Tooth Grinding, Clenching and Bruxing

Bruxing or otherwise known as grinding or clenching can cause permanent damage to your teeth and jaw joint (Temporomandibular Joint or TMJ).  Most people who clench and grind their teeth do it during sleep periods, however this may also occur during the day. 

The sign and symptoms that you may be grinding or clenching may include;

• Headaches or facial pain which may be caused by muscle tension.  Headaches particularly behind the eyes, across the forehead, down the ear, the side of the face and down the side of the neck.
• Having difficulty in opening your mouth.  Particularly an inability to open as wide as you are normally able to.   Having the jaw ‘ lock’ open or closed and unable to or having difficulties in moving it open or closed
• Sensitivity to hot, cold, sweet or acidic type foods, this is due to the wearing of the outer surface of the tooth (enamel) and the exposure of the dentine (the underlying layer of the tooth) which is a very sensitive part of the tooth.  The wearing down of the cusps (the pointy bits) on the back chewing molars teeth may result in difficulties in chewing and eating.    Chipped or worn enamel, particularly the anterior (front) teeth.  Fracture lines in the enamel surface which may be sensitive, particularly when biting down firmly.
• Grinding may be noisy (heard by others); however many of us are silent grinders. Noise in the jaw joint on opening or closing.  This may include clicking, popping, cracking or grating.
• Loose or mobile teeth and possible toothache.
• Ear aches, ringing in the ears, hearing loss.

Why do we grind our teeth?

• Stress! Anxiety and tension in both adults and children.  This is the main reason why most clench and grind.
• The occlusion or ‘bite’– the manner in which you teeth fit together when biting may not be ideal & this may lead to grinding.

Are you a Bruxer? – Here’s how we find out.

On dental examination we examine the wear patterns on the enamel.  If cusps are worn flat or anterior (front) teeth are chipped or worn this is usually the first indication that you have been grinding or clenching. The dentist will ask you if you are aware of any symptoms associated with clenching and grinding and may request that you open and close your mouth several times, to examine the range in your jaw movement and to examine if there are any noises on opening or closing your mouth.  We also test the chewing muscles and jaw joint for abnormalities.

Depending on the findings of the examination the dentist may decide to monitor the jaw joint (or TMJ) and will make another assessment at the next examination or make some suggestions to treat the grinding and clenching

Treatment of Grinding or Clenching

• Jaw rest.  Avoid over-opening, e.g. Careful with yawning, eating apples, yelling at the kids, etc.
• Relaxation and Stress Management.  Learn how to relax and reduce the stress that you feel.   Good Luck!   However we encourage you to take time in investigating some possible stress management strategies that would be suitable for you.
• We may prescribe to medication for muscle relaxing in advanced cases where pain and headaches are debilitating, and consider also pain relief medication.
• Warm or Cold packs applied to tender areas.
• Occlusal Splint.  This is a small dental device which is worn at night. It is a small soft plastic guard which sits on the lower teeth and prevents grinding or clenching from causing any further damage to your natural irreplaceable enamel. The splint may also make you less inclined to grind or clench.  It acts like a cushion between you upper and lower teeth.
• Be aware the only time that your teeth should be together is when you eat or chew. If you are clenching and grinding during the day (we may recommend that the splint is worn during the day) there is an increase likelihood that you will grind or clench at night. Try to break the habit!

A NTi de-programming device.

In certain special circumstances (severe migraines) we may recommend a different dental device that helps to break the cycle of clenching.  We tend to reserve this treatment for advanced cases that have not benefited from the above treatment options.