Bruxism & Teeth Grinding
Bruxism is a harmful condition in which an individual grinds or clenches their teeth together. There are two classifications of this disorder. The first is awake bruxism, affecting approximately 20% to 30% of the population, whereby you unconsciously clench and grind during the day. The other is sleep bruxism whereby you exhibit this behavior in your sleep. Studies have reported the prevalence of sleep bruxism in children to be between 14% and 20% and 10% in adults.
Bruxism is considered a para-functional habit. A para-functional habit is when a particular body part is persistently exercised in a way other than the most common use of that body part. Para-functional habits tend to be very destructive.
Most people think that chewing is the main cause of tooth wear and breakage, but this is not the case. During normal chewing, teeth do not contact, resulting in 20 to 80 psi of pressure applied to the teeth. However, when grinding or clenching the pressure on the teeth can range from 300 to 3000 psi! Additionally, while chewing food, the forces on the teeth are mainly favorable and vertical along their anatomical long axis. Grinding transposes these forces horizontally, which is tremendously destructive.
It is not uncommon for a patient to call our office with a dental emergency caused by chronic bruxism. Most commonly, the dental emergency is pain from a fractured, chipped or broken tooth, jaw or TMJ pain, or increased tooth sensitivity from one or more teeth. Others present with tired or tight jaw muscles, dull headaches, or an “earache” not caused by an ear problem. We even receive complaints from bed partners being kept awake by loud teeth grinding!
It is not unusual for patients to come to us seeking cosmetic correction of unaesthetic chipped, worn and broken teeth cause by bruxism.
In some individuals, teeth grinding can be so severe as to fracture a tooth in half down into the bone, therefore requiring extraction. When this occurs it is desirable to restore natural function and replace the tooth with a dental implant. Less severe damage might require a dental crown (cap), porcelain veneers or something as conservative as cosmetic bonding.
In order to achieve optimal results it is important to address an individual’s grinding or clenching habits when determining an appropriate course of treatment.
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Stress, anger and frustration increase the risk of bruxism as can aggressive, competitive or hyperactive personality types. Drinking alcoholic or caffeinated beverages and smoking tobacco may stimulate bruxism. Bruxism is more common in young children than in adults.
More than 60% of the individuals who snore loudly suffer from sleep apnea. Bruxism is a primary symptom of sleep apnea wherein a person’s airway becomes partially or totally blocked causing them to stop breathing while they’re sleeping. This can lead to heart attack, stroke or other serious diseases.
Currently, there is no curative treatment for sleep bruxism. Oral sleep appliances are most commonly used. This is another area in which Drs. Levy and Kotkin have received comprehensive training.
One such appliance is a night guard, designed to keep teeth separated to avoid damage due to grinding and clenching.
Oral sleep appliances are used to treat for those suffering from mild to moderate sleep apnea or for those with severe sleep apnea who are CPAP intolerant. They are designed to keep a person’s teeth apart and airway open.
Other treatment therapies may include bite adjustment, braces or in severe cases oral surgery. Therapies that may relieve bruxism include stress management through professional counseling, behavior therapy, and biofeedback. To relieve acute discomfort, muscle relaxants may be prescribed for a short period of time.
Please call Drs. Levy and Kotkin, at Progressive Dentistry Phone Number 516-378-8600, to discuss your particular concerns.