Studies show that over 90% of Americans experience bruxism, clenching and grinding of ones teeth. While there is some debate over the causes of bruxism, recognizing and minimizing the damage caused by bruxism will save you time and money (and sometimes pain) in the years to come. Night guards are usually the first-line treatment for bruxism.
What is a night guard (occlusal guard)?
A night guard is an appliance designed from dental models of your teeth and made of a rigid plastic. It covers either your upper or lower teeth and prevents the teeth from coming together while sleeping at night. It also provides a guide for your jaw so that muscles can relax and bite problems will not trigger the bruxing action. A night guard is not a cure but it can decrease the damage done by clenching and grinding when worn while sleeping. A person (especially severe bruxers) will still clench and grind during the day time when his/her guard is not being worn. It must fit “like a glove” in order to do its job. Therefore major changes to your teeth or jaw may cause your night guard not to fit. We recommend that all major dental work be completed before investing in a night guard.
What causes bruxing (clenching and grinding) to occur?
This is a very difficult question to answer. Some researchers say that if the occlusion (bite) of someone is not correct they will brux. Others say that it is a central nervous system disorder. Others say it is a multifaceted problem and that it is related to stress factors. Research has also been conducted that suggests that there is often a hormonal component to bruxism as well. We do know that incidences of bruxism increase due to stress and changes in your bite such as a new dental restoration(s), braces, trauma to the mouth or the loss of teeth.
Why does bruxism cause damage to your teeth?
Clenching and grinding exerts pressure that can be generated across the teeth that can range from 100 to 600 psi (pounds per square inch). That incredible amount of force can cause many different problems related to your gums, jaw, and teeth. The problems outlined below occur as a result of these forces being applied slowly, over many years.
What are possible signs, complications or damage that may occur due to bruxism?
- Wearing of teeth
Wear occurs from the movement of the teeth harshly against one another. Although all teeth may show this type wear, it is especially noticeable when a person has front teeth that appear to have the same length as if they were filed down.
- Breaking of teeth
As teeth wear, the edges of front teeth and the cusps or corners of back teeth will begin to show microfractures or cracks. These cracks can not be seen on x-rays. It takes magnified vision and/or an intraoral magnified image to diagnose them. Teeth with these types of fractures will eventually chip, break a corner, or require root canal therapy. Or at worst need to be removed. Root canal therapy is needed when the fracture begins on the surface of the tooth and eventually deepens until the crack enters the area of the nerve. Removal of a tooth is required when a crack extends into the root system.
- Sensitive teeth
Usually a generalized soreness and/or a cold sensitivity.
- Receding gums and/or teeth with gum line “notches”.
Most people have been told or assume that receding gums occurs because of aging, using a hard bristle toothbrush or the occurrence of gum (periodontal) disease. However, another major cause of receding gums is bruxism. When teeth grind hard against each other year after year, they flex at the gum line and the enamel (which is thinner at the gum line) chips away. The end result is an area at the gum line that you can catch your fingernail in and may get extremely sensitive to touch and/or cold.
- Loose teeth
Teeth loosen because of the “rocking” back forth that occurs. The best analogy is the example of getting a fence post out of the ground by rocking it back and forth.
- Periodontal pockets (gums losing their attachment to the teeth)
Sometimes, instead of the teeth getting loose, the natural pocket that is found between the teeth and gums will get deeper and deeper as the gums start to pull away from the teeth. This allows bacteria to hide in these pockets and may lead to a gum infection called periodontal disease.
- Bony ridges (tori)
Instead of losing bone support – some people actually form “extra” bone to support the teeth. Tori appear as bony ridges that can be seen and felt on the jaw bones as a bumpy, raised near the level of the roots. These tori are harmless and can be removed but may return if bruxism is not treated.
- Cheek irritation
A ridge or line of toughened tissue on the inside of the cheek that corresponds to where the teeth come together may form. Sometimes a person will actually bite themselves along this line.
- Sore muscles (especially in the cheek and temple area)
When these muscles are overused, they may get extremely sore (just like when you over exercise) and this can lead to a painful condition called TMJ disorder
- Headaches (especially upon waking in the same muscle areas mentioned above)
Instead of soreness, the muscle aches will appear as a headache.
- TMJ problems (soreness of the temporomandibular joint or “jaw joint”)
The jaw joint may be overloaded causing damage to the joint bones and cushions. If this type of damage occurs, then an oral surgeon should be consulted to determine if corrective treatment is necessary.
Is there a cure for bruxism?
There is no cure for bruxism. However damage can be prevented by making a splint customized to your mouth called an occlusal guard or night guard. Dr. Morgan offers 3 types of night guards so that a patient’s specific needs can be met.