Bruxism is the word given to the action of ‘parafunctional’ (i.e. outside of normal function e.g. eating and chewing) grinding or clenching your teeth. It can be brought on when you are stressed or anxious but is often an unconscious action and often patients do it while sleeping. While not everyone experiences pain or discomfort caused by bruxism, some people can suffer from headaches, neck ache, facial pain, earache, disrupted sleep, and pain and stiffness in the jaw.
But, what can bruxism do to your teeth themselves?
What does tooth grinding do to your teeth?
Excessive regular grinding or clenching your teeth creates excessive wear on the teeth and any dental restorations such as fillings and crowns. This can happen either during the day or while you’re asleep and can result in tooth surface loss (TSL) as the grinding motion wears away the enamel of the tooth (the hard coating).
Once the enamel is worn away by grinding, it exposes the dentine – the inner part of the tooth structure. This is much softer than enamel (enamel is the hardest substance in the human body) so it wears away much quicker, hollowing out the teeth and bringing the centre of the teeth and nerves closer to the surface. This can make your teeth sensitive and uncomfortable.
Not only that, bruxism can also make your teeth flatter and, due to reduction in tooth height, your face shorter.
Dental treatments for bruxism
Bruxism is a condition that needs to be treated carefully. Since it can be caused by a multitude of factors, bruxism needs to be diagnosed before treatment is suggested, to make sure the root causes are addressed. Tooth surface loss and tooth wear isn’t always caused purely by teeth grinding – it can also be exacerbated by excessive acid in the diet, acid reflux, over-aggressive tooth brushing or other damage to the teeth.
Treatment for bruxism is dependent on a number of criteria since every patient’s circumstances will be unique. Criteria include the condition of the teeth, the patient’s face type, bite type and any dental work that has previously been carried out. Bruxism usually affects multiple teeth or even all the teeth, so a more comprehensive treatment approach is often required, involving preventative measures. Depending on the overall condition of the patient’s mouth and teeth, treatment can be relatively simple and conservative, or more complex. In some cases, full mouth treatment may be required.
There are a few different options for treatment worn teeth, depending on the severity of the condition of the teeth. In mild cases, a simple nightguard and changes in your diet may be sufficient to prevent and control the damage to your teeth. However, in moderate and more advanced cases, restorative treatment may be required to rebuild the teeth. This usually involves composite bonding as a first stage but can also involve ceramic veneers, onlays, crowns or partial crowns on your teeth. Sometimes orthodontic treatment is also required to improve the tooth alignment and bite.
How can nightguards treat bruxism?
A nightguard is a simple appliance that fits on your teeth and can be used during a number of different stages when treating bruxism. It prevents further wear and damage to the teeth and may also help with tooth sensitivity. Nightguards also hold the jaw in a better position in order to reduce jaw muscle activity and muscle spasm, so are also used therapeutically to reduce joint pain from grinding.
Finally, nightguards can be used as a protective mechanism. When someone with bruxism uses a mouth appliance, it will be the guard that is worn down and not the teeth themselves. Mouth guards can also help ‘de-program’ people who have a clenching or grinding habit at night and may help the habit to stop.