Dr. Mark Love
One of the most common problems I see among dental patients is that of bruxism, or chronic, habitual clenching and grinding of the teeth. Bruxism affects people of all ages, from very young children to older adults. We most easily recognize bruxers by the excessive wear on the chewing surfaces of the teeth, although other signs do exist.
Bruxism is a big problem not only because of the extreme tooth wear it can cause, but also because of the other major dental/medical issues associated with it. Cracked teeth, sore teeth, loose teeth, shifting teeth, temperomandibular joint pain and dysfunction, facial pain and headaches are all conditions often directly related to clenching and grinding. While bruxing can occur at any time throughout the day, it most commonly occurs during sleep.
Malocclusion (misaligned teeth and/or jaws), missing teeth or other factors that influence the way the upper and lower teeth meet and contact can stimulate a person to grind.
Stress and anxiety are often looked to as a reason someone has episodes of bruxing.
One of the most overlooked and misunderstood major causes of chronic bruxism is obstructive sleep apnea. We see this very often in young children with enlarged tonsils/adenoids which severely restricts their airway. Likewise in adults whose airway collapses during sleep causing snoring and breathing cessation, we usually find evidence of often severe bruxism.
It has been shown if during sleep, the airway is closed and normal breathing is not possible, that a reflex arc is triggered which causes us to constrict our facial muscles, clenching our jaws and often moving the lower jaw rapidly side to side and/or front to back. This temporarily opens the airway allowing for a breath. A few seconds or minutes later the whole process is repeated.
The most effective treatment is found by identifying the underlying stimulus to grind and eliminating it ,if possible. For causes related to poor occlusion (bad bite), restoration of broken- down teeth, replacing missing teeth or orthodontics to properly align teeth is a critical step. For these and stress related causes a custom designed and fitted removable “night guard” appliance can protect your teeth and restorations and often diminish clenching activity if regularly worn.
For apnea related causes, children should be evaluated by an ENT physician or an Oral Surgeon. Adults may need a sleep study, a CPAP device or a mandibular (lower jaw) repositioning device.
If you have reason to believe you could be a bruxer, see your dentist for a thorough oral exam, so that together we can put a stop to “the nightly grind”.
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