Do You Grind Your Teeth?

What is Bruxism? 

Bruxism is the unconscious grinding, clenching or gnashing of the teeth, typically at night.  There are two types; awake bruxism and the more common and typically more severe sleep bruxism.  Sleep bruxism is typically more severe the force generated has profound effect on the teeth, TMJ and muscles (1).

How do I know if I grind my teeth? 

There are several symptoms that indicate that you may have bruxism (1,3) such as: 

• A grinding sound at night, which may disturb the sleep of someone who shares a bedroom with you 
• A dull morning headache and or jaw muscles that are tight or painful to open fully
• Damaged teeth, broken dental fillings and injured gums
• Painful jaw joint
• Teeth that are wearing flat

If you have any of these symptoms you may be a bruxer.  We will be able to help assess your dentition for signs of bruxism.  We will ask about your general dental health, what sources of stress you have in your life, and any medicines you take as some medications induce bruxism (termed secondary bruxism).  We will examine the muscles of your jaw, the TMJ function and of course your teeth for evidence of grinding and bite problems.  If your bruxism is related to stress, professional counseling may help. You also can try strategies to help you relax. It may help to cut down on stimulants such as tobacco and caffeine.

Can Bruxism be Treated? 

You do not have to live with the pain, tooth wear or the sound of bruxism.  Your partner will appreciate the quiet too!  Bruxism can be treated medically (2) or more typically, dentally.   We will be able to address the tooth-to-tooth interaction directly by fabricating a custom made occlusal bite splint, also known as an occlusal-guard or night-guard.  These devices are ideal for separating the jaw at night (see image).  They distribute bite force evenly and allow the teeth to slide easily from side to side preventing the muscle soreness and tooth wear associated with trying to grind tooth cusps over tooth cusps.  The appliance takes time to get used to but patients quickly grow comfortable with daily use and welcome the reduction in pain, wear and the improved sleep that they and their partner experience.

  

Interestingly, 5-50% of children grind their teeth (depending on criteria used for study), mostly in the under 5 age group (4).  This typically self resolves as they grow unless it is stress related.  Oral appliances of this type are not indicated in children as their jaws are still growing.

An ounce of prevention

Many of you have heard me say “If you cut yourself it will heal, but a hole in a tooth just gets worse”, similarly, continued bruxism associated tooth wear is preventable with early intervention.  We can always reconstruct your entire mouth to restore a youthful look and bite, but is far easier to protect the teeth you already have.    

Share if you care!  Please feel free to share this or any Dental Health Matters article and if you have any questions, please feel free to email me at Doodes@ParkBlvdDentistry.com  Who knows, maybe your question will be the subject of another edition!

References: 

1. J Orofac Pain. 2013 Spring;27(2):99-110. Epidemiology of bruxism in adults: a systematic review of the literature.
2. Cochrane Database Syst Rev. 2014 Oct 23;10: Pharmacotherapy for sleep bruxism.Macedo CR1, Macedo EC., et al., GFCochrane Database Syst Rev. 2014 Oct 23;10. 
3. J Orofac Pain. 2013 Winter;27(1):14-20,Temporomandibular disorders, sleep bruxism, and primary headaches are mutually associated. Fernandes G et al.
4. Dental Press J Orthod. 2014 Nov-Dec;19(6):54-61.,Prevalence of sleep bruxism in children: a systematic review.  Machado E et al. 

© Paul Doodes DDS PhD.  All rights reserved.