Call it bruxing, grinding, clenching or gnashing. It all refers to the extremely concentrated and long term pressure being applied to our teeth. Many times, we’re not aware it’s happening because it usually occurs while we’re sleeping. It’s safe to say that more than 50% of my patients suffer from the effects of night time bruxing and grinding. Unfortunately, many of these patients refuse to accept recommended treatment due to either cost or complacency. It’s only after years of demolishing their teeth and causing irreparable damage they finally accept treatment. I started wearing a night time occlusal guard about 15 years ago due to being a severe grinder myself. Prior to wearing a protective guard, my teeth suffered from hundreds of pound per square inch of pressure night after night. There are many possible causes for chronic bruxism/grinding which I will save for a future post, but suffice it to say that stress, anxiety and a poor bite pattern are recognized as major contributors. If you think you or a loved one is a bruxer, here’s a list of signs and symptoms to look out for:
1. Headaches: Specifically in the temple region, being most intense in morning and tapering off into the afternoon and evening.
2. Jawaches/Toothaches: Similar to the headaches, bruxing-related tooth and jaw pain will typically be worse upon waking and gradually subside.
3. Shortened/Chipped teeth: Obviously, when prolonged tooth-grinding is taking place, something’s gotta give. Many times the teeth will simply wear down and appear flattened, chipped and/or cracked.
4. Cracked Tooth Syndrome: A heavy bruxer can sometimes present with a severe toothache. The tooth looks normal on the x-ray however a vertical fracture inside the tooth may be present. Usually the treatment is root canal treatment with a specialist followed by a crown. If the fracture has reached below the gumline then extraction will be needed..
5. Exposed Dentin/Wear Facets: Dentin is the second layer just underneath the enamel. Once the enamel is gone, the dentin is exposed and will appear darker. This not only leads to sensitivity but can be an esthetic problem
6. Prolonged Tooth Sensitivity: As mentioned, once the dentin is exposed the tooth can become hypersensitive to extreme temperatures. Enamel is the inorganic protective layer, and dentin is the soft, nervous layer. Exposed to the oral cavity, dentin is prone to moderate pain and possible decay.
7. Abfraction: This term relates to the enamel loss at the gum line. Not only does bruxism lead to loss of tooth structure at the chewing surface, it also leads to enamel erosion at the gum line portion of the tooth. This is unsightly and leads to sensitivity.
8. Gum Recession: As the tooth suffers from extreme pressure, it will sustain damage to its structure. This pressure will then transfer into the periodontium (the gums and jaw bone) causing receding gums and bone. This is why some people develop gum disease despite good oral hygiene.
9. Loose Teeth: Obviously, if the gum and bone start to go south, there is no foundation to support the teeth.
10. Spouse/family members can hear you grind: For some heavy grinders, the sound can be obvious. Ask your spouse/significant other if they hear teeth grinding or clicking while you’re sleeping. People who merely clench their teeth do not make a side to side motion with their jaw therefore won’t make noise. However, clenchers can still have signs and symptoms previously mentioned.
NOW WHAT?….If you notice any of these signs, tell your dentist if they haven’t already brought it to your attention. If you’re experiencing symptoms mentioned here without any obvious signs inform your dentist or dental hygienist. If you have this condition, your teeth can be protected using a night guard or gum shield. If your smile has been damaged due to years of teeth grinding, then your smile can be digitally designed to bring back your best smile possible.