Frequently asked questions about teeth grinding (bruxism)

If you wake up with headaches or acute pain similar to that of tightening of a vise, you may be one of many persons who grind their teeth at night. Many persons are unaware they have this disease (called bruxism) because it occurs mainly at night, during sleep. Your dentist can usually detect the signs of degradation on your teeth. Bruxism is the technical term used for grinding and clenching the teeth that leads to the abrasion of the teeth and to facial pain. Persons who grind and clench the teeth, called bruxers, take a deep bite at inappropriate moments, such as during their sleep. In addition to grinding teeth, bruxers also bite their fingernails, pencils or chew the inside of their teeth. Usually the disease is diagnosed too late because many persons do not realize that they show signs of the disease. Other persons mistakenly think that their teeth must touch at all times. About one in four persons suffers from bruxism, which can be treated by our dentists.

Directly or indirectly bruxism can cause many problems. Grinding can lead to teeth abrasion or teeth loss. Patients can practically lose parts of their teeth, the effect being the degradation and fissuring of the enamel. Persons who have healthy teeth and gums can clench so often and so hard that over time their teeth become sensitive and may experience jaw pain and headaches. Hard bites when not eating may cause pathologic mobility of the jaw.

Grinding is a common sign among many persons at a determinate time. If you have facial pains, fatigue or other problems, treatment may be needed. Talk with your dentist if you suspect that you have bruxism. During a normal dental visit, we usually check for physical signs of bruxism.
If we notice signs of bruxism, the condition of the patient may be observed over several visits to be sure of the problem before recommending and starting treatment. When a person has bruxism, the margins of the teeth look flat. Teeth are deteriorated so much that the enamel is rubbed off, exposing the inside of the tooth, which is called dentin. When exposed, dentin may become sensitive. Bruxers may experience pain in their temporomandibular articulation (TMA), which may manifest itself as popping and clicking.
Women, who are more susceptible to TMA, also have a higher risk of bruxism, most probably because they are more likely to suffer from tissue lesions in the jaw resulting from clenching and grinding. Stress and certain types of personality may represent the main cause for bruxism. Over time, bruxism has affected persons suffering from nervous tension. Anger, pain and frustration can cause bruxism. Persons who are aggressive, competitive and always in a hurry have a greater risk for bruxism.

More study is needed to determine the exact cause of bruxism, but it is believed that the factors that trigger the disease are both of physical and psychical nature. Some of the factors that are contributing to the disease may be stress or sleep disorders, an abnormal bite or missing or fractured teeth.

There are a number of methods to treat bruxism. Our cosmetic dentist specialists will determine which single treatment or combination of treatments is most adequate in your case. In case stress is the major cause of bruxism, patients need to find ways to relax.
Persons who have difficulty in handling stress, may need specialized help or our dentists may prescribe muscle relaxant to relax jaw muscles. In other cases we can prescribe a nigh guard that will prevent bruxism from occurring during sleep. Physical therapy may be needed to help alleviate muscle pain. The objective of therapy is to make the patient to change behavior, by learning methods to relax the tongue, the teeth and the lips properly.
When some persons become aware of their problem, simply advising them to relax the tongue upward with teeth apart and lips shut may be enough to change their behavior and eliminate discomfort. However, the dentist can make a mouth device, such as a night guard, in order to absorb the force of biting that causes lesions and pain and also helps to change patient behavior.

Designed correctly, protective devices against bite help teeth from moving, protect the ceramic restorations and protect teeth from wear damage caused by grinding and clenching. A night guard is a plastic mouth guard, worn at night to prevent teeth grinding.
A bite plate is a plastic device which prevents teeth from coming together. In some cases, such as with an overbite, it may eventually improve the bite. A method used to treat injuries caused by severe cases of bruxism involves reshaping or reconstruction of the biting surfaces with crowns or inlays or a full-mouth restoration.