Understanding the connections between these conditions can help with diagnosis and treatment

5 minute read

Oral health and overall health are intricately linked. Many people who grind their teeth at night, have a stiff or painful jaw, or struggle with a sleep disorder may find that they experience more than one of these related problems, which sometimes have related solutions.

While this isn’t always the case, evidence shows a correlation between teeth grinding and clenching (bruxism), temporomandibular joint disorders (TMJD) and obstructive sleep apnoea (OSA) that can help dentists and doctors to identify related conditions and recommend treatments to address the underlying causes.

If you or a family member are dealing with any of these issues, read more about the teeth grinding, TMJ and obstructive sleep apnoea links, how to spot the warning signs, and how your dentist can help. If you need to see a dentist in Kelmscott, contact our friendly team to make an appointment today.

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Teeth grinding (bruxism)

Bruxism is the medical term for habitual grinding (teeth) or clenching (jaw), and it’s thought to affect around 5% of Australian adults. Some people grind or clench during the day, though they’re often not aware of doing it. More common is nighttime bruxism, which occurs unconsciously during sleep.

Bruxism symptoms

People grind their teeth for various reasons, such as physical or emotional factors, and the symptoms can be mild or severe. You may not know that you grind your teeth unless someone sees you, but there are some possible warning signs, such as:

  • Feeling or hearing your teeth grinding together
  • Teeth surfaces looking flatter
  • Scalloped tongue (wavy lines alongside the sides of the tongue)
  • Worn or damaged teeth
  • Tooth pain or sensitivity
  • Stiff or painful jaw
  • Headache or pain in your ear or face

Causes of bruxism

Bruxism can affect adults and children, and it can have a range of causes. People may grind or clench due to:

  • Feeling anxious or stressed
  • Concentrating (daytime bruxism)
  • Misaligned teeth
  • Uneven biting surfaces
  • Sleep disorders (nighttime bruxism)

Addressing the root cause or causes of bruxism can sometimes relieve the symptoms. If it’s left untreated, bruxism may cause permanent damage to teeth, or weaken teeth and make them more prone to cracks and chips or other damage, which may need corrective treatment to fix.

Bruxism can also put strain on the jaw joints, increasing the risk of TMJ disorders, and it may be a risk factor for developing obstructive sleep apnoea.

Temporomandibular joint disorders (TMJD)

The temporomandibular joints (TMJ) are the two joints at the sides of the head that connect your jaw to your skull. They allow your jaw to move when you eat, talk or perform other actions. Problems affecting these joints are known as TMJ disorders or TMJ dysfunction (TMJD). Research in 2021 revealed that TMJD is prevalent in around 10% of the Australian adult population.

TMJD symptoms

Symptoms of TMJ disorders can involve the jaw and joints themselves, or surrounding areas of the head, face and upper body. These can include:

  • Clicking, grinding or popping sounds when you move your jaw
  • Limited jaw movement or the jaw locking
  • Pain in the TMJ joints, jaw or ears
  • Headache or facial pain
  • Stiffness in the shoulders
  • Difficulty hearing or feeling dizzy

Causes of TMJ disorders

TMJD happens when the jaw joints are damaged or put under strain. Teeth grinding and clenching, can exert prolonged pressure on the jaw joints and surrounding muscles, leading to muscle fatigue, soreness, and joint inflammation over time. However, while bruxism is a significant contributing factor, TMJD can have multiple causes, including:

  • Misaligned or Uneven Teeth: An improper bite (malocclusion) can place excessive stress on the jaw joints, leading to discomfort and dysfunction.
  •  Joint Conditions Such as Arthritis: Degenerative conditions like osteoarthritis or inflammatory disorders such as rheumatoid arthritis can directly impact the health and function of the temporomandibular joint.
  • Trauma to the Jaw or TMJ: Direct injury from accidents, falls, or blows to the face can result in joint displacement or damage.
  • Psychological Stress and Somatic Trauma: Emotional stress and muscle tension can lead to clenching, which over time, may contribute to joint dysfunction and discomfort.

Key Predictors of TMJD development

There are many factors that can influence the likely development of TMJD, and may include:

Biological Factors:

  • Female gender (as hormonal influences may play a role in joint laxity and pain perception)
  • Fatigue, cramping, stiffness, and soreness in muscles and joints
  • Pressure or tenderness in the jaw region

Psychosocial and Lifestyle Factors:

  • Perceived stress and psychological conditions (e.g., anxiety, depression)
  • Other medical conditions, such as irritable bowel syndrome (IBS), depression, and insomnia
  • Poor sleep quality and pain interference with daily activities
  • Smoking, which may contribute to inflammation and muscle dysfunction

It’s important for to seek professional advice if you experience persistent jaw pain, clicking, or difficulty in opening and closing your mouth. Your care team will develop a personalised treatment plan that may include stress management, bite correction, and lifestyle modifications can help manage TMJD effectively.

Obstructive sleep apnoea (OSA)

If you or a family member experience loud snoring or frequently wake up choking or gasping for air during the night, it could be a sign of obstructive sleep apnoea (OSA). OSA occurs when the muscles that support your tongue and soft palate relax during sleep, allowing excess tissue to block the airway and disrupt normal breathing. As a result, the body must work harder to restore airflow, often causing the person to wake up throughout the night.

OSA symptoms

Sleep apnoea can affect sleep quality, often leading to a number of problems related to sleep deprivation. Some signs that you or someone else might have OSA are:

  • Snoring, snorting or breathing loudly during sleep
  • Waking up suddenly in the night
  • Waking up with a headache
  • Feeling constantly tired and fatigued during the day
  • Difficulties with concentration and memory
  • Being more prone to irritability, anxiety or depression
  • High blood pressure
  • Impotence or reduced sex drive

Sleep may be interrupted multiple times a night, even hundreds of times in severe cases. Sleep deprivation caused by OSA may cause serious health complications if it’s left untreated.

Causes of OSA

Obstructive sleep apnoea is a fairly common sleep disorder that’s thought to affect around 10% of Australian adults, although it’s more common in males and the risk factor increases with age. Other risk factors include:

  • Being overweight
  • Having a narrow airway, or enlarged tonsils or adenoids
  • High blood pressure (hypertension)
  • Chronic nasal congestion
  • Certain medical conditions, such as asthma, thyroid disorder, diabetes and obesity-related conditions
  • Smoking

How are teeth grinding, TMJ and obstructive sleep apnoea linked?

While not everyone with bruxism, TMJ or sleep apnoea will develop the other conditions, multiple studies have demonstrated a correlation between these issues, particularly involving sleep-related bruxism. One reason for this is that they share certain causes and risk factors – such as anxiety and stress, misaligned teeth and airway issues. The upside is that treating the underlying cause of one problem may help to alleviate the others.

For example, a person with sleep apnoea may move their mouth and jaw more during sleep as they try to reopen the airway. This may result in teeth grinding, which in turn puts pressure on the jaw joints. On the other hand, someone who already has bruxism or TMJ may find it harder to get a restful sleep, which may contribute to sleep apnoea or make symptoms worse.

Research is ongoing into the teeth grinding, TMJ and obstructive sleep apnoea link, but your dentist will consider all of your symptoms and look for other signs when developing an effective treatment plan. To talk to our dentists at Kelmscott Dental, call us now on (08) 9495 7999 or book online.

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Diagnosing bruxism, TMJD and OSA

If you think you might have one of these conditions, or your dentist spots possible warning signs, they will conduct a comprehensive assessment to evaluate the condition of your mouth, your medical history and diagnostic tests. This may include a combination of the following:

Bruxism

  • Reports of teeth grinding or clenching (often noticed by a partner or family member).
  • Symptoms such as jaw pain, headaches, tooth sensitivity, and worn-down teeth.
  • Checking for signs of excessive tooth wear, fractures, or flattened chewing surfaces.
  • Evaluation of jaw muscle tenderness and TMJ function.
  • Assessing gum recession or damage to restorations (e.g., fillings or crowns).
  • Bite analysis to evaluate how the teeth come together and to identify a misalignment that may contribute to bruxism.
  • Sleep studies (in cases where sleep bruxism is suspected alongside obstructive sleep apnoea.
  • Electromyography (EMG) to measure muscle activity to detect excessive jaw clenching.

 

Temporomandibular Joint Disorder (TMJD)

  • Reports of jaw pain, clicking, popping, or difficulty in opening or closing the mouth.
  • Presence of headaches, earaches, or facial pain.
  • History of habits like teeth grinding or jaw clenching.
  • Palpation of the jaw muscles and TMJ to check for tenderness, stiffness, or abnormal movement.
  • Assessing the range of motion in the jaw.
  • Listening for clicking or grinding sounds during jaw movement.
  • X-rays to check for structural abnormalities in the jaw and teeth alignment.
  • MRI to obtain detailed images of the soft tissues, including the position of the TMJ disc.
  • CBCT (Cone Beam CT): Offers a 3D view of the TMJ bones and surrounding structures to detect degeneration or misalignment.

 

Obstructive Sleep Apnoea (OSA)

  • Symptoms such as loud snoring, gasping for air during sleep, excessive daytime sleepiness, and morning headaches.
  • Reports of poor sleep quality, fatigue, and difficulty concentrating.
  • Examination of the airway, neck circumference, and oral structures (e.g., enlarged tonsils, nasal obstruction, or excessive soft tissue in the throat).
  • Evaluation of risk factors such as obesity, lifestyle habits, and family history.
  • Sleep Study to monitor breathing patterns, oxygen levels, heart rate, and body movements during sleep.
  • Home Sleep Study.
  • CT Scan to assess airway structure and identify anatomical causes of obstruction.

Treatment options for bruxism, TMJD and sleep apnoea

The treatment options your dentist recommends will be based on the problems you are experiencing, its severity and its cause. In some cases, the same treatment may help with more than one related issue. Treatments may target an underlying cause or aim to reduce associated symptoms.

Bruxism treatments

Treatments and therapies for teeth grinding or clenching may include:

  • Stress and anxiety management
  • Muscle relaxants
  • Wearing a night guard to prevent the teeth from touching
  • Teeth straightening using orthodontics or aligners
  • Crowns or other restorative treatments to repair and protect damaged teeth

Treatments for TMJ disorders

TMJ disorders can sometimes go away by themselves, or when addressing a related problem, but dentists may also recommend:

  • Jaw exercises and physical therapy
  • Bite adjustment with orthodontics or other dental treatment
  • Muscle relaxants or other medication
  • Jaw surgery (in severe cases)

Obstructive sleep apnoea treatments

Dentists may be able to help with obstructive sleep apnoea, depending on the cause, or they may refer patients to other professionals. Treatments and therapies for OSA may include:

  • Lifestyle changes to lower your risk factors, such as losing weight or adjusting your sleep posture
  • Wearing a mandibular advancement device (MAD) or a mouthguard to push the jaw forward and hold the airway open during sleep (for mild to moderate cases)
  • Continuous positive airway pressure (CPAP) for severe cases
  • Surgery to remove an obstruction if necessary

Occlusal splints prescribed for obstructive sleep apnoea may also help with bruxism in some cases.

How to prevent bruxism, TMJD and OSA

Bruxism, TMJD and OSA can’t always be prevented, but there are easy changes you can make to lower your risk of developing one or more of these conditions, or to avoid making your symptoms worse.

Practising good sleep hygiene

You can follow healthy habits and practices to promote consistent, high-quality sleep and overall well-being. These include:

  • Go to bed and wake up at the same time each day
  • Aim for 7 to 9 hours of sleep each night
  • Adopt a relaxing bedtime routine with calming activities
  • Limit exposure to screens at least an hour before sleep
  • Keep the room dark, quiet and cool (ideally 16-19 degrees Celsius)
  • Invest in a comfortable mattress and pillows
  • Use blackout blinds, white noise or earplugs (if needed)
  • Avoid caffeine after 12pm midday
  • Limit alcohol
  • Exercise regularly during the day to help you fall asleep faster and deeper
  • Avoid heavy meals and a lot of liquids that can cause discomfort and frequent wake-ups
  • Spend time outside during daylight hours to regulate sleep-wake cycles and melatonin production
  • Avoid day napping

Improve lifestyle habits

  • Obesity: It’s estimated that 58% of moderate-to-severe OSA is due to obesity. Losing excess weight has been proven to alleviate symptoms of OSA and in some cases, resolve it completely.
  • Quitting smoking can help reduce symptoms of obstructive sleep apnoea (OSA) and improve overall sleep quality.

Managing stress and anxiety

  • Practising relaxation techniques
  • Cognitive behavioural therapy with a professional health practitioner
  • Biofeedback therapy to identify unconscious habits and help manage them
  • Jaw and muscle exercises and massage to release tension
  • Seeking professional help through counselling or therapy to manage chronic stress

Keep regular dental check-ups

  • Keeping up with your regular dental visits – your dentist may be able to spot warning signs and provide early intervention
  • Treating outstanding dental issues – talking to a dentist about correcting a misaligned bite or rebuilding worn teeth

Bruxism, TMJD and sleep apnoea treatment in Kelmscott

If you need to see a dentist about teeth grinding, TMJ pain or sleep apnoea, our local professionals at Kelmscott Dental have extensive experience in all of these areas, so we can recommend the most effective treatments to help you relieve pain and other symptoms.

To book a consultation with our experts today, call our team on (08) 9495 7999 or make an online booking. We also welcome patients from all surrounding areas, including Gosnells and Armadale.

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References

  1. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/teeth-grinding
  2. https://pmc.ncbi.nlm.nih.gov/articles/PMC4689239/
  3. https://pmc.ncbi.nlm.nih.gov/articles/PMC7074179/
  4. https://pubmed.ncbi.nlm.nih.gov/39079850/
  5. https://pmc.ncbi.nlm.nih.gov/articles/PMC3706181/
  6. https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-021-01773-z
  7. https://www.sleepfoundation.org/sleep-apnea/link-between-sleep-apnea-and-teeth-grinding
  8. https://www.sleephealthfoundation.org.au/sleep-topics/how-much-sleep-do-you-really-need
  9. https://www.racgp.org.au/afp/2017/july/obstructive-sleep-apnoea-and-obesity
  10. https://pubmed.ncbi.nlm.nih.gov/25192671/
  11. https://pmc.ncbi.nlm.nih.gov/articles/PMC7874406/