Just about everyone will grind their teeth from time to time. Grinding of your teeth (bruxism is the medical term for this) on rare occasions generally does not cause any harm. But when teeth grinding and clenching occurs on a regular basis damage can occur to the teeth, surrounding tissues, and other oral health complications can present themselves.
What is Teeth Grinding?
Bruxism is the term that refers to a constant grinding and clenching of the teeth and jaws, unintentionally, and at inappropriate times. Bruxers (people with bruxism) are often unaware that they have developed this terrible habit. They often do not know or realize that treatment is available until damage to the mouth and teeth has already been done. Bruxism damage can present itself in a variety of ways. Every individual may experience symptoms a little differently.
Stress and anxiety are often thought as the major culprits of grinding. But it often occurs during sleep and is just as likely to be caused by an abnormal bite alignment (occlusion) or missing or crooked teeth.
Bruxism is considered to be a habit rather than a normal reflexive chewing activity. Reflexive events are responses to various stimuli and always occur without you being able to stop them (like the little hammer on the knee which makes your leg kick). Chewing and clenching can be controlled either consciously or subconsciously by the brain. During sleep, and often during daytime awake hours when we are distracted, our subconscious can take over allowing teeth grinding to happen. Bruxism can be quite rhythmic in nature. Researchers have classified bruxism as a habitual behavior and a sleep disorder.
Signs and symptoms of bruxism or teeth grinding can include:
-Anxiety, stress, and/ or tension. This can include tense musculature of the face and jaws. Waking up with an ache in the jaws face or teeth, or a headache.
-Teeth appear worn down or loose. Wear occurs from the aggressive movement of the teeth against one another. Although all teeth may show this type wear, it is especially noticeable when a person has front teeth that appear having the same length, as if they were somehow filed down.
-Chipped or cracked teeth. As teeth become worn, the edges of front teeth and the cusps (or corners) of back teeth will begin to show tiny fractures or cracks. These cracks generally can not be visualized by x-rays. It takes magnified vision or use of a dental microscope to diagnose them. Teeth with these type of fractures may eventually require further extensive treatment to restore their function. This could include large fillings, crowns, or even root canal therapy. Root canal treatment would be needed if the nerve was so inflamed that it could no longer heal itself, or a fracture extended into the nerve or pulpal area of the tooth allowing bacteria to leak in.
-Teeth sensitivity that is quite pronounced. Can be a constant ache, sensitive to touch or chewing, hot, cold, or even sweet sensitivity.
-Receding gums and/or teeth with notches in them at the gum line. Most people have been told or assume that receding gums occur because of age, aggressive brushing or the presence of periodontal disease. In the majority of cases this is wrong. These are called abrasion areas. When teeth grind hard against each other over time, the teeth will flex at the gum line and the enamel (which becomes quite thin in this area) micro fractures away. You end up with an area at the gum line that you can catch your fingernail in and can get very sensitive to touch and/or cold due to exposure of the root and closeness to the nerve endings.
-Jaws falling out of normal position or locking.
-Wearing away of the tooth enamel, exposing the dentin under the enamel.
-A popping or clicking in the temporomandibular joint (TMJ).
-Damage to the inside of the cheek tissues and tongue. Sometimes a bruxer will actually bite themselves on inside of the cheeks and tongue, (especially in the back part of the molar area).
The symptoms of bruxism can resemble other conditions or medical problems.
How is Bruxism Diagnosed?
During routine dental examinations, your dentist will examine the teeth for evidence of bruxism. This often noted by the damage to the teeth. If the signs are present, the dentist may ask you some follow up questions to see if you have any of the other symptoms, such as snoring.It has been found that patients who both snore and grind have a much higher chance of developing sleep apnea.
Treatment
The goals of treatment are to reduce or remove pain, prevent permanent damage to the teeth, and to decrease the actual clenching. Treatment generally includes a custom made nightguard. The night guard is made for you to hold your teeth in a better position and protect your teeth when you grind to absorb the force of biting. This guard may help to prevent future damage to the teeth and aid in changing the patient's behavior over time.
As always maintain a regular schedule of visiting your dentist so that these issues can be diagnosed in a timely manner should they arise. Also, of note is that this can affect children as well.