Do you suffer from painful jaws or experience headaches in the morning?
Does your spouse complain that you keep him or her up all night?
Have your teeth become more sensitive to cold, touch, or other stimuli?
Do you have fractured teeth or fillings, or repeatedly un-cemented crowns?
If so you may be one of the millions of people who unknowingly suffers from bruxism (tooth grinding).
What is Bruxism?
The term bruxism is defined as; "to grind the teeth a clenching of the teeth associated with forceful jaw movements resulting in rubbing, gritting or grinding together of the teeth usually during sleep.”
Bruxism, commonly known as tooth grinding affects between 10-50% of the population depending on the particular study cited. Bruxism is a subconscious behaviour so many people do not realize that they are doing it ! Often it is the partner who tells them about the night-time sounds that their bruxism produces. Although it can occur during the waking hours, bruxism most frequently occurs while we sleep. During sleep, the biting force (the force at which the jaws clench together) can be up to ten times greater than the pressure during waking hours and for much longer periods of time. One researcher was lead to state that "one night of grinding is equal to a life-time of chewing". Consequently, significant damage is much more likely to occur with this night-time bruxism.
What causes bruxing 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. For all practical purposes...EVERYONE bruxes. Therefore, the question is NOT whether a person does in fact brux. Rather, the better question is to what degree do they brux. There is not a scale of bruxing that exists, but, we could imagine that there is such a scale. This scale could run from a 1 indicating a very very slight habit to a 10+ which would indicate a severe bruxer. A person at level 1 would not show any signs of bruxing at all. On the other hand the people in the higher end on the scale would show one or several signs. The pressure that can be generated across the teeth can range from 100 to 400psi (pounds per square inch) this is an incredible amount of force. The problems outlined below occur as a result of these forces being applied over many years - slowly - and it can be difficult to recognize the cause/effect sequence.
Possible signs, complications or damage that may occur are:
1. Wearing of teeth (Cosmetic Damage) 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 having the same length - as if they were filed down.
2. 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 cannot be seen on x-rays. It takes magnified vision and/or an intraoral magnified image to diagnose them. Where this becomes especially important, is that teeth with these type of fractures will either eventually chip, break a corner, or yet require root canal therapy. The reason for root canal therapy is that the fracture begins on the surface of the tooth and eventually deepens until the crack enters the area of the nerve.
3. Sensitive teeth. Usually a generalized soreness and/or a cold sensitivity..
4. Receeding gums and/or teeth with gum line "notches". Most people have been told or assume that receeding gums occur because of age, using a hard bristle brush or the occurence of gum (periodontal) disease. In some cases the lesion may be as a result of excessive pressure caused by bruxing. These are referred to as abfraction areas. When teeth grind hard against each other year after year, they flex at the gum line and the enamel (which ends thinly at the gum line) microfractures 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.
5. 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.
6. Sore muscles (especially in the cheek and temple area) When these two muscles are overused. They may get sore - just like when you over exercise, your other muscles get sore.
7. Headaches (especially upon waking in the same muscle areas mentioned above). Instead of soreness, the muscle aches will appear as a headache ear-ache, or neck pain. 8. Temporomandibular Joint Damage Bruxism can cause damage to the temperomandibular joint. This is the "hinge" which connects the lower jaw to the upper jaw allowing use to chew and talk.
How to Treat Bruxism If you suspect that you suffer from bruxism see your dentist. They can tell you if your symptoms are in fact due to bruxism. In most cases, they can create a custom mouth guard for you to wear while you sleep. The mouth guard takes the punishment that your teeth would normally endure during your bruxism. This will minimize the damage associated with bruxism. Additionally, your dentist may help you properly position your teeth and tongue so as to reduce your bruxism. Reducing alcohol intake is also advisable since alcohol has been shown to worsen bruxism. It is now well known that stress and anxiety play the major role in causing bruxism. If you suffer from bruxism try to more effectively manage the stress in your life. By carefully monitoring and controlling the stress you can often dramatically reduce bruxism.
Acrylic Spilnt
A splint (when made correctly) is a physiologically correct bite. In other words..........when the splint is placed over the upper teeth it instantly provides a bite where the muscles, joint and teeth do not antagonize each other, rather they work in harmony with each other as nature intended. So.........IF symptoms diminish while wearing a splint, then it can be assumed that the problem truly was TMJ in nature, and definitive treatment can be performed to minimize future problems.
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