23 Jan Teeth & The Daily Grind
Clenching and grinding of the teeth during sleep is something roughly 60% of patients will experience at some point in their lives, usually during times of high emotional stress.
Dentists are well aware of this and are happy to reassure many patients that these episodes will pass and require little or no treatment, but that is often where our knowledge runs out. This subject is not always covered in much detail during our years in dental school, so it is only through postgraduate courses that we really learn how to deal with bruxism.
What I didn’t realise until taking a course in the early part of 2017, is that around 6-8% of the population clench or grind every single night, regardless of their stress levels. Every time these patients fall asleep their central nervous system takes over and repeatedly activates the jaw muscles with huge force. These, “True CNS Bruxist,” patients often experience worn or broken teeth, headaches and a poor quality of sleep.
Another surprise to me was that clenching or grinding during waking hours is also very common. In fact I found that I do it myself!
So if you repeatedly fracture teeth or lose fillings, are gradually wearing down your teeth, sleep poorly or wake up with tender jaw muscles or headaches, what can be done???
- If you snore heavily, or wake up feeling tired despite having slept for several hours, ask your GP to organise a sleep study. It is important to rule out sleep apnoea before deciding on the correct dental approach to the problem.
- Ask your dentist for help. They can examine your jaw joints, muscles and teeth to help you uncover what is happening.
- While sleeping you have no conscious control over what your jaw muscles are doing. We want to protect the teeth and encourage the jaw muscles to relax as much as possible.
- This can be achieved by making a night-time splint. Various designs are available depending on what the main treatment goal is (stop snoring/protect teeth/heal a damaged jaw joint etc).
- Try to resist the temptation to ask for the splint you think looks the most comfortable, wearing the wrong type of splint can make matters worse! Let your dentist advise you and if they aren’t sure, a specialist will be able to offer guidance.
- Patients have often been clenching or grinding while they are awake for years without ever realising, this is surprisingly common but it also costs nothing to treat!
- Waking bruxism is a habit, it is something you can consciously control. You can self-treat this condition.
- You need to become aware of when your upper and lower teeth are in contact with each other and when your jaw muscles tense up.
- Normally our teeth touch very infrequently during the day, they should never need to stay in contact for several seconds or minutes at a time.
- Recognise when these habits occur. In the car? In front of the computer? Browsing on your phone? At the gym?
- Once you recognise the feeling of bruxism and know when you are most likely to do it, make a conscious effort to relax all your muscles, from your temples down to your toes.
- Set a 15 minute timer on your mobile phone. Every time it goes off check your teeth and jaw muscles. If you have everything relaxed when the timer goes off three times in a row, increase the time to 20 minutes and so on.
- Don’t be tough on yourself and don’t expect to resolve daytime clenching or grinding overnight. Remember, you may have been reinforcing this habit for several years, it will probably take at least a couple of months to re-train your jaw muscles to stay relaxed and to leave your teeth slightly apart.
Keep brushing, keep smiling.
Dr Calum Imray