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Bruxism
If you wake up with dull headaches or vise-like pain, you may be one of many people who grind their teeth at night. Many people are unaware they even have the disorder (called bruxism) because it often occurs at night during sleep. Your dentist can usually detect the telltale signs of wear on your teeth. Bruxism is the technical term for grinding and clenching that abrades teeth and may cause facial pain. People who grind and clench, called bruxers, unintentionally bite down too hard at inappropriate times, such as in their sleep. In addition to grinding teeth, bruxers also may bite their fingernails, pencils and chew the inside of their cheek. People usually aren't diagnosed with bruxism until it is too late because so many people don't realize they have the habit. Others mistakenly believe that their teeth must touch at all times. About one in four people suffer from bruxism, which can easily be treated by a dentist.
Bruxism causes harmBruxism can either directly or indirectly cause many problems. Grinding can cause teeth to become painful or loose. Patients can literally grind away parts of their teeth, leaving them with worn surfaces or fractured enamel. People who have otherwise healthy teeth and gums can clench so often and so hard that over time their teeth become sensitive and they experience jaw pain and headaches. Forceful biting when not eating may cause the jaw to move out of proper balance.
Signs of bruxismGrinding is a common occurrence among many people at some time or another. If you develop facial pain, fatigue or other problems, treatment may be needed. Talk with your dentist if you suspect that you are grinding your teeth. During regular dental visits, we usually check for physical signs of bruxism. If we notice signs of bruxism, the condition may be observed over several visits to be sure of the problem before recommending and starting therapy. When a person has bruxism, the tips of the teeth look flat. Teeth are worn down so much that the enamel is rubbed off, exposing the inside of the tooth, which is called dentin. When exposed, dentin may become sensitive. Bruxers may experience pain in their temporomandibular joint (TMJ)-the jaw-which may manifest itself as popping and clicking. Women, who are more susceptible to TMD, also have a higher prevalence of bruxism possibly because they are more likely to experience tissue alterations in the jaw resulting from clenching and grinding. Tongue indentations are another sign of clenching. Stress and certain personality types are at the root of bruxism. For as long as humankind has existed, bruxism has affected people with nervous tension. Anger, pain and frustration can trigger bruxing. People who are aggressive, competitive and hurried also may be at greater risk for bruxism.
Factors contributing to bruxismMore research is needed to determine the exact cause of bruxism, but it is thought that both emotional and physical factors are involved. Some of the contributing factors may be stress or sleep disorders, an abnormal bite or crooked or missing teeth.
Treating bruxismThere are a number of ways to treat bruxism. Your dentist will determine which single treatment or combination of treatments is right for you. When stress is the major cause of bruxism, people need to find ways to relax. People who have difficulty handling stress may need to seek counseling or the dentist may prescribe muscle relaxants to relax jaw muscles. We many times can prescribe a night guard, which prevents grinding from occurring during sleep. To help alleviate muscle pain, physical therapy may be needed. The objective of therapy is to get the bruxer to change behavior by learning how to rest the tongue, teeth and lips properly. When some people become aware of their problem, simply advising them to rest their tongue upward with teeth apart and lips shut may be enough to change their behavior and relieve discomfort. However, the dentist can make a plastic mouth appliance, such as a night guard that's worn to absorb the force of biting which causes damage and pain and also helps to change patient behavior.
Dental night guards and other protective appliancesNighttime appliances help keep teeth from moving and protect the ceramic restorations. Designed correctly, they protect teeth from wear damage caused by grinding or clenching. A night guard is a plastic mouth guard worn at night to prevent tooth grinding. A bite plate is a removable plastic device, which prevents teeth from coming together. In some cases, such as with an overbite, it may eventually improve the bite. A method used to treat the damage caused by more serious cases of grinding involves reshaping or reconstruction of the biting surfaces with crowns or inlays or a full mouth restoration.
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