What medications can worsen nocturnal bruxism (teeth grinding at night) and what are the treatment options to improve it?

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From the Research

Medications such as selective serotonin reuptake inhibitors (SSRIs) like fluoxetine and sertraline, antipsychotics, amphetamines, and certain antidepressants can worsen nocturnal bruxism, and treatment options include custom-fitted night guards, behavioral approaches, and botulinum toxin injections. Several medications can exacerbate nocturnal bruxism, including SSRIs, antipsychotics, amphetamines, and certain antidepressants, as reported in studies such as 1 and 2.

  • Treatment options for nocturnal teeth grinding include:
    • Custom-fitted night guards or occlusal splints to prevent damage
    • Behavioral approaches like stress management, relaxation exercises, and avoiding caffeine and alcohol before bedtime
    • Botulinum toxin (Botox) injections into the masseter muscles for severe cases, as seen in 3
    • Physical therapy focusing on jaw exercises and massage to relieve muscle tension If medication-induced, discussing dosage adjustments or switching medications with a doctor might be necessary, as suggested in 4. Addressing underlying sleep disorders like sleep apnea can also improve bruxism. Most patients benefit from a combination approach, starting with a night guard and behavioral modifications before considering more invasive treatments, as bruxism often occurs during sleep arousal periods and is associated with increased muscle activity in the jaw, which is why treatments target either protecting teeth or reducing muscle activity. According to the most recent study 5, the importance of sleep hygiene cannot be over-emphasized, and bedtime should be relaxed and enjoyable, with limited mental stimulation and physical activity before going to bed.

References

Research

SSRI-associated nocturnal bruxism in four patients.

The Journal of clinical psychiatry, 1993

Research

Possible paroxetine-induced bruxism.

The Annals of pharmacotherapy, 1996

Research

Botulinum toxin injection for bruxism associated with brain injury: case report.

Journal of rehabilitation research and development, 2014

Research

Sleep Bruxism in Children: A Narrative Review.

Current pediatric reviews, 2024

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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