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Clenching and Grinding

I’m on a plane right now, heading to Arizona to visit my wife’s grandparents and relax for a few days with my wife, son, daughter, and mother-in-law.  My little guy, Jackson, who is almost 3 is watching the movie Secret Life of Pets and my little girl, Mila, who is 10 months is blowing bubbles at me while she is supposed to be napping with Mama.  No crying and everybody is happy, so I thought I would pull out the computer to write some thoughts for you on clenching and grinding your teeth. Yes, that’s the weird dentist in me coming out but it is something I deal with myself and is a topic that a lot of people have questions about.

baby looking out plane window

“I don’t think I clench and grind my teeth but I’m not really sure because I’m sleeping.”  This is something I hear on a daily basis from my patients. The conversation can come up at a new patient exam, routine cleaning, or often times during an emergency exam.  Clenching and grinding, or bruxism, can cause severe damage to your teeth and can even cause severe pain in some cases.

What are common signs of clenching and grinding?

  1. Flattened cusps on teeth in the back of the mouth and wear on the incisal edges of front teeth.  We also see wear facets and cracking/craze lines on teeth.
  2. Generalized recession of the gums.  Clenching and grinding causes damage to the gums and bone that support your teeth.
  3. Increased cold sensitivity due to recession and increased wear on teeth.
  4. An achy feeling in the jaw that is most severe in the morning or during stressful times of the day. Many times, people describe jaw pain or “ear pain” that radiates from the ear down along the mandible.
  5. Popping or grinding of the TMJ, temporomandibular joint, when opening and closing.
  6. Frequent headaches in the morning.

What are the reasons people clench and grind their teeth?

  1. Stress.  We all live stressful lives with work, family, school, etc. which increases the incidence of clenching and grinding.
  2. Airway issues.  Sleep apnea is a common cause of clenching and grinding and can have much larger consequences if undiagnosed.  Often times people who suffer from sleep apnea clench and grind as a subconscious response in trying to re-establish an open airway.
  3. Malocclusion.  When teeth are not in a stable bite relationship it can lead us to subconsciously clench and grind our teeth.
  4. Caffeine in the evening too close to bed time can increase chances of clenching and grinding.
  5. Too much stimulation before bed time with TV screens, computers, and phones.
  6. Lack of sleep.  Sleep deprivation often times leads to clenching and grinding.

What can I do to help prevent clenching and grinding naturally?

  1. Make sure to get plenty of sleep.  Aim to get 8 hours of sleep per night.
  2. Do things in your life to reduce stress.  Workout at the gym, go for a walk, read a book, or spend time with family.
  3. Avoid caffeine in the evenings.
  4. Avoid “screen time” in the evenings.

What can we do for you as your dentist?

  1. We will evaluate for signs of sleep apnea and when indicated recommend a referral to a physician for further evaluation to determine if a sleep study is needed.  The consequences of untreated sleep apnea can be devastating so this really needs to be ruled out first.
  2. We will evaluate your occlusion and see if malocclusion is a factor in your clenching and grinding. We offer Invisalign in-office that can fix minor malocclusions but a referral to an orthodontist may be indicated in more severe cases.
  3. If having an acute flare-up of jaw pain associated with clenching and grinding, we often times recommend a soft diet and over the counter ibuprofen for a few days until symptoms improve.  We may also fabricate you a custom, soft “athletic” mouth guard in the office as a temporary solution to relieve pain.
  4. We may recommend a bruxism splint or “night guard” that you wear at night to protect your teeth from the effects of clenching and grinding.  Also, opening your bite up slightly with a night guard can give relief to the TMJ’s. “Night guards” are clear and comfortable to wear. We take accurate impressions of your upper and lower teeth as well as a bite registration to show the lab the bite relationship we want for maximal benefit for you.  The impressions and bite registration are then sent to our local lab that will fabricate your night guard. About 2 weeks later, you will come back in the office for us to deliver your night guard and adjust as needed.

As the dentist, I had been in denial for a while that I need to be wearing a night guard when I sleep even though I have recognized many of the signs (tooth pain, morning headaches, tooth wear).  I finally broke down and decided to have a night guard made for myself. I had one of our assistants, JoAnna, take impressions and a bite registration on me. We then went ahead and poured up models.  When I looked at the models of my teeth, I was absolutely shocked at the amount of wear and damage I have done to my teeth by clenching and grinding. I even went so far to question “were those impressions accurate” because I could not believe the amount of damage I saw on my teeth.  I have since been wearing a night guard at night when I sleep and trying to get a better night’s rest. That has been about 2 months now and I notice significant improvement in the mornings in regards to tooth aches and headaches. Just as importantly, I am protecting my teeth from further damage that can result in bigger dental issues down the road.

I hope this helps some of you reading this, please feel free to email me if you have any questions at all. My email address is drsullivan@hamiltontowndentistry.com.  I am also happy to set-up a time do a comprehensive evaluation at the office.  

Matthew Sullivan, DDS

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