The Two Basic Types of Bruxism
There are two major classes of bruxism: sleep bruxism and awake bruxism.
Both cause similar symptoms, like jaw pain, tooth sensitivity, tooth wear, headaches, and the like; but those with sleep bruxism are often unaware that they are grinding their teeth every night, especially if symptoms are mild.
However, sleep bruxism normally has worse symptoms than awake bruxism, and the fact that symptoms are strongest in the early morning and then diminish as the day goes on is a big clue.
Awake bruxism is much more common with women and girls, but sleep bruxism is about as common for both males and females. And all chronic teeth grinding is more common among kids than adults. Often, in kids, it is referred to as the mixed dentition bruxism because the primary teeth are gradually being replaced by the permanent teeth. When the permanent teeth are erupted and are in good occlusion the symptoms may disappear. Orthodontic repositioning of the teeth can help with achieving a stable dentition.
Dental Guards As A Treatment For Teeth Grinding
The treatment for teeth grinding will vary from one dental practitioner to another, based on which type of bruxism you have, and based on the specifics of the case.
But dental guards (occlusal splints) are probably the most common treatment for sleep bruxism. They are usually made of acrylic and can cover all or part of a jaw; upper jaw, lower jaw, or both; and be made or hard or soft plastic. A single, full lower-jaw dental guard is most common as it is less likely to affect people with a hypersensitive "gag reflex." Sometimes a smaller appliance is recommended and is referred to as a NTI appliance which can be worn day or night.
Occasionally a tooth-desensitizing toothpaste will be applied to the patient's teeth before wearing the dental guard, and it can help to put it on half an hour before bed to prevent sensitivity and decay and the half hour head start will reduce excessive saliva production at night.
Dental guards may get worn by the teeth grinding and clenching, but they can be replaced. And the wear marks are used to examine your teeth grinding patterns. Also, dental guards help relax your jaw and prevent TMJ disease.
Other Common Treatments For Teeth Grinding
For awake bruxism, stress is often the main underlying cause. Therefore, behavioral therapy, stress relief and management strategies, relaxation techniques, and even hypnosis are sometimes used as treatment. There is mounting evidence that sleep apnea, a medical complication that is potentially harmful to the body, may cause the bruxing at night in an attempt to wake up the body and signal it to start breathing.
Sometimes, medications will be prescribed to fight teeth clenching. These would be things like muscle relaxants and antidepressants.
Biofeedback devices have sometimes been tried. These devices monitor your muscle tension and alert you in some way to remind you to relax your jaw.
Occlusal adjustments, meaning using orthodontic or restorative dental procedures to create better "equilibrium" in your mouth, is another option for more difficult cases (or where misaligned or "wrong-height" teeth are part of the problem.)
Finally, the same methods used in Botox procedures to remove wrinkles, can also be used to relax muscles used in clenching the jaw or grinding the teeth. The dosage is kept low so that it doesn't interfere with normal activities like chewing, talking, and smiling.
To learn more about how bruxism (teeth grinding/clenching) is diagnosed and treated, contact periodontist Dr. Raymond A. Kenzik in Ormond Beach, FL, and throughout Volusia and Flagler Counties.