache. She began having bad headaches and problems chewing and opening her mouth wide.

When the pain continued to get worse, Sally and her parents spoke with their family doctor. He referred Sally and her parents to a local dentist who specialized in jaw disorders. After examining Sally and asking her some questions, the specialist said Sally had a TMJ disorder.

What Are TMJ Disorders?

TMJ disorders are medical problems related to the temporomandibular joint (TMJ), the joint that connects the lower jaw to the skull. These problems can cause pain, difficulty chewing, and other issues.

You can feel your TM joints by placing your fingers directly in front of your ears and opening your mouth. What you're feeling are the rounded ends of your lower jaw as they glide along the joint socket of your temporal bone (that's the part of your skull that contains your inner ear and temple).

TMJ disorders can affect people of any age. Many people who have TMJ disorders are young women.

What Are the Signs and Symptoms?

There are lots of different types of TMJ disorders. So it follows that there are also many different symptoms. Some of the more common signs of a TMJ disorder are:

•Pain in the facial muscles, jaw joints, or around the ear. Some people also feel pain in the neck and shoulders, especially when they talk, chew, or yawn. Occasionally people with TMJ disorders may have muscle spasms.

•Popping, clicking, or grating sounds when opening or closing your mouth. (Some people hear these noises but don't have other symptoms. When that's the case, they may not have a TMJ disorder.)

•Difficulty chewing or biting.

•Headaches, dizziness, ear pain, hearing loss, and ringing in the ears (tinnitus).

•Trouble opening your mouth all the way or jaw locking. It is possible for the jaw to lock wide open or lock shut.

What Causes TMJ Disorders?

It's often not clear what causes a TMJ disorder, but many things can contribute to it.

Jaw clenching or teeth grinding can make a TMJ disorder more likely. When the joint is overworked, a disc can wear down or move out of place. Grinding and clenching also can cause the way the teeth line up to change, and can affect the muscles used to chew. Sometimes people don't realize that they're clenching or grinding — they may even do it during their sleep.

Stress can influence TMJ symptoms by making people more likely to grind their teeth, clench their jaw, or tighten their jaw muscles.

TMJ disorders are also more common in people with other dental problems (like a bad bite), joint problems (like arthritis), muscle problems, or a history of trauma to the jaw or face.

How Are TMJ Disorders Diagnosed?

If you're having symptoms of a TMJ disorder, let your dentist know. The earlier a TMJ disorder is diagnosed and treated, the better.

Your dentist will ask you questions and examine you. He or she may need to order imaging tests, like X-rays, a CT scan, or an MRI in order to see if you have a TMJ disorder.

Treating TMJ Disorders

If you do have a TMJ disorder, the pain may go away on its own in a few days. In the meantime, try to eat soft foods.

Avoid doing things that might aggravate the temporomandibular joint or face muscles, such as chewing gum, clenching or grinding your teeth, or opening your mouth extra wide when you yawn. Applying ice packs or heat on the side of the face may offer some relief.

If the pain is especially intense or does not go away on its own, see your doctor or dentist right away.

If your jaw gets locked open or shut, go to a hospital emergency room. Doctors may manipulate your jaw until you can open or close it. (Sometimes doctors will give people medication if it's needed to keep them comfortable during the procedure.)

Some treatments can help with TMJ disorders. For instance, if pain is caused by clenching your jaw or grinding your teeth, your dentist may fit you with a splint or bite plate to wear at night to help reduce clenching and grinding.

Sometimes doctors prescribe medication to help relieve the pain or relax the muscles. And if a problem with your bite is contributing to your TMJ disorder, your dentist may recommend braces or other dental work to fix the problem.

Occasionally, when the symptoms do not respond to other treatments, someone may need surgery to repair damaged tissue in the joint. But most people don't need surgery for a TMJ disorder.

What You Can Do

You can take control and help lessen problems from TMJ disorders by reducing stress through breathing exercises and getting plenty of exercise. Also, try to be aware of times when you might clench your jaw or grind your teeth.

You may notice you're clenching or grinding your teeth when you're under pressure — like during a test. However, lots of people clench or grind when they don't feel stressed — like while they focus intently on a task or push their limits during a workout or game. Just being aware of these habits is the first step to ending them.

Your dentist can give you more tips on avoiding the symptoms of TMJ disorders.

Reviewed by: Kenneth H. Hirsch, DDS –For Kidshealth.org

Date reviewed: July 2015



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