Using Nightguards for Tooth Grinding (Bruxism)
Bruxism, commonly know as tooth grinding, is the clenching together of the bottom and upper jaw accompanied by the grinding of the bottom and upper jaw and followed by the grinding of the lower set of teeth with the upper set. This behavior will remove critical portions of healthy enamel from the chewing surfaces of your teeth and may cause facial pain. People who grind and clench their teeth are called bruxers. They unintentionally bite down too hard at inappropriate times, such as when you sleep, especially in the early part of the night.
During sleep, the biting force — the force at which the jaws clench together — can be up to six times greater than the pressure during waking hours. Bruxing is like clinching your two fists and holding them tightly against each other for eight hours. This behavior would cause you to end up with sore hands, arms and shoulders. Well, this same thing happens to your jaw muscles.
Bruxism is a force that is far more destructive to teeth than caries because your teeth are worn down so much that their enamel is rubbed off, exposing the inside of the tooth called dentin. This exposed dentin will become sensitive.
About one in four people suffer from at least one of the following:
- Pain or discomfort often around the ears and when yawning or chewing
- Tenderness of the jaw muscles
- Clicking, locking or popping in the jaw
- Jaw muscle contraction, spasms or cramping
- Jaw clenching or teeth grinding, severe or very loud
- Headaches and neck aches
- Ringing in the ears
- Tooth indentations on the tongue
- Fractures of teeth and fillings, especially on the front teeth, due to the high pressure
- Teeth sensitive to cold, pressure and other stimuli
As bruxism can be a subconscious behavior that you do not realize is happening, symptoms might not be present.
- Damage to teeth
- May awaken sleep partner
- Worsening of TMJ dysfunction and dental disorders
- Limitation or difficulty in jaw movement, jaw locks when opened or closed
- The tips of the teeth wear flat
- Tooth sensitivity and mobility
- Emotional stress
- Personalities characterized by aggression, controlling, precision, nervousness, competitiveness or people who have time urgency and achievement compulsion
- Malocclusion (teeth that are not aligned properly)
- Jaw, head or neck injury
- Diseases such as arthritis or missing teeth
- Treatment: The goal is to change behaviors in order to relieve symptoms
- Learning how to rest the tongue, teeth and lips properly. The tongue should rest upward with teeth apart and lips shut to help relieve the discomfort.
- Learn to control bad habits, such as chewing on ice or chewing fingernails or pens.
- Chewing gum much of the day increases the wear and tear on the joint, giving little opportunity for your jaw to recover between meals.
- If you chew habitually only on one side of your mouth, you concentrate all the pressure on one side rather than equally on both sides of your mouth. You need to learn to chew evenly — left vs. right.
- Clenching and grinding can be consciously suppressed.
- Treat symptoms first with cold packs and as pain and spasms resolve, try hot packs for a half hour at least twice daily.
- Nonsteroidal anti-inflammatory agents (ibuprofen, Naprosyn®, Tylenol®, Aleve®) and even aspirin are very effective for reducing inflammation in joints, and are recommended before bed and upon waking.
- Most importantly, the joint should be placed at rest by eating a soft diet and avoiding hard, chewy or sticky foods.
- Mouth exercises to improve mouth opening, e.g., slow opening and closing, stretching the muscles to their extent then relaxing them.
- Relaxation or stress management techniques.
A nightguard, which takes the punishment that your teeth would normally endure during bruxism, minimizes the damage from grinding your teeth. A nightguard is a thin transparent horseshoe-shaped retainer-like appliance made of hard or pliable plastic that has shallow borders for good tooth alignment and ideal bite relationship. This splint is worn between the top and bottom teeth and does not allow the teeth to interlock, which absorbs the force of the clenching and grinding to reduce joint irritation and inflammation.
It takes two simple appointments. At the first appointment, an accurate impression of your upper and lower teeth will be made. These impressions are used to create models of your teeth. A bite record may be taken. These items are used to form a customized heat-processed plastic nightguard. At the second appointment, the nightguard will be fitted and adjustments made. The lifespan of a nightguard is 3-10 years. It can protect you from the symptoms of teeth grinding if you wear it regularly, which can even lead to a better night’s sleep for you and your partner!