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  • October 21, 2014

Bruxism - Ladue News: Health-wellness

Bruxism

The Nightly Grind

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Posted: Thursday, May 20, 2010 12:00 am

If you could save thousands of dollars in dental work, not to mention pain and suffering, by wearing a simple mouth guard at night, why wouldn’t you? Tooth grinding, or bruxism, occurs mostly at night and can damage our teeth in any number of ways. “Bruxism is very destructive and most people don’t know they are doing it,” says dentist Steven Workman of Des Peres Dentistry. “It causes wear and cracking of the teeth. Symptoms include headaches, especially in the morning; sore jaw; tooth sensitivity; and sometimes earache.” The dentist can check for wear on the teeth and bite imbalances. Treatment is wearing a night guard or splint.

He says tooth grinding is very common in children, as their jaws and teeth are growing and constantly changing. Using a mouth guard could have a negative effect on development, but usually, their tooth grinding is transient and doesn’t require treatment, he says.

For adults, however, these are the only teeth we’re going to have. Workman says that a night guard should be custom-made for your mouth. Most over-the-counter guards are too soft, according to Workman. “Even though the teeth are covered, the soft material makes you want to clench your teeth even more,” he explains. “The one your dentist makes is hard and protects teeth, discouraging clamping down.” Most mouth guards are made for the full jaw, either upper or lower. For people who find a full-mouth guard cumbersome or who experience migraine-like headaches, a specialized guard called an NTI splint is approved by the FDA for both migraines and bruxism. It usually fits over the four top front teeth and prevents the canines on either side from engaging. That prevents the masticator muscles from clenching and creating tension in other head muscles that can trigger some migraines.

Christopher Wolken, who practices dentistry at Wolken Dental, says the majority of his patients have signs of bruxism. “Those signs may include headaches, jaw pain, chronic tooth tenderness and worn-down teeth,” Wolken elaborates. “People don’t realize how many types of problems are related to tooth grinding…Stress is a big part of it, especially during a down economy, and can come out in tooth grinding. It has a cumulative effect. If you have periodontal disease and add trauma to it with bruxism, it makes the periodontal disease worse and adds inflammation.”

Wolken explains that the guard provides a stable position for the jaw to rest in at night and a sturdy platform across all the teeth. He uses the NTI guard for specific patients. “The masseter muscle in the jaw is the strongest muscle in the body, pound for pound,” he says. “By preventing the canines from engaging, we can prevent the grinding impact and firing of that muscle group that can perhaps trigger a migraine.”

Tooth grinding, over time, has a snowball effect. Wolken says some people grind their teeth so much that they inflame the nerves and need root canals. After a root canal, the tooth becomes more brittle, so continued grinding breaks it. Then the tooth has to be crowned, and if the patient continues to grind, it can break down the bond between the crown and the tooth, allowing decay under the crown.

For patients who have cosmetic dentistry done, protecting their investment should be a concern. “When we do porcelain veneers on a patient, we also make a mouth guard to protect their investment,” Wolken says. “Grinding the teeth at night can shatter the veneers and that’s a lot of money down the drain.”

He reports that over-the-counter mouth guards, while cheaper, can actually aggravate problems. “When you bite down on the soft material, the teeth sink in and are locked into position, which can actually torque the temporomandibular joint,” Woken explains. “Having your own custom-made rigid mouth guard is a good investment.” The math says it all: night guard, $300; a single crown from breaking a tooth, $1,000; keeping your own teeth: priceless.

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