TMD and teeth grinding: Is there a link?

Key takeaways:

• Teeth grinding (bruxism) involves clenching or gnashing the teeth — often during sleep — and may or may not lead to symptoms or damage.

• TMD (Temporomandibular Disorders) refers to conditions affecting the jaw joint and surrounding muscles, causing pain, jaw movement issues, and joint noises.

• Bruxism and TMD can occur together, with one sometimes triggering, worsening, or resulting from the other. But having one does not automatically mean you will experience the other.

• Shared risk factors like stress, anxiety, sleep disorders, caffeine, and nicotine use can contribute to both conditions.

• Management often overlaps — using splints, stress reduction, physiotherapy, or self-care techniques may benefit both TMD and bruxism.

• A holistic, individualised approach is key — treating one issue may help the other, but professional assessment is essential for effective care.

What is teeth grinding?

Teeth grinding, also known as bruxism, is the gnashing or rubbing of the teeth, often during sleep, but can also occur whilst awake. This can lead to tooth wear, sensitivity, painful, and cracked teeth. However it is also important to note that bruxism also happens in healthy individuals without any substantial effects. This is one of the main challenges that bruxism presents: when is bruxism ‘too much’ and going to cause problems with the teeth, mouth or jaw muscles, and when is it a ‘normal’ amount?

What is TMD?

TMD (Temporomandibular disorders), on the other hand, refers to a group of disorders that cause pain and dysfunction in the temporomandibular joint (TMJ), the hinge-like joint connecting the lower jaw to the temporal bone of the skull or in the muscles around it. TMD can cause a range of symptoms, including pain and discomfort in the jaw, difficulty opening and closing the mouth, and clicking or popping sounds when moving the jaw.

How are they related?

Teeth grinding (bruxism) and Temporomandibular Disorders (TMD) are two common oral health issues that affect millions of people worldwide. Research has found there may be a link between the two conditions with one occurring commonly in the presence of the other, but having one does not automatically mean you will experience the other. Understanding how the two may be related can help you take the necessary steps to manage and treat these conditions effectively.

While bruxism and TMD are distinct conditions, they can occur together, and one can exacerbate the other due to their impact on the TMJ and surrounding structures. 

The link between TMD and teeth grinding can be understood in the following ways:

• Bruxism as a trigger, cause, or prolonging factor for TMD: Teeth grinding places additional stress on the TMJ and the muscles involved in chewing (muscles of mastication). This strain may form part of several factors that can result in TMD. 

• TMD as a cause of bruxism: In some cases, TMD can contribute to the development of bruxism. The discomfort or dysfunction caused by TMD may lead to clenching or grinding the teeth. This response might be an unconscious or conscious effort to find a more comfortable jaw position or to alleviate pain or tension in the TMJ and its surrounding muscles.

• Shared risk factors: TMD and teeth grinding also share common risk factors, such as stress, anxiety, and sleep disorders. High levels of stress or anxiety can lead to increased muscle tension in the jaw, which can manifest as teeth grinding or contribute to TMD. Similarly, sleep disorders like sleep apnea can disrupt normal muscle function and cause both bruxism and TMD. Additionally, certain lifestyle factors, such as caffeine consumption and smoking/nicotine use, have been linked to both bruxism and TMD.
  

Prevention

Practicing good sleep hygiene, managing stress and anxiety, avoiding excessive caffeine and smoking/nicotine use, and regular dental check-ups can help in the prevention of both conditions.

In some cases, treating one condition may help alleviate the symptoms of the other. For example, a dental mouthguard (also known as a“splint”) may be prescribed to help reduce the impact of teeth grinding on the TMJ and surrounding structures, thereby alleviating TMD symptoms. Similarly, physical or physiotherapy and self-care techniques that address TMD issues may also help reduce the frequency and intensity of teeth grinding. Addressing the underlying causes and breaking the cycle of worsening symptoms is key to successful management of both teeth grinding and TMD.

Conclusion

Understanding how teeth grinding and TMD can sometimes be linked is important in managing both. It is also essential to remember that effective treatment often requires a comprehensive and holistic approach. If you suspect you may have TMD or are experiencing teeth grinding, consult a dental professional for a thorough evaluation and a comprehensive treatment plan.

References:

1. Lobbezoo, Frank, et al. "Bruxism Defined and Graded: An International Consensus." Journal of Oral Rehabilitation, vol. 40, no. 1, 2013, pp. 2–4. https://doi.org/10.1111/joor.12011.

2. Sanders, A. E., et al. "General Health Status and Incidence of First-Onset Temporomandibular Disorder: The OPPERA Prospective Cohort Study." The Journal of Pain, vol. 14, no. 12, 2013, pp. T51–T62. https://doi.org/10.1016/j.jpain.2013.06.001.

3. Manfredini, Daniele, et al. "Self-Reported Bruxism and Temporomandibular Disorders: Findings from Two Specialised Centres." Journal of Oral Rehabilitation, vol. 39, no. 5, 2012, pp. 319–325. https://doi.org/10.1111/j.1365-2842.2011.02281.x.

4. Paesani, Daniel A., et al. "Correlation Between Self-Reported and Clinically Based Diagnoses of Bruxism in Temporomandibular Disorders Patients." Journal of Oral Rehabilitation, vol. 40, no. 11, 2013, pp. 803–809. https://doi.org/10.1111/joor.12101.