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Modern dentistry has evolved from the days of just a simple nightguard for grinders. A well trained dentist can treat a number of issues that were not even considered even 15 years ago. Bite appliances can be utilized in treatment of, the combination of clenching and bruxing, obstructive sleep apnea, TMJ pain, and sports mouthguards. These appliances allow patients to live more comfortable, healthier lives while enjoying the activites they love.

Teeth Clenching and Teeth Grinding (Bruxism)

These are fairly common issues for many Americans. Studies have been unable to pinpoint the exact number of people in the population that grind or clench but it is believed, that most people at some point in their life will experience this habit. This is sometimes considered to be a stress related habit. Most patients with these habits, do so while sleeping, so they are unaware of the forces exerted on their teeth while they sleep. Teeth clenching and grinding can cause a number of dental issues that include:

-Loose Teeth.

-Temperature Sensitivity.

-Tooth Chipping and Fracturing.

-Flattened teeth.

Bite Appliances are used to protect the teeth and also to re-train us to prevent continued grinding and clenching. These bite appliances are made from polymers and acrylics. They are generally custom made for each patient for added comfort and protection. These bite appliances work by not allowing the teeth to touch, making it restrictive to clench or grind. For those with an extreme form of these habits, it is not unusual to grind through the appliance over time necessitating a new appliance to be made.

Obstructive Sleep Apnea (OSA)

This is sometimes known as the “silent killer”. Obstructive sleep apnea can be potentially a very serious sleep disorder in which breathing repeatedly stops and starts during sleep time. Obstructive sleep apnea is believed to affect about 25% of the population. Obstructive sleep apnea is characterized by:

-Excessive daytime sleepiness.

-Both habits of clenching and grinding at night.

-Episodes of breathing cessation during sleep.

-Awakening abruptly accompanied by shortness of breath.

-Dry mouth or sore throat upon waking in the morning.

There are generally two types of bite appliances available for obstructive sleep apnea. These include over the counter ones and custom fabricated ones. The idea behind either of these bite appliances is to maintain an open airway during sleep to stop the disturbances from occurring.  These bite appliances work by repositioning the lower jaw, tongue, and soft palate. The custom fitted appliances tend to work far better than the generic ones.

TMJ Disorder appliances

These bite appliances help to reposition and decompress the jaw. TMJ disorder appliances are generally worn at night, and help to decrease the inflammation and pain associated with TMJ instability.

Athletic Mouthguards

These have really come into fashion in the last decade, as more and more research has gone into sports medicine, better airway maintenance and prevention of concussions. The old days of the generic “boil and bite” mouthguard are slowly fading away. We are now in the age of custom fitted athletic mouthguards that are able to not only give better protection against injury but also increase athletic performance. The thinking is, that how an athlete clenches his/her teeth together changes the way the brain reacts. When using a proper athletic mouthguard, your brain will be better able to handle temperature regulation as well as stress.

Bite Appliances Conclusion

Bite appliance therapy has been around for quite some time but recent advances (in both technology and theory) have made the treatments even more effective than before. A small investment in a good bite appliance can make the world of difference in the health and well being of your teeth for the rest of your life.

Just about everyone will grind their teeth from time to time. Grinding of your teeth (bruxism is the medical term for this) on rare occasions generally does not cause any harm. But when teeth grinding and clenching occurs on a regular basis damage can occur to the teeth, surrounding tissues, and other oral health complications can present themselves.

What is Teeth Grinding?

teeth grinding

Bruxism is the term that refers to a constant grinding and clenching of the teeth and jaws, unintentionally, and at inappropriate times. Bruxers (people with bruxism) are often unaware that they have developed this terrible habit. They often do not know or realize that treatment is available until damage to the mouth and teeth has already been done. Bruxism damage can present itself in a variety of ways. Every individual may experience symptoms a little differently.

Stress and anxiety are often thought as the major culprits of grinding. But it often occurs during sleep and is just as likely to be caused by an abnormal bite alignment (occlusion) or missing or crooked teeth.

Bruxism is considered to be a habit rather than a normal reflexive chewing activity. Reflexive events are responses to various stimuli and always occur without you being able to stop them (like the little hammer on the knee which makes your leg kick). Chewing and clenching can be controlled either consciously or subconsciously by the brain. During sleep, and often during daytime awake hours when we are distracted, our subconscious can take over allowing teeth grinding to happen. Bruxism can be quite rhythmic in nature. Researchers have classified bruxism as a habitual behavior and a sleep disorder.

Signs and symptoms of bruxism or teeth grinding can include:

-Anxiety, stress, and/ or tension. This can include tense musculature of the face and jaws. Waking up with an ache in the jaws face or teeth, or a headache.

-Teeth appear worn down or loose. Wear occurs from the aggressive movement of the teeth against one another. Although all teeth may show this type wear, it is especially noticeable when a person has front teeth that appear having theteeth grinding same length, as if they were somehow filed down.

-Chipped or cracked teeth. As teeth become worn, the edges of front teeth and the cusps (or corners) of back teeth will begin to show tiny fractures or cracks. These cracks generally can not be visualized by x-rays. It takes magnified vision or use of a dental microscope to diagnose them. Teeth with these type of fractures may eventually require further extensive treatment to restore their function. This could include large fillings, crowns, or even root canal therapy. Root canal treatment would be needed if the nerve was so inflamed that it could no longer heal itself, or a fracture extended into the nerve or pulpal area of the tooth allowing bacteria to leak in.

-Tooth sensitivity that is quite pronounced. Can be a constant ache, sensitive to touch or chewing,  hot, cold, or even sweet sensitivity.

-Receding gums and/or teeth with notches in them at the gum line. Most people have been told or assume that receding gums occur because of age, aggressive brushing or the presence of periodontal disease. In the majority of cases this is wrong.Bruxism These are called abrasion areas. When teeth grind hard against each other over time, the teeth will flex at the gum line and the enamel (which becomes quite thin in this area) micro fractures away. You end up with an area at the gum line that you can catch your fingernail in and can get very sensitive to touch and/or cold due to exposure of the root and closeness to the nerve endings.

-Jaws falling out of normal position or locking.

-Wearing away of the tooth enamel, exposing the dentin under the enamel.

-A popping or clicking in the temporomandibular joint (TMJ).

-Damage to the inside of the cheek tissues and tongue. Sometimes a bruxer will actually bite themselves on inside of the cheeks and tongue, (especially in the back part of the molar area).

The symptoms of bruxism can resemble other conditions or medical problems.

How is Bruxism Diagnosed?Teeth grinding

During routine dental examinations, your dentist will examine the teeth for evidence of bruxism. This often noted by the damage to the teeth. If the signs are present, the dentist may ask you some follow up questions to see if you have any of the other symptoms, such as snoring.It has been found that patients who both snore and grind have a much higher chance of developing sleep apnea.

Treatment

The goals of treatment are to reduce or remove pain, prevent permanent damage to the teeth, and to decrease the actual clenching. Treatment generally includes a custom made nightguard. The night guard is made for you to hold your teeth in a better position and protect your teeth when you grind to absorb the force of biting. This guard may help to prevent future damage to the teeth and aid in changing the patient’s behavior over time.

As always maintain a regular schedule of visiting your dentist so that these issues can be diagnosed in a timely manner should they arise. Also, of note is that this can affect children as well.