Dr. Al Danenberg ● Nutritional Periodontist
August 21, 2022
We all clench or grind our teeth at times. We may do it when we’re sleeping, or we may do it when we are awake. The medical term is bruxism. Most times, bruxism is not a problem. If you do grind your teeth at night, you might develop a dull, constant headache or sore jaw when you wake up. Many times, people learn that they grind their teeth after their loved one hears them grinding at night.
The problem of bruxism is not limited to adults. Children may grind their teeth when their baby teeth emerge and when their permanent teeth come in. However, most children lose this habit after these two sets of teeth have come in more fully.
There may be many causes of, and methods to treat, bruxism. Continuous bruxism should not go unchecked. It could cause serious damage to the teeth, the jawbone, and the jaw joint.
The tooth root is anchored in the jawbone just like a pole is anchored in the dirt. If you continuously wiggled a solid pole in the ground, it probably would become loose. The reason it would loosen is because the side-to-side rocking of the pole would push the dirt aside.
Assume the pole was your tooth and the dirt was your jawbone. If you wiggled that tooth in the bone by grinding or clenching your teeth, you could weaken the surrounding bone. Since the bone around the tooth root on the cheek sides of the teeth is extremely thin, it is very vulnerable. Any wiggling of the tooth in the bone could cause that very thin bone to melt away. Once the bone is gone, it is gone for good.
With the bone gone, the gum tissue covering that area of the tooth would no longer have a scaffolding to attach to. The gum would become unstable. The gum could then recede exposing the root because the bone would no longer be there to hold the gum in place.
In some cases, there can be an opposite effect on the jawbone. Bruxism could cause excess growths of bone called “tori”. This result is basically a protective mechanism of the bone to build itself up to repel the pressures from bruxism.
Bruxism also may cause tooth pain and cause the tooth to feel loose. Bruxism can exacerbate existing periodontal disease by furthering the breakdown of the bone surrounding the tooth root.
The heavy forces of bruxism could cause severe wear on the chewing surfaces, cracks in teeth, muscle pain, and damage to the jaw joint.
Sometimes, a poorly fitted crown on a tooth or a filling on the chewing surface of a tooth may have “high spots”, which may create an interference with the tooth on the opposite arch when they bite together. If that is the case, you may unconsciously grind your teeth to make them “fit together better”. That process of grinding your teeth (i.e., bruxism) can create serious problems for the teeth, the jawbone, or the jaw joint.
Sometimes, bite treatment (orthodontic treatment) may cause teeth to be moved into positions in the jaw that do not fit well together with the opposing teeth in the opposing arch. This could cause interferences in the chewing surfaces of the teeth that cause a person to grind or clench.
Often, when a person is under emotional stress or performing strenuous physical activity, they may clench their teeth.
In addition, if the jaw is not shaped correctly, and the tongue does not have adequate room to function, there may be a problem with breathing called obstructive sleep apnea. When that occurs, frequently bruxism could result while asleep.
First, the most obvious potential causes must be addressed.
If the chewing surface of a tooth is interfering with the chewing surface of a tooth in the opposite arch, then the bite pressure must be adjusted. To correct these heavy “pressure spots”, the chewing surfaces of the teeth are selectively smoothed and polished to remove the interferences. This may be all that is necessary to stop the grinding.
If a patient grinds his or her teeth habitually, sometimes a bite guard could be worn during sleep to reduce the pressures. If people go to the gym and perform strenuous workouts, they often clench. This also would be a good time to wear a bite guard to protect the teeth and jaw joint.
Generally, the best bite guard is made in a dental office that fits the upper teeth and is hard rather than soft. This type of bite guard can guide the teeth in the lower jaw to slide gently on the bite guard during bruxism and prevent damage to the tooth, the jawbone, and the jaw joint. A dentist can do a “compatibility blood test”, to determine the best material to use to construct the bite guard in the dental lab for that patient.
A more inexpensive and immediate type of bite guard that could be used would be a store-bought bite guard that is soft and just reduces the pressure from bruxism.
At other times, orthodontic treatment might be necessary to correct the bite. In more complicated cases, the upper and lower arch may be too narrow to allow the tongue to fit comfortably between the lower teeth. In this case, the upper and lower jaw arches could be widened, the teeth properly positioned, and the tongue given more comfortable space. These efforts will open a compromised airway space regaining normal function for the tongue, improved oxygenation, and reduced bruxism.
Almost everyone clenches or grinds their teeth at times. Most of the time, it is not a problem. When it becomes habitual and continuous, there can be serious damage caused to the tooth, the jawbone, and the jaw joint.
So, how can you tell if your teeth grinding is cause for concern?
Well, any pain in a tooth, the jaw muscles, or jaw joint area would be indicative of damage from bruxism. Also, headaches especially upon wakening could mean that you have been grinding your teeth at night. The only way to determine the true extent of the damage would be for a dentist to evaluate the bruxism habit and the actual areas of the tooth and the jaw joint.
It is incumbent upon an individual who wants to be proactive to seek a proper diagnosis and pursue necessary treatment from a qualified dentist to prevent damage from bruxism.
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