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Nightguards are the treatment of choice for Bruxism

Treatments:

The goal is to change behaviors in order to relieve symptoms

• Nightguard (see below)
• Learning how to rest the tongue, teeth and lips properly. The tongue should rest upward with teeth apart and lips shut to help relieve the discomfort.
• Learn to control bad habits, i.e., chewing on ice or chewing fingernails or pens.
  Chewing gum nervously much of the day increases the wear and tear on the joint giving little opportunity for your jaw to recover between meals.
• If you chew habitually only on one side of your mouth, you concentrate all the pressure on one side rather than equally on both sides of your mouth so you need to learn to chew evenly, left vs. right.
• Medication may need to be used to relieve sore muscles or reduce stress
• Clenching and grinding can be consciously suppressed.
• Treat symptoms first with cold packs and as pain and spasms resolve than try hot packs for half-hour at least twice daily
• Nonsteroidal anti-inflammatory agents (Ibuprofen, Naprosyn, Tylenol, Alleve) even aspirin are very effective for reducing inflammation in joints and are recommended before bed and upon waking
• Most importantly, the joint should be placed at rest by eating a soft diet, which avoids hard, chewy or sticky foods
• Mouth exercises to improve mouth opening (slow opening and closing, stretching the muscles to their extent then relaxing them)
• Relaxation or stress management techniques
• Regular exercise to reduce stress
• Repair teeth that have been damaged from the grinding

Nightguard takes the punishment that your teeth would normally endure during bruxism to minimize the damage from grinding your teeth.

A nightguard is a custom-made thin transparent horseshoe-shaped (retainer like appliance) made of hard plastic that has shallow borders for good tooth alignment and ideal bite relationship.

This splint is worn between the top and bottom teeth and does not allow the teeth to interlock which absorbs the force of the clenching and grinding to reduce joint irritation and inflammation.

It takes two appointments:

1. The first appointment an accurate impression of your upper and lower teeth will be made. These impressions are used to create models of how your teeth fit together. A bite record may be taken. These items are used to form a customized heat-processed hard plastic nightguard.
   
2. At the second appointment the final fit of the nightguard will be done and adjustments made.
   

The lifespan of a nightguard is three to ten years. It can protect you from the symptoms of teeth grinding if you wear it regularly which can even lead to a better night’s sleep for you and your partner!

Nightguard home care guide: Nightguard Home Care

1. Rinse the guard before wearing .
2. Rinse the guard after removing if from your mouth.
3. Brush it gently with a soft toothbrush and toothpaste, denture cleaner, or liquid soap once a day.
4. Soak your nightguard in denture cleaner once a week to keep it fresh and clean.
5. Check your guard of signs of wear.
6. See us every six months to monitor your dental condition

Bruxism is commonly know as tooth grinding, is the clenching together of bottom and upper jaw accompanied by the grinding of the bottom and upper jaw followed by the grinding of the lower set of teeth with the upper set.

This behavior will:

• Remove critical portions of healthy enamel from the chewing surfaces of your teeth
• May cause facial pain.
  

People who grind and clench their teeth are called bruxers. This condition is found in 20% of adult population during waking hours and 8% during sleep, and up to 18% of children. These individuals unintentionally bite down too hard at inappropriate times like when they sleep, especially in the early part of the night.

During sleep, the biting force (the force at which the jaws clench together) can be up to six times greater than the pressure during waking hours. Nighttime bruxer's teeth can grind up to 40 minutes for every hour of sleep, with as much as 250 pounds of force per square inch (this is enough force to crack a walnut!).

Clenching by contrast (pressing the teeth together) is more a waking activity. While equal numbers of women and men brux during sleep, more women clench their teeth during the daytime which may be do their vigilant reaction to stimuli perceived by the conscious mind. Bruxing is like clinching your two fists and holding them tightly against each other. This behavior would cause you to end up with sore hands, arms and shoulders. Well this same thing happens to your jaw muscles.

Bruxism is a force that is far more destructive to teeth than caries because your teeth are worn down so much that their enamel is rubbed off, exposing the inside of the tooth called dentin. This exposed dentin will become sensitive. About one in four people suffer from at least on of the following:

Symptoms: A person may have one or a combination

• Pain or discomfort often around the ears and when yawning or chewing
• Tenderness of the jaw muscles
• Clicking, locking or popping in the jaw
• Jaw muscle contraction, spasms or cramping
• Jaw clenching and/or teeth grinding, severe or very loud
• Headaches and neck aches
• Ringing in the ears
• Tooth indentations on the tongue
• Fractures of teeth and fillings especially on front teeth due to the high pressure
• Teeth sensitive to cold, pressure and other stimuli
• No symptoms because bruxism can be a subconscious behavior that you do not realize you do it.
• Teeth that look flat at the tips
• Tooth enamel is rubbed off causing extreme sensitivity
• Tongue indentations

Top 10 clues for detecting bruxism

1) Flat canines
2) Abfraction
3) Popping, clicking, and pain in TMJ
4) Frequent headaches and/or migraines
5) Chipped, worn incisal edges
6) Worn cusp tips
7) Isolated bone loss
8) Cracked teeth
9) Broken restorations
10) Patient indicates stress and anxiety, or state they grind or clench

Complications-Over the years bruxism takes it toll. When we bite our teeth flex and rock a bit from the gumline which will eventually affect the way they sit in the gums.

• Damage to teeth
• Front teeth worn to exactly the same length
• May awaken sleep partner
• Break fillings or other dental work-a specific result of the tip of the tooth biting action
• Worsening of TMJ dysfunction
• Worsening of dental disorders
• Limitation or difficulty in jaw movement, jaw locks open/close
• The tips of the teeth wear flat
• Headaches
• Tooth sensitivity
• Tooth mobility
• Chip teeth
• Erode gums and supporting bones
• Micocracked teeth that may damage the nerve
• Possible increase in acid reflux, due to altered saliva flow