Bruxism refers to the subconscious oral habit of clenching the jaw and grinding the teeth either during the day and/or at night. The result of the continual grinding habit can lead to excessive tooth on tooth wear. Patients demonstrating bruxism can have biting forces up to ten times greater than normal as a result of having extra strong facial muscles due to continued use while clenching and grinding. The destructive elements of the condition are a result of this increased biting force and the amount of time that those forces are applied to the teeth.  

Bruxism can be exacerbated by the use of certain medications such as antidepressants, sleep apnea, and often accompanies chronic stress. If left untreated, bruxism will continue to wear the teeth to the point that they may no longer be restorable. 

One of Dr. Benting's patient cases in particular demonstrates the results of excessive tooth wear caused by bruxism. Note the flattened tooth edges and the shortened appearance of the teeth. This shortening of the teeth results in a "closed bite" as the upper and lower jaws become closer together.  

The patient has worn through the enamel into the underlying softer tooth structure called the dentin. Once into the softer dentin, the progression of tooth wear increases dramatically. Any further tooth wear at this point could limit the treatment options available for restoring the teeth to normal shape and function.   

A BiteStrip^® is an economical device used to diagnose bruxism at home. The device itself is a small electromyography which senses and monitors any activity in the jaw muscles during sleep. The frequency and severity of the condition can then be assessed and the best treatment plan can be formulated.

Reasons for the Treatment of Bruxism

Here are some of the main reasons why bruxism should be promptly treated:

• Closed Bite - Continuous grinding of the teeth can lead to excessive tooth wear and shortening of the teeth thus bringing the jaws closer together. This closing of the bite can cause changes in facial appearance.    
• Gum recession – The constant forces applied to the teeth while clenching and grinding can lead to gum recession.
• Occlusal trauma – Increased biting force placed on certain teeth can lead to loosening of the teeth. In addition, the abnormal wear patterns on the occlusal (chewing) surfaces can lead to fracturing of the teeth, which may require restorative treatment.  
• Arthritis – In severe and chronic cases, bruxing can eventually lead to painful arthritis in the temporomandibular (TMJ) joints (the joints that allow the jaw to open smoothly).
• Myofascial pain – The grinding associated with bruxism can eventually shorten and blunt the teeth. This can lead to muscle pain in the myofascial region and debilitating headaches.

Occlusal Guard 

An Occlusal Guard is a removable dental appliance constructed as a palliative measure for patients with a history of clenching and grinding habits with the goal being to minimize tooth wear. An acrylic occlusal guard can be custom designed from dental impressions to protect the teeth by minimizing the abrasive action of tooth to tooth contact during sleep.

Because clenching and grinding the teeth is (in most cases) an unconscious habit, it is impossible to turn off the signals to the chewing muscles that transmit the destructive forces involved in clenching and grinding. Occlusal guards should be worn daily and on a long-term basis to help prevent tooth damage, damage to the temporomandibular joint, and to help stabilize the occlusion (the bite).