Teeth Grinding

What Is It?

Teeth grinding (Bruxing) is a very common occurrence even in children. For the majority of people it does not cause any problems but it can have a negative effect over a period of time

Grinding of the teeth, grating the teeth between each other with backward and forward movements, creates severe wear of the teeth.

Sometimes people only clench the teeth which is the activity of clamping the teeth together hard without moving them so wear is usually not so evident.  However the teeth show fissures, that means small lines of breakdown of the enamel. Fractures of teeth and prostheses, or loss of fillings and decementation of crowns and bridges can also occur.

What Causes it?

We now know it is primarily a reflex action like breathing and often cannot be ‘cured’ Certain factors such as stress makes it worse..  The key is to help reduce the occurrence and to protect the teeth.

What are the signs of teeth grinding?

Do any of these describe you?

• Do your jaw muscles ache in the morning?Do you have difficulty in eating, first thing?
• Do your teeth show premature wear?
• Do your teeth appear flatter, shorter than they used to?
• Do you suffer from frequent headaches, migraines or facial pain?
• Do you suffer from repeated earaches?
• Has your partner ever complained about you making strange grinding noises in your sleep?

How do we treat it?

If you are a true bruxist, you cannot prevent it so the aim in treatment is to protect the teeth.

The commonest treatment is an occlusal splint.

Occlusal Splint

There are different designs, different names but in essence we make a custom hard plastic guard to protect your teeth.  This is an extremely skilled procedure because a new occlusion (bite) is created that is more stable than your own.

This is worn at night which is when most of the damage occurs. It avoids wear and damage to the teeth, because it prevents the teeth coming in contact, allowing just the contact between the teeth and the plastic appliance.

The splint is not as hard as the teeth, therefore with time it will wear down, but the teeth will not. At the same time it reduces the load to the supporting structures of the teeth and so often results in immediate relief from headaches.

Occlusal Equilibriation

This basically means adjusting your bite so the teeth meet evenly.  It may involve your dentist trimming away some of the surface enamel or the opposite, adding material to change the shape of the teeth.  Often after providing veneers for patients that have worn their teeth from grinding, their biggest change is not the aesthetics, but finding they no longer suffer from headaches because as part of the treatment we can give them a better bite. Either way, the aim is to distribute the forces evenly over all your teeth.

Botox! We are now experimenting with using Botox to help the muscles relax. Botox has been used for many years on medical conditions where the muscles go into spasm (e.g. Cerebral Palsy). It does not change your appearance in any way. Behaviour changes…ie relax.  This is often the most difficult but stress does make the situation worse.