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Grinding and Clenching

March 31, 2014

Filed under: General Dentistry — drasinmaz @ 5:23 pm

Have you ever looked at your teeth and wondered “are my teeth actually getting smaller?” Grinding (bruxism) and clenching is highly destructive to the teeth and periodontal (gum and bone) structures that support them. This doesn’t happen overnight. It is a cummulative affect that may take years to progress to the point where you actually notice the destruction. Even then, some people don’t realize that the destruction is something preventable.

Grinding and clenching occurs mostly at night time, but can happen during the day as well. It is considered to be a habit that is picked up in response to a stimulus, and often continues even long after that stimulius has been removed.

During every examination, I look for the signs of grinding and clenching so that we can address the problem and prevent this catastrophic destruction.

Let’s start by identifying some of the signs and symptoms:

  • short teeth and teeth that appear flat and lack the apprporiate anatomy.
  • wearing through the hard enamel of the tooth and into the soft secondary dentin layer. I can take a picture and show you on the monitor very easily.
  • soreness in the muscles of the face, neck and shoulders, especially when you wake up in the morning.
  • pronounced jaw mucles. Think of a bodybuilder who does heavy weight lifting. They have big muscles right?

Well your grinding and clenching is like taking your jaw muscles to the gym every night. They start to look bigger!

  • catching yourself clenching your teeth when you are stressed
  • presence of headaches
  • teeth and restorations that are fracturing or are showing fracture lines
  • receeding gums
  • V-shaped notches where the tooth and gum meet that may or may not be sensitive
  • generalized feeling of sensitivity of all teeth in the mouth
  • teeth that are noticeably getting looser

I see too many older patients where the destruction is so advanced that the only way to correct is with reconstructive dentistry with implants or crowns, or a combination of the two.

This is an extremely costly way to restore your teeth. To avoid this, I will recommend a custom made occlusal splint (night guard).

How does an occlusal splint work?

An occlusal splint does not stop you from grinding and clenching. What is does is it limits the amount of force your jaw muscles can place when you do inevitably grind and clench and limits the wear to the splint and not your teeth!

The splint is worn at night time and will fit on either the top or bottom teeth (usually the top).

How is an occlusal splint made?

We start by taking an impression of your teeth. Our lab will then make a custom fitting occlusal splint that is comfortable and does not interfere with your airway or push up against your lips and cheeks. It is hard on the outside and soft on the inside.

You will see a “knock-off” version of these in many pharmacies. They are essentially large pieces of plastic which you have to boil to fit to your teeth. They are bulky and uncomfortable when compared to a custom made splint. They are not even remotely close to providing the functionality of a true occlusal splint because they are too soft and cannot limit the forces of the jaw muscles effectively.

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