Teeth grinding (also known as bruxism) is a condition characterized by clenching the jaw and grinding the teeth. Usually teeth grinding occurs during sleep, but some people may also grind and clench during the day.
Years of jaw clenching and teeth grinding can lead to tooth damage and damage to the structure of the jaw joint, or temporomandibular joint (also known as TMJ). A TMJ dysfunction can lead to worsening pain in the head, neck, and face as the muscles become stressed and worn over time. It is very important to treat these conditions as early as possible before more serious health issues develop.
Teeth Grinding Causes & Progression
The causes of teeth grinding are not perfectly understood. Some potential causes are sleep apnea and breathing issues, emotional stress, a sudden change in the way teeth fit together, or an abnormal bite position due to previous dental work. Any change in the jaw or jaw joint function may trigger grinding.
Left untreated, teeth grinding may cause damage to the teeth, cracking or fractures in the teeth themselves, and it may damage the bone supporting the teeth, resulting in bone loss. The teeth may become worn and the bite changes. Eventually, the teeth may be lost as a result of the overall damage. The jaw joint, or temporomandibular joint, and its supporting structures can become damaged as well, as the individual struggles to maintain a compromised position and function.
Successfully treating a teeth grinding condition starts with understanding why the grinding occurs.
Teeth Grinding Treatment
We start with a consultation to evaluate the individual patient and severity of the teeth grinding condition. A treatment plan for the individual is designed based on the clinical evaluation.
Here are some of the options for teeth grinding treatment:
- A splint (also known as an orthotic) is worn 24/7 until the muscles in the jaw and head calm down. We use the appliance as a reversible diagnostic device to find the best functional jaw position. Clenching the jaw during the day and night forms knots in the muscles, and the orthotic keeps the teeth from touching and the patient from over-using the muscles that are compromised. Restoring a better muscle function will also decrease pain.
- A sleep study may be warranted at home or in a sleep lab to determine why the patient is grinding. A night orthotic is utilized if the patient is grinding at night or has a sleep problem. If the teeth grinding is related to the airway, a sleep appliance is used to help hold the airway open.
How Jaw Position Relates to the Airway
Many patients with dislocated/displaced joints also have sleep disturbances due to airway constrictions. A compromised jaw joint is related to airway constrictions.
The back of the jaw is the front of the throat/airway. If the jaw joint is seated too far back in the socket, not only are the tissues compromised but so is the airway. An orthotic is used to help find a better jaw/muscle relationship that not only brings the jaw forward to give the tissue time to heal but also helps open up the airway and helps with some of our patients that have problems sleeping at night. It has been suggested that some people with sleep disturbances grind their teeth to bring their jaw forward to help open their airway.
It is important that the position of the jaw be taken into consideration when diagnosing and treating a chronic teeth grinding condition.