Clenching and Grinding

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For many years it was thought in dentistry that people would clench and grind their teeth at night due to stress. An examination of the literature shows that this is not the case. It has been proven time and time again that stress causes clenching and grinding during the day, however the same has not been proven to be true for night time. Though there is some debate about the cause of night time grinding (bruxism), we know that it is a malady that can cause some real problems for patients in their day to day lives. As far as day time bruxism, the main key to remember is that this action is controlled by the subconscious so anytime our brain is occupied with another task, clenching and grinding can occur as we are distracted. The action of clenching and grinding causes repeated contraction and relaxation of the muscles we use to chew. This causes a build up lactic acid which results in sore muscles. This phenomenon is similar to what happens after an intense work out. As lactic acid builds up, the chewing muscles can become more and more tense causing pain, discomfort, headaches, jaw-locking and popping.

Unfortunately, there is rarely a quick and easy cure for this disorder. Initially, we often recommend three steps be taken. Those steps are:

1) Semi soft diet for 10-14 days- This does not mean only pudding and soup. Regular types of foods are usually okay but you want to avoid very chewy foods like gum, taffy, chewy candy, and tough meats.

2) Ibuprofen for 10-14 days- Ibuprofen is a NSAID (non-steroidal anti-inflamatory drug) and really helps to reduce the inflammation in the muscles. Take the ibuprofen as directed on the package for 10-14 days continuously, even if there is no pain.

3) Warm moist compress- This increases circulation to the muscles, allowing the lactic acid and inflammatory factors to be eliminated faster. Moist-heat heating pads can be purchased at drug stores or a wash cloth that has been soaked in hot water and wrung out will suffice. With a moist-heat heating pad, you will not need to get up to re-warm the wash cloth. You want to ensure that each side of your jaw gets around 10-15 minutes of contact with the moist heat once or twice a day for 10-14 days.

With these three steps, some of the symptoms of bruxism should be diminished. If night time grinding is occurring, we may start a conversation with you about sleep. There is good evidence that night time bruxism can result from an issue with breathing during sleep. If this is the case, then we will work with the appropriate medical specialists to achieve a diagnosis. You may also need to wear a custom calibrated night guard on a nightly basis to promote healthy jaw posture and prevent further wear on your teeth. A custom night guard works much better than one of the pre-fabricated night guards available at drug stores. The pre-fabricated or boil and bite night guards can put unnecessary stress on your jaw joint, exacerbating the problem. An ideal night guard should fit comfortably and not impede with normal sleep function. We find that night guards reduce wear on patient’s teeth and reduce pain and headaches. In addition, a well fitted custom night guard can increase the quality of sleep you are getting.

Certainly many patients can clench or grind their teeth and have little to no pain or discomfort. This can be a problem when the teeth are being worn down at an accelerated rate. A night guard will help with this as well as it protects the teeth from wearing down even more.

If you feel you are suffering from this disorder, please let us know and we can formulate a treatment plan for you!