Teeth grinding, medically called bruxism, is a condition characterized by excessive clenching of the jaw and the grinding or gnashing of teeth. Most people have experienced this from time to time, usually under conditions of elevated stress. But when it becomes chronic, when it goes on unconsciously, it becomes what is known as a parafunctional activity (the habitual exercise of a body part in a way that is other than what nature intended). In cases such as these, serious dental consequences are inevitable.
Oddly enough, the two main types of bruxism (asleep and awake) do not seem to overlap. Sleep bruxers have their worst symptoms in the morning and get better during the course of the day, while sufferers of awake bruxism start out fine, only to worsen as the day goes on. Ranging in severity from mild to extreme, bruxers exhibit a variety of symptoms.
I Want My MPD
Actually, no one does. Originally called TMJ (temporomandibular joint) syndrome, it has been re-designated MPD (myofascial pain dysfunction) syndrome, due to the fact that the problem originates in the muscles that move the jaw. Dull, aching pain in and around the ear is the most common symptom, which sometimes radiates to the head or down into the neck. Bruxers bring this on by the imposition of constant, unrelenting pressure on the structure of the jaw and its related muscles. This can even lead to overdevelopment of the masseter muscle, leading to a classic ‘square-head appearance. Talk about your lantern jaw…
Abfraction Lesions Caused by Bruxism
Abfraction lesions are small notches caused by pressure forces on teeth. Over time, this pressure can cause cracks and splits in the thinnest part of the enamel, near the gumline. Most older people have these as a result of normal biting and chewing. Clenching and grinding put abnormal pressure on teeth, over and over. For this reason, victims of bruxism are more likely to get abfraction lesions.Teeth with abfraction lesions are not more likely to decay, but they can get weaker over time. Weak teeth may be more likely to break.
Bruxism and Excessive Tooth Wear
The grinding away of the surface enamel can result in attrition, a flattening of the biting surface of the teeth. If left unchecked, this process continues on to destroy the softer, underlying dentin, resulting in little more than nubs. At this point, things can get extremely painful. Fillings, crowns and dentures will likewise be similarly destroyed. For this reason the strength of the restoration becomes more important, sometimes at the cost of esthetic considerations.
What Causes Bruxism?
The cause of bruxism is largely unknown, however, a number of hypothesis have been put forward, mostly involving stress and anxiety. People who grind their teeth in the absence of psychosocial stressors may be victims of a bad upbringing in the home, leading to lifelong (but repressed) psychological trauma. In children, bruxism may occasionally represent a response to earache or teething. A chemical imbalance in the brain is often cited, particularly that of dopamine release, or serotonin re-uptake. Needless to say, alcohol, drugs (prescription or otherwise), and diet can effect all of this.
The Treatment for Bruxism
Obviously, if stress is the culprit, then we must reduce stress. You could buy a house in Winter River, Connecticut and try to relax: Or maybe that’s not such a good idea. As an alternative to psychological counseling, you could try the Woody Boyd method: Although this is probably what led to the problem in the first place. It is beyond the scope of this article to repair 20 generations of multi-dysfunctional trauma. The best we can do in this regard is to suggest drinking plenty of fluids. Not for any relevant reason. It’s just that everyone should always drink plenty of fluids.
Since bruxism is an unconscious activity, biofeedback techniques have been used in an effort to alert the patient that grinding/clenching is happening. He can then make a conscious effort to stop. As you would need to be wired up like a Christmas tree (not to mention questionable efficacy in general), biofeedback techniques have never become popular. Although this is the season for it.
An aggressive bruxism treatement technique, equilibration (grinding the teeth until the bite is completely harmonious – or, if you prefer jargon: a reshaping of inclines to eliminate interferences to lateral and protrusive function) can sometimes be effective. Used only in extreme cases, this method of treatment will slow, but not stop continued damage. In addition, if the patient is experiencing MPD related pain due to a damaged or destroyed condylar-disc assembly (the discs act as shock absorbers between the mandible and temporal bone – kind of like the torsion bar suspension on a 2004 Pontiac GTO), equilibration can do more harm than good.
The BenchMark Dental Care Bruxism Solution
After repairing the damage that has already been done, the best way to prevent further erosion is with an occlusal splint (also termed dental or night guard). Made of plastic or acrylic, the splint is best made of a hard, glossy material, and depending on the bruxing pattern, can cover all or only a portion of the teeth (partial or full-coverage). A lower appliance can be worn alone, or in combination with an upper appliance. In cases where bruxism is aggravated, some patients will periodically return with splints having holes worn through them. When tooth-to-tooth contact is possible through the holes in a splint, it is offering no protection against tooth wear and needs to be replaced.
How Do I Know if I Brux?
Most people who brux, or grind their teeth, suffer from some sort of symptoms. A great way to know is to ask at your next checkup. The signs of bruxism appear on the teeth, and we see them constantly. Other signs include tense jaw muscles upon awakening, a sore neck in the morning, headaches in the morning, frequent migraines, or teeth that are sensitive or painful without any apparent cause. If you have any of these symptoms, give our office a call to get checked out. We have the right kind of treatment for your clenching and grinding.