Protect Your Teeth & Jaw
You May Be Grinding or Clenching Your Teeth At Night If You Any of the Following Signs & Symptoms
Worn Down, Damaged Teeth
Teeth that are flat, worn down, with indentations on the biting surfaces or thinning/chipping edges are all indicative of damage due to grinding or clenching your teeth at night. Such damage is easily preventable.
Teeth Sensitivity Where the Teeth Meet the Gums
Sensitivity along the gumline can often be present with our without wedged out or scooped out areas along the gumline. In the absence of gum disease, this is often the result of teeth bending at the neck due to excessive forces being placed upon them. Aggressive brushing along the gumline exacerbates the situation further.
Teeth Mobility or Looseness
Looseness of teeth either with or without biting down can occur even in the absence of severe gum and bone disease.
Excessive pressure on teeth can result in soreness.
Notching at the Gumline (Abfraction) and Gum Recession
Often, excessive grinding and clenching can encourage your gums to receede, and the subsequent exposure of root surface. Normal brushing can cause notching in the root surface as it is softer than enamel. These notches are more prone to sensitivity and decay.
Jaw Pain - Tension Type Headaches
This kind of discomofort can occur in the morning after waking up, but at any other time durig the day when grinding/clenching may be going on.
You or your partner may be suffering from Sleep Apnea if they often feel sleepy during the day and never feel fully rested. Other signs include:
- Loud snoring
- Gasping for air during sleep
- Severe daytime drowsiness or fatigue
If you have any of the above symptons, you are very likely grinding or clenching your teeth at night! The habit itself cannot always be stopped, however, the symptoms and damage resulting form them can be easily prevented and controlled with the aid of a nightguard. This can be quite effective and a wonderful alternative to medications, surgery and other more invasive methods.
Talk to us about the different types of nightguards we offer. We offer full nightguards, as well as NTI type nightguards, appliances for snoring and sleep apnea.
Frequently Asked Questions About Grinding/Clenching
1. Could I be clenching/grinding my teeth and not be aware of it?
Absolutely! While in some cases you may be aware of some of the symptoms described above, quite often the only tell-tale sign is the evidence present on your teeth. You may not feel like you are grinding/clenching, especially if it's limited to moments during your sleep. And this is quite common.
2. How can this be if I sleep with my mouth open?
You may not necessarily be grinding or clenching your teeth for the entire duration of your sleep. It can happen intermittently throughout the night. However, the excessive forces are enough to do significant damage during these short bursts of activity.
3. Are there different types of nightguards?
Yes, depending on your symptoms, and the kind of damange present, there are different types of nightguards that would be better suited to you. Often you only need a nightguard to be fitted either your top or bottom teeth, not both!
4. Can I just purchase one over the counter?
Nightguards fabrciated by your dentist are custom fit to your mouth specifically. They are fabricated by taking moulds of your teeth and then a dental lab technician will custom make a nightguard specifically to fit your teeth and jaw. Store-bought nightguards offer a much softer appliance of inferior quailty, and more importantly, a one-size fits all approach that often worsens the situation and can lead to serious damage down the line.
5. Will a nightguard relieave my headaches?
Yes. If the primary reason for your tension type headaches and sore muscle jaws is nightime clenching and grinding of your teeth, you will feel great relief. Other reasons could be the culprit as well, however. Thus, it is very important to have the correct diagnosis before any treatment is indicated.
6. Do I have TMD?
Temperomandibular Disorders (TMD) refers to a wide collection of conditions associated with the Temperomandibular Joint (TMJ) and associated structures. What we have described above is limited specifically to issues resulting from habits like grinding and clenching, and not necessarily related to problems within the joint itself. A proper diagnosis can differentiate a problem with the joint itself from issues resulting from habits. Often times, joint problems require a nightugard as well to stabilize the joint. However, as always, a thorough examination is the only way of establishing a correct diagnosis and effective treatment.
7. How much do they cost? Is it covered by my dental benifits?
The cost is often about the same as a regular dental filling, and less than third of what it would cost ot repair a broken tooth with a crown or cap. Dental benifits typically cover preventative procedures - however, the only way to know is to send an estimate in and find out.
Teeth Grinding in The Media
When Stress Takes a Toll on Your Teeth
By CAMILLE SWEENEY
WITH economic pressures affecting millions of Americans, dentists may have noticed a drop in patients opting for a brighter smile, but they are seeing another phenomenon: a rise in the number of teeth grinders.
“I’m seeing a lot more people that are anxious, stressed out and very concerned about their financial futures and they’re taking it out on their teeth,” said Dr. Steven Butensky, a dentist in Manhattan.
One of his patients lost hundreds of thousands of dollars invested with Bernard L. Madoff. Another reported that he had lost a job with a seven-figure salary. A third, a single mother with a floral design business on Long Island, said she was working twice as hard for half as much.
“All three are grinders, directly affected by what’s going on out there,” Dr. Butensky said, gesturing outside his Midtown office window.
Dr. Robert Rawdin, another Manhattan dentist with a specialty in prosthodontics, said he had seen 20 to 25 percent more patients with teeth grinding symptoms in the last year. And in San Diego, Dr. Gerald McCracken said that over the last 18 months his number of cases had more than doubled. They, along with other dentists interviewed for this article, chalk it up to the economy.
“We’re finding in a lot of double-income families, we have the people who have lost jobs and are worried, and then we have the spouse, who still has the job, with the added pressure and uncertainty,” Dr. McCracken said. “This can cause some real grinding at night.”
With or without economic hardship, 10 to 15 percent of adult Americans moderately to severely grind their teeth, according to Dr. Matthew Messina, a dentist in Cleveland and a consumer adviser for the American Dental Association.
Because it is a subconscious muscle activity, most grinders grind without realizing it, until a symptom such as a fragmented tooth or facial soreness occurs.
While many experts believe that genetics may play a role in bruxism (or teeth grinding), stress has long been known to set off clenching and grinding in some people, Dr. Messina said. “Recession breeds stress and our body responds to stressful events so in times like these, the incidence of bruxism goes up,” he said, adding that over the last year or so he had heard from dentists around the country who had seen an uptick in patients with bruxism while also complaining about financial stress. In his own practice, he said he had treated twice as many cases in the last year than in the year before.
“Stress, whether it’s real or perceived, causes flight-or-fight hormones to release in the body,” he said. “Those released stress hormones mobilize energy, causing isometric activity, which is muscle movement, because that built-up energy has to be released in some way.”
The most expensive option for rebuilding teeth damaged by grinding is with veneers, but this year, dentists say that many of their bruxism patients are requesting one of the least costly treatments: a night guard, also known as an occlusal splint.
Stan Goff, executive editor of Dental Products Report, a monthly publication, wrote in an e-mail message that all this teeth grinding “may be playing a role in the introduction of several new products designed to not only prevent bruxism, but to help fight against tooth sensitivity” and other conditions that are aggravated by grinding.
While experts believe bruxism is not a dental disorder per se, but rather originates in the central nervous system, the condition can greatly affect the teeth and the entire craniofacial structure.
“Normally, we exert about 20 to 30 pounds per square inch on our back molars when we chew,” Dr. Rawdin said. “But teeth grinders, especially at night without restraint, can exert up to as much as 200 pounds per square inch on their teeth.”
Some nocturnal grinders will grind up to 40 minutes of every hour of sleep. The relentless wear and tear can quickly erode enamel (10 times faster than that of nongrinders),fracture teeth, affect bite and damage the temporomandibular joint at the hinge of the jaw, and the masseter muscle, which controls the jaws. Jaw and face pain, as well as earaches and headaches, may also occur.
“I kind of thought I was going crazy,” said Adrienne Lee Kornstein, 48, a patient of Dr. Butensky, whose floral design business in Jericho, N.Y., has suffered because of the economy. “A tooth broke for what seemed like no reason, and by the time I got to Dr. Butensky, I’d been to my physician, other dentists, even a dermatologist to try to get relief from migraines and facial pain I was taking painkillers for. I had no idea I was grinding or that grinding your teeth could even lead to all that.”
The most common treatment for the disorder is to wear a night guard, which may not only alleviate grinding but, in some cases, train someone to stop grinding altogether.
Fitted in the dentist’s office, a custom guard is usually a clear, hard plastic device that runs over the top or lower teeth from front to back and prevents the top and bottom molars from making contact. Although not cheap (the price can range from $350 to $1,000), dentists reccommend a custom guard to over-the-counter guards, which are usually made of softer material and can encourage chewing and exacerbate masseter muscle activity.
Many teeth grinders interviewed said they would not go to bed without their night guards.
“Sometimes I wake up in the middle of the night and having my guard in makes me more aware if I’m tensing my body or gripping my jaw, and I can just take a moment to relax,” said Alisa Fastenberg, 50, a graphic designer in Manhattan.
Other treatments for teeth grinding include acupuncture, medical massage, hypnosis and Botox injections into the masseter muscle to relax the muscle enough to stop it from going into spasms without changing one’s chewing function.
“Grinding is like body building,” said Dr. Alexander Rivkin, a head and neck surgeon at Westside Aesthetics in Los Angeles, who has also seen an increase in grinding-related cases this past year. “The constant workout of the masseter muscle, the largest in the head, builds up that muscle and that can cause a lot of pain, not to mention make the face appear more square.”
He added, “For, I’d say, 85 percent of the people who come to me complaining about headaches, jaw soreness and pain, Botox injections into the masseter muscle on both sides of the face is the answer.”
But even something as simple as taking time before bed to de-stress has been known to help.
“Good sleep hygiene goes a long way to keeping the mind relaxed and the jaws from starting to smack together,” said Dr. McCracken, who has studied the relation of sleep to teeth grinding. “We know that the stress center of the brain is directly next to the part of the brain that controls teeth grinding. We’re not sure how it relates to the disorder, but it’s intriguing. Lately, I even tell my patients, before they go to bed, not to watch the news.”