Sleep Bruxism (Teeth Grinding) Treatment Singapore

If you suspect that you grind your teeth at night or you are certain about it, this article is a must-read. Bruxism is an involuntary movement disorder that seems to affect Singaporeans now more than ever. Dentists have reported an increase in teeth grinding cases after a year fraught with stress and uncertainty over the COVID-19 pandemic and the end of the circuit breaker. The extent of the damage is still to be figured out, that’s why you should go get checked before things get worse.

In the sections below, we will tell you about the available sleep bruxism treatment in Singapore and what you can expect. This is where you will have your questions answered. Stick around.

Quick Facts about Tooth Grinding, Sleep Bruxism

• Sleep bruxism is clenching or gnashing of the teeth that present at night when you are asleep, completely unaware of it. There is also awake bruxism which happens during the day. It is more prevalent in adults 1. Awake bruxism in children is not as common. You should visit a paediatric dentist if you notice your child grinding her or his teeth during sleep.
• Symptoms of teeth grinding/bruxism include earache, headaches, facial pain, stiffness and pain in jaw joints, sensitive teeth, neck pain or stiff neck, and poor sleep quality for both the patient and their partner (because of the clicking sounds).
• Without treatment, teeth grinding can cause damage to the enamel as well as excessive tooth wear and tear in the long-term.
• Many different factors could contribute to the condition, including the way you breathe.
• Bruxism in children is thought to be related to maternal depression 2 3.

What Causes Teeth Grinding, Sleep Bruxism?

Before we talk about any treatments, you need to know what brings upon the condition in the first place. The causes of bruxism are varied and need to be ruled out one by one.

For one, elevated stress levels, frustration, anxiety, and anger have been linked to the condition. Tension manifests itself in many ways. Everybody handles it differently. Some folks get headaches or stomach aches, some tend to binge eat, while others can’t have a single serving of food when they are under a lot of stress. And then, there are individuals who clench their teeth at night.

Scientists also suspect that certain vitamin deficiencies might be a culprit as well. It is believed that magnesium, calcium and vitamin B5 can help with the problem. Not to mention, teeth grinding, bruxism is thought to also result from teeth misalignment in some patients.

Another trigger that is not to be underestimated is genetic predisposition. 20%-50% of teeth grinding patients present with a family history of bruxism. Because it acts on the jaw, the disorder may damage the temporomandibular joint, TMJ (a TMJ disorder).

According to experts, high blood pressure is a potential predictor and result of sleep bruxism. Next, there are certain sleep disorders like sleep apnoea and attention deficit hyperactivity disorder (ADHD) that could co-occur with teeth grinding, especially the nocturnal version. Adding more conditions to the list may make it more challenging to find a solution.

And finally, bruxism could be a side effect of medications. If that’s the case, you should talk to the practitioner who prescribed them and have them replaced with something that won’t make you clench your jaws. In all other cases, you had better talk to a qualified expert on what to do.

How Much is Bruxism Treatment in Singapore?

Here are the prices depending on the treatment type:

• Botox: around $500 per treatment
• Mouthguards: between $200 and $1,000 depending on the type (OTC versus custom-made), material, insurance plan, number of dental visits, and other specifications
• Cognitive-behavioural therapy: appr. $100 per session
• Muscle relaxants: $2 per item

Sleep Bruxism Treatment in Singapore: How Can I Stop Bruxism in my Sleep?

Now that you are familiar with the main triggers of tooth grinding, let’s see how it can be managed.

Mouthguards

A mouth guard for bruxism looks a lot like the ones they use in rugby and boxing. It is designed to act as a barrier between your lower and upper teeth. This prevents them from applying pressure on each other and reduces damage. In turn, it helps with the pain in the jaw that bruxism causes.

There are both over-the-counter mouth guards and custom-made appliances. The former is more affordable than the latter. If you want a perfect fit and better precision, you need to go to a specialist who will take into account your jaw specifics and tailor the device to match your mouth. OTC devices are less effective and may not yield the desired results. They are sold in pharmacies.

Mouthguards not only reduce the symptoms, if any but also help save your teeth from damage. Not to mention, it may boost your breathing if you happen to have other sleep conditions.

Botox and muscle relaxants

Some cases of bruxism respond well to Botox 4. Other than for cosmetic purposes, it is used for health problems too. Botox is a potent neurotoxin that can reduce the function of the masseter muscles temporarily to stop jaw clenching. It is injected in tiny doses so that it doesn’t cause paralysis and the patients can still move their jaw after that.

Basically, what Botox does is weaken the jaw muscles, which minimises involuntarily grinding of the teeth and improves the symptoms. It has to be said that this treatment works in very specific cases, usually with severe bruxism. It is not suitable for every patient. Plus, only qualified experts can administer it. A dentist may not be the best option, although there probably are such practitioners in Singapore that are certified to provide Botox injections.

Patients may also be prescribed muscle relaxants like acetaminophen (paracetamol) to inhibit muscle contraction and stop the pain temporarily.

Reversing the jaw-clenching habit

This is a technique that people can try to stop teeth grinding, bruxism by eliminating the habit. As you can imagine, it’s not an easy thing to do and there is no proof it will work. But there is no harm in giving it a go, either. While many people grind their teeth at night without being aware of it, there are folks that tend to do this during the day too.

If you catch yourself clenching your jaw, it may be a good idea to note it down. Exploring your habits will help you highlight the times at which you are most likely to do them. Being aware of your actions is a key step in the process of reversing a habit. Don’t forget that bruxism is often paired with other sleep disorders. Some of them can interfere with breathing, so by addressing bruxism you also positively affect said conditions.

Stress management

While mouth guards can protect your teeth during bruxism episodes, they only work on the symptoms. It is important to address the cause in the first place. As mentioned above, stress and anxiety are one of the contributing factors for teeth grinding in patients.

So much is going on right now. We Singaporeans have not been spared. The COVID-19 pandemic has caused a surge of mental health issues and anxiety episodes among people of all ages. When this mixes in with your personal problems and physical pain, it can be difficult to cope with.

If you find yourself in a similar situation, don’t be afraid to seek help. The sooner you do it, the better. Cognitive behavioural therapy might be able to fix things but it’s a long journey. You need to go to a trained specialist to tell you about the steps and get you ready for the experience.

Lifestyle adjustments

Fighting sleep disorders should always start with mild lifestyle adjustments like limiting your caffeine intake. Make sure to avoid tobacco and alcohol as well. It may be difficult to give up those habits but it is for your own good and you know it. Also, find ways to treat depression because it may contribute to your bruxism 5, making you feel miserable and unwilling to co-operate with your dentist or health care provider.

You and your physician will go through your sleep habits and discuss what changes could be made so that you reverse the effects of teeth grinding. It is best to refrain from electronic screens that emit blue light at least an hour before going to bed so that your brain can rest and your body and muscles can relax. This means you need to put down your phone and forget about it.

Last but not least, you want to incorporate gentle massages around your temporomandibular joint to your night-time routine to relax the muscles so they don’t get tense in your sleep 6. These are just small steps that may not cure your bruxism but that can have a positive impact on it overall.

Can MediSave be Used?

Unfortunately not. To start with, Botox is not claimable under MediSave. Even though bruxism treatment is not a cosmetic procedure in itself, it’s still not available at insurance companies. Don't be afraid to ask your physician just in case. There may be exceptions. Besides, things change all the time.

Although Singapore’s national savings scheme covers some psychiatric conditions, it’s very limited. Cognitive-behavioural therapy is not on the list of treatments.

As for mouth guards, they are not covered by insurance plans either. MediSave does not typically include dental procedures unless they are surgical.

Who can Diagnose and Treat Bruxism?

If you grind your teeth, you want to consult a dentist in the first place. After taking an X-ray to inspect the damage, they will create a mouth guard to fit your bite. If they suspect something else might be going on or if you don’t respond well to the first line of treatment, they will refer you to a dental sleep medicine specialist for further screening.

He or she will ask questions about your symptoms plus medical history as well as order some tests to rule out sleep apnoea as the primary cause. Then, they will put you on the right treatment. You will get guidelines on how to take better care of yourself to reduce stress on your temporomandibular joint (TMJ disorder) and facial muscles.

If you take things seriously and follow the advice given both by your dentist and sleep specialist, you will be able to avoid the negative consequences of sleep bruxism and improve the quality of your life. This will impact your partner’s or family’s life as well.

Managing your teeth grinding, bruxism is nothing but crucial. It will prevent tooth sensitivity, worn enamel, and other tooth problems that dentists see all the time. In addition, it will enhance other sleep conditions that can hurt your breathing.

Frequently Asked Questions About Bruxism

Can bruxism take place in children?

Yes. Many children can develop the condition in their early years but the majority of them outgrow it naturally. It is believed that 3 out of 10 kids grind their teeth.

How old must I be to do Botox for bruxism/teeth grinding in Singapore?

Medical treatments in Singapore require that you are at the age of 21 or higher. Otherwise, you will need parental consent to undergo Botox.

How much Botox do I need for bruxism in Singapore?

No less than 20 units. Keep in mind that every patient is unique and the dose will be picked carefully on an individual basis.

How frequently do I need Botox for bruxism in Singapore?

In most cases, the effects of Botox fade away within 6 months but your doctor will let you know how often you should have it.

What is the cost of Botox for bruxism in Singapore?

A single treatment runs around $500 but the price will vary from dentist to dentist.

What is the difference between bruxism and temporomandibular joint (TMJ) disorder?

A TMJ disorder manifests itself in malfunctioning of the joints and muscles around the area. It causes lots of pain. Bruxism is teeth grinding.

• 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849828/
• 2. https://www.researchgate.net/publication/312873698_Influence_of_maternal...
• 3. https://pubmed.ncbi.nlm.nih.gov/22049927/
• 4. https://journals.lww.com/ajpmr/Fulltext/2010/01000/Effect_of_Botulinum_T...
• 5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2934876/
• 6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5479477/