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Temporomandibular disorders (TMD) and sleep bruxism (SB) can both take a toll on a patient’s quality of life. And it’s not hard to imagine the two could be linked ‒ it’s long been speculated that grinding or gnashing one’s teeth could cause or contribute to temporomandibular joint pain.

Yet, until recently, the connection between the two conditions hadn’t been thoroughly investigated.

A new study published in Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology provides greater insight into the connection between SB and TMD, shedding light on how dentists and other oral health specialists can help patients suffering from these two mandibular ailments.

Before diving into the results of the study below, you’ll find a brief overview on sleep bruxism and TMD.

TMD, Sleep Bruxism, and the Relationship Between Them

Found on both sides of the head and in front of the ears, the temporomandibular joint (TMJ) connects the jaw and temporal bone. It works alongside ligaments and muscles, aiding in yawning, chewing, swallowing, and speaking.

Research shows that around 10 million Americans suffer from disorders of the temporomandibular joint, or TMDs. Dentists commonly observe the following symptoms as symptoms of TMD:

• Pain or tenderness in the jaw muscles/joints, face, temples, and around the ears
• Issues when opening or closing the mouth
• Popping, grinding, clicking, or crunching sounds while chewing, yawning, or opening the mouth
• Neck pain and headaches.

Historically, TMDs result from jaw injuries, joint diseases (e.g., arthritis), or a combination of the two. Dental experts have long speculated that sleep bruxism (clenching/grinding the teeth) worsens TMD symptoms.

Despite the apparent connection between the two conditions, the science behind the link remains unclear.

Summarizing the UTSD’s Study

Recently, researchers at UTHealth School of Dentistry (UTSD) in Houston, Texas took a closer look at the link between TMD and sleep bruxism.

Using its electronic health system (known as axiUm), UTSD performed a chart review, looking at patients complaining about jaw pain.

Patients were all seen and referred to UT Dentists, the faculty group practice at the school.  They were all seen from November 1, 2015, to April 1, 2018.

During that time, the review looked at patients who filled out International Network for Orofacial Pain and Related Disorders Methodology history questionnaires.

Patients also met the Diagnostic Criteria for Temporomandibular Disorder clinical examinations.

52 patients ended up meeting the study’s criteria. This group included 12 people who only had TMD, while 40 had TMD combined with SB.

Here’s a list of what the researchers assessed and investigated during the study:

• Measurements and descriptions of symptoms
• A statistical analysis using chi squared (aka an X2 test):
• Nonrandom associations between two categorical variables (this process is called Fisher’s exact test)

In short, these were intensive studies meant to draw insightful, accurate results, which brings us to the next section:

What Were the Results of UTSD’s Study?

Many dental professionals wouldn’t be surprised with the results of UTSD’s study, which were as follows:

• Compared to patients who only had TMD, patients with a combination of TMD and SB experience more oral behaviours (e.g., clenching, grinding) during sleep and waking hours.
• Moreover, patients with both conditions chewed gum for extended periods (or had similar habits) more often than those with only TMD.
• Patients with both conditions tended to have more TMD-related headache symptoms than those who only had TMD.

By the end of the study, UTSD’s team reached these conclusions:

• There is clinical evidence that dentists must diagnose and treat patients with TMD and SB.
• Dentists also need to weigh the chances of SB being present when diagnosing patients suffering from temporal headaches caused by TMD.

Always Consider the Relationship between SB and TMD

As a dental professional, you want to do everything to improve your patients’ oral health and overall quality of life.

Anybody coming into your practice with TMD-related issues is going through discomfort that you can help soothe. Unfortunately, by neglecting the possibility that sleep bruxism is a factor, you might not solve their problem.

While the two conditions hadn’t been directly connected before, UTSD’s study should give dental professionals a nudge in the right direction. Treating someone’s sleep bruxism might get to the root of their TMD, relieving their symptoms for good.