Perils Of Bruxism And Its Management By Mouth Guards

Grinding teeth, may be your way of dealing with stress or anxiety but, do you know regular teeth involuntary grinding, called bruxism, can wear your teeth down and also cause headache, jaw pain, earache, stress in facial or temporal muscles.

Do you feel that even after waking up you are tired and your teeth or mouth and/or temples are hurting?  Does your partner complain about your teeth grinding while asleep or the irritating voices coming from your mouth as a result of teeth grinding? Do you grind involuntarily or clench your teeth whenever you are angry or stressed? Are your dental crowns, bridges, fillings or dental implants failing, despite your good oral hygiene or without any pathological reason? Are you facing trouble while sleeping? Are your teeth hurting without any oral hygiene or gums or teeth issue? If you are facing any of the problems, be ready to get yourself ruled out for bruxism from your dentist.

What Are The Hazards Of Teeth Grinding And How Mouth Guards Can Help You?

Bruxism is an abnormal teeth grinding condition in which you grind, gnash or clench your jaw and/or teeth involuntarily, unknowingly and repeatedly. The mouth forces that are being applied during the teeth grinding are unorthodox and deviate from normal planes of forces, which are being experienced by your teeth during the chewing and biting process. Bruxism forces can be in any direction and magnitude which surely damages not only the oral tissues (teeth, gums and alveolar bone) but also the facial and temporal muscles, adjacent joints and other sensitive organs like ears and eyes.

Primary bruxism is without any prior medical condition while secondary bruxism is the result of psychiatric or medical condition.

Mostly, bruxism is due to stress or anxiety getting, displayed in the form of teeth grinding either while we are awake or during sleep; malocclusion of teeth, missing teeth or dento-alveolar developmental problem causing the abnormal bite; sleep apnea due to psychological or physiological abnormality; or the result of some drugs and some other psychiatric conditions.

Mild bruxism does not need medical treatment other than interventional measures like life style modification, counselling and occlusal splints (mouth guards), while moderate to severe bruxism requires active medical, psychological/psychiatric and dental intervention as it may lead to jaw disorder (TMJ pain, clicking of jaw or cracking sounds from jaw, dislocation of jaw disc etc), broken teeth, tension type headaches. .

Bruxism is exhibited either while we are awake or during sleeping. During sleep, the teeth grinding cannot be stopped without intervening.

A Mouth guard is the best option for halting the sleep teeth grinding in mild to moderate and severe bruxism along with other life style modification or medical and psychological treatments, according to the requirement. The involuntary teeth grinding comes with severe effects which are as follows:

  • The development of facial muscles and temporal muscle stress which develops into muscle tension type These unorthodox stresses are developed due to continuous stress which will be stored within the facial (mouth, cheeks) and temporal muscles (on your temporal region) and thereby, exhibiting into muscle tension type headaches. With the use of mouth guards, the involuntary teeth grinding will stop and thereby stops the stress getting stored within the facial and temporal muscles.
  • TMJ (Temporo-mandibular-joint) pain can develop as a result of bruxism. Bruxism will show its initial signs in the form of cracking or clicking sounds coming from jaws, partial locking of jaw while yawning and limited mouth opening, which finally developed into TMJ pain. The association is now considered weak but a certain number of people have self -reported the association. Mouth guards can help in abating the involuntary movements of the jaws and may stop the initiation of the TMJ problems.
  • Facial pain and fatigue throughout the day, is a common feeling reported by the people suffering from bruxism. The unorthodox movements of teeth grinding, which are not coherent to the normal planes of forces within the mouth, are stronger than the usual masticatory (biting and chewing) forces -so this results in to fatigue of the muscles. Mouth guards help in putting grinding to a halt, thus fatigue feeling starts to evade with its continuous use.
  • Teeth grinding can lead to teeth abrasion with respect to the force of application during bruxism. Usually this abrasion is following a set pattern. Either the teeth are getting abraded on left to right plane or from right to left plane or both. The front teeth start to get sharp due to abrasion and then finally chip off. Teeth grinding people have small front teeth in height or they have broken edges which are grinded on a certain plane. Mouth guard is an interventional technique, and it can help in abating those grinding forces and later the damage to the teeth can be restored by the dentist by making use of aesthetic dentistry.
  • The chances of developing a gingival disease (gum disease) are enhanced. The unorthodox involuntary forces which are usually moderate to severe in nature, display excessive forces on the gums which result into the breaking of periodontal ligaments thereby weakening the gums. The gums may develop dental pockets, soaring gums, bleeding gums and teeth start to loosen up. You do not want the anchorage of your teeth, as these may damage your gums, and hence all you will be having are mobile or lose teeth at a young age.
  • The dental crowns, dental bridges, dental implants and dental fillings are likely to fail as a result of teeth grinding. This uncontrolled grinding will loosen the dental prosthesis as the forces are being applied from all unorthodox directions. Dental prosthesis or dental restorations are always built, while keeping in mind the direction of normal dental forces and their magnitude. The plane of the normal forces is when replaced by haphazard and unorthodox plane of forces, it disrupts the dental restorations and dental prosthesis very easily. So, the chances of failure for your fillings and other dental restorations will be enhanced by leaps and bounds. People with bruxism should use stronger prosthesis material which will be recommended by your dentist.
  • The chances of getting an ear pain is high in moderate to severe bruxism and mouth guard can benefit such people before developing such a pain.

Who Can Be Helped By Mouth Guards In Case Of Bruxism?

Mouth guards are recommended by the dentists in bruxism patients in following cases:

-People experiencing mild to moderate bruxism and are unable to comply with lifestyle modification options like exercise.

-People who grind teeth while sleeping due to any reason should get a mouth guard.

-There is an association of bruxism with sleep talking or violent behavior during sleep, REM sleep disorders and hallucinations during sleep and wakefulness due to state of consciousness.

In short, problematic sleep or sleep disorders can have a strong association with involuntary teeth grinding.

-People who grind teeth due to medical reasons like sleep apnea or psychiatric/psychological disorders should get mouth guard.

– People who use drugs that affect the mood, like antidepressants or psychotropic drugs; if they experience bruxism, then mouth guard is a good option for them.

-People who have high intake of alcohol, smoking, caffeine and psychoactive substances, experience bruxism while wakefulness and sleeping. They should get mouth guard from the dentist along with life style modification.

– If you have malocclusion due to posterior teeth malalignment (misaligned molar relationship) or teeth irritation or missing teeth and you are facing bruxism, then get the dental issue eliminated with the orthodontic and prosthetic treatment on priority. Meanwhile, if the bruxism is severe, you are a likely case for a mouth guard too. In patients with dento-development disorder should seek treatment from orthodontic and maxillofacial surgeon for the help.

Whether you grind your teeth just out of habit or have been diagnosed with bruxism, it’s time to talk to your dentist about the mouth guard. Mouth guards or splints are the simplest and most effective way of occluding the tooth abrasion. These special guards are designed to keep the teeth separated in order to prevent the witting or unwitting grinding and clenching.

Following signs may indicate you have bruxism and require mouth guards.

  1. You Have Chipped A Tooth

The pressure that you have been applying on your teeth and jaws during clenching or grinding can result into a chipped tooth. Not only the chipped tooth requires a dental repair, it is also a giveaway of teeth grinding, which you have been considering benign till now, has become serious.

As you grind your teeth together and repeatedly, you are putting a lot of pressure on your tooth enamel that can wreak havoc on your tooth health. Tooth enamel is a hard protective layer that covers dentin which in turn protects the nerves and blood vessels present in the tooth. Mouth guards protect the tooth enamel by providing a barrier between teeth and preventing tooth erosion.

A chipped tooth can even lead to cavities.

It is better to speak with a dentist about the mouth guard before you chip other teeth. Remember, teeth are not replaceable; you do not want to delay your decision to the point of regret.

  1. You Have A Chronic Habit of Grinding Your Teeth

Stress and job pressures make us all grind our teeth periodically but if your habit has become chronic and you find yourself gnashing your teeth regularly – and even during sleep – it’s probably time to consult a dentist.

Bruxism is of two types:

  • Awake Bruxism (AB) – You have AB when you grind your teeth during the during day.
  • Sleep Bruxism (SB) – When you grind and clench – brux – your teeth, usually involuntarily, during the night, it is called SB.

Awake bruxism is more common in females and is semi-voluntary. Affecting about 20% of adults, AB is usually related to stress, anxiety and familial pressures. Sleep bruxism (SP), on the other hand, is prevalent in both genders and accounts for 80% of the cases of bruxism. In sleep bruxism, people brux their teeth and may be unaware of it. People who sleep-brux, usually have other sleeping disorders such as obstructive sleep apnea (OSA), a condition in which breathing is interrupted during sleep, and snoring. SB appears predominantly younger population, i.e., 14-20% of children.

A chronic bruxing, particularly if it is untreated can erode teeth damaging the enamel and dentin leading to exposure of nerves and blood vessels. Once the integrity of tooth is compromised, you experience intense pain.

Mouth guard is the simplest solution to prevent the long term damage. There is a wide variety of mouth guards to choose from.

  • A soft rubber mouth guard is the solution if you clench your teeth and jaws.
  • If grinding is moderate, your best choice is a hybrid laminate guard (HLG) that has a soft interior and a hard exterior.
  • If you grind teeth heavily and regularly, a hard acrylic guard is the answer.

Mouth guards are durable and last for years.

  1. You Wake Up With A Head or Jaw Ache

Do you wake up tired with a head or jaw-ache? It may be a sign of sleep bruxism. You definitely need a mouth guard! A mouth guard may not stop the habit, because in sleep you do it involuntarily, but it will definitely prevent the damage to your teeth.

Do you know your jaw muscles are incredibly strong? Nature has designed them to exert a force of up to 1,300 Newtons. Now imagine the pain if you clench your jaws for an entire night? You need a mouth guard to provide a cushioning between the upper and lower row of teeth to prevent jaw muscles from exerting so much force. A soft rubber or dual laminate mouth guard prevents jaw pain and is effective for sleep bruxism.

  1. You Have Temporomandibular Joint Disorder

Teeth grinding or clenching may seem like a benign habit that we all do from time to time but, as mentioned earlier, if it is not controlled, it can lead to serious disorders such as Temporomandibular Joint Disorder (TMJD). TMJD occurs as a result of inflammation of muscles around the jaw and is characterized by:

  • Pain in neck and jaw limiting motion
  • Clicking or popping sound during opening and closing of mouth

TMJDs affect more than 10 million Americans.

If you have been diagnosed with TMJD, ask your dentist about a mouth guard. A mouth guard is the first-line treatment of TMJD. Mouth guards for TMJD are always rigid and made of acrylic that reposition the jaw to provide relief. Mouth guards for TMJDs require multiple adjustments before a perfect position can be achieved. For this reasons, you should always consult a dentist and never order a mouth or night guard online for TMJDs.

  1. You Are Taking Antidepressants

Do you know that some antidepressants can cause sleep bruxism? A 2012 study, published in Clinics, reported that paroxetine, a type of selective-serotonin reuptake inhibitor (SSRI), causes sleep bruxism among users.

Sleep bruxism is a side effect of many psychotropic medications, including antipsychotics and antidepressants, particularly SSRIs (sertraline, fluoxetine and paroxetine)

If you regularly take antidepressants, talk to the dentist about the mouth guard or speak with your doctor about adjusting the dosage. If teeth grinding has become a problem, you may need to switch to another antidepressant.

Teeth grinding is a common problem and it, more often than not, does not require treatment but even if it has become an issue, it doesn’t mean you should suffer. Make an appointment with the dentist and talk about mouth guards and other solutions to cure the habit.

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