Bruxism or Tooth Grinding
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:
Nightguards
Nightguards are the treatment
of choice for Bruxism. 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.
CLick
here to watch a video about Nightguards
It takes two appointments:
- 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.
- 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
- Rinse the guard before wearing .
- Rinse the guard after removing if from your
mouth.
- Brush it gently with a soft toothbrush and
toothpaste, denture cleaner, or liquid soap once a day.
- Soak your nightguard in denture cleaner
once a week to keep it fresh and clean.
- Check your guard of signs of wear.
- See us every six months to monitor your
dental condition
Complications if Nightguards
are not used
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
Other Treatments:
The goal is to change behaviors in
order to relieve symptoms
- 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
Symptoms of Bruxism
(Teeth Grinding)
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
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