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Monday 9am to 6pm
Tuesday 8am to 2pm
Thursday 9am to 6pm
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What is Bruxism?
Bruxism (pronounced BRUK-sizm) is the technical term for forcible grinding and clenching of the teeth. It usually happens at night, during sleep, although some people grind their teeth during the day as well. People who suffer from bruxism may also bite their fingernails or pencils, or chew the insides of their cheeks.
Do you grind your teeth?
How to find out if you're grinding your teeth? Because most bruxism happens at night, most sufferers aren't even aware of it until a sleep partner mentions the noise (an extremely disturbing sound, like fingernails on a blackboard), or until a dentist notices that their teeth are damaged. Here are some typical symptoms that may indicate nighttime teeth grinding:
Symptom checklist:
Jaw or facial pain and tenderness on awakening that lessens throughout the day
Headaches or earaches in the morning that go away as the day wears on
Spouse or sleep partner complains that the noise is keeping them awake at night
Teeth have become sensitive to cold, pressure, or other stimuli
Indentations on tongue
Tips of teeth appear flattened
Bruxism., Teeth grinding, TMJ, TMD, All of these words fall into the “catch –all” of TMJ syndrome. There is no real definition of TMJ because it is many things and can involve many structures of the head, neck and shoulders. TMJ symptoms range from pain in front of the ears (joint areas), to neck/shoulder pain, headaches, pain in temple areas and teeth.
Most TMJ symptoms are not strictly from joint problems. They are symptoms of the occlusion (how the teeth fit together) and / or the joints being in an incorrect position during heavy teeth grinding (bruxism).
Ideal occlusion is when the left and right TMJ are in the correct position and the back teeth can come together fully closed with no interferences and the front teeth do not touch. The front teeth only touch when the lower jaw moves left, right, or forward. The front teeth engage and separate the back teeth to keep them from grinding. This ideal is hardly ever seen.
What is usually seen is that when the dentist holds the jaw so the joints are in the correct position and the teeth are gently closed these is a first contact (or touch) keeping the rest of the teeth apart. Then when the jaw muscles are squeezed the teeth all come together. This means something changed position. What changed position was the lower jaw which means the joints moved out of ideal position. This creates stress in the area in front of the ears and in the muscles on both sides of the face and can involve the temple areas, sides of the head, neck and top of the shoulders.
Not all people have symptoms, some people grind their teeth and never have toothaches, muscle aches, earaches, headaches or neck/shoulder ache symptoms. These people just inexplicably chip, crack, break, and kill teeth over the years, never realizing it is the extra stress of grinding that is causing these problems.
An interesting measurement that scientists have done is this. People can generate about 100-150 lbs. of pressure per square inch by gritting their teeth together- when awake! That number goes up about 9 times during deep (REM) sleep to over 1000 lbs per square inch. That’s a lot of pressure.
So…how to treat? After an exam to define the areas of the problem, we make a hard acrylic splint (or occlusal guard/night guard) to fit on the lower teeth. This is custom fabricated to be in perfect occlusion so that when the joints are placed in correct position all contact will be even and simultaneous (both sides) on the back teeth only. Then when the jaw moves right, left, or forward the splint will separate the back teeth so they can’t grind. This allows us to treat but also to diagnose the problem.
TMJ/grinding problems are usually intra capsular (inside the joint) or extra capsular (outside the joint). Strictly intra capsular problems are rare and usually caused by some form of trauma or blow to the jaw. Most problems are extra capsular (with some component of intra capsular) resulting from chronic teeth grinding over a period of time, we use the splint as treatment , but also to diagnose. When worn correctly and maintained in adjustment, the splint usually brings about a lessening of the symptoms to where must people won’t sleep or be without it. For the few whose pain persists or whose symptoms don’t get better, they may have possible internal derangement of the joint or some other problem and can then be referred to the appropriate specialist.
The splint (or night guard) which is used to diagnose and treat is also considered phase I treatment. Many people choose to stay in phase I, wear their splint and do very well. They just need a new one every so often because they will wear out.
People who want to progress past wearing the splint need to go to phase II. Phase II consists of getting the teeth to do what the splint does. In other words, to get the teeth into ideal occlusion (or bite).
Phase II can consist of four modes, 1. Equilibration 2. Rebuilding some or all of the teeth. 3. Braces to move teeth 4. Surgical intervention. To use all four is extremely rare an in fact most cases can be handled by the first option – equilibration. This is a process of reshaping the tops of the teeth to remove the interferences to produce an ideal occlusion (or bite). If you feel you have symptoms or your teeth have strange wear patterns, schedule a consultation/exam to investigate your options.
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