Teeth Grinding and Clenching

Dr. Shapira Blog 0 Comments

Are you a teeth grinder or clencher?

Teeth grinding and clenching, chicagoGrinding and clenching of teeth is a disorder that many people do not know they have. It’s an involuntary action that often occurs while you are sleeping, and the clencher is often not aware that it is happening. The condition is normally first noticed by someone else who can observe you while you sleep.

 Grinding your teeth is a warning sign of possible Sleep Apnea or UARS

These sleep disorders contribute to chronic pain and a host of other medical problems.  Evaluation for Sleep Disordered Breathing should always be considered in patients with bruxism.

Nevertheless, this is a sleep disorder that could benefit from medical evaluation for a potential TMJ problem. The clenching episodes are not normal and they could be an indication of an underlying medical problem, which may be more severe than you realize.

Grinding can take a toll on your teeth

Night time teeth grinding is common, and many people grind their teeth while sleeping on a minimal basis. However, people who experience daytime teeth clenching are probably having gripping episodes during sleep also.


What is Bruxism and what is a bruxism appliance.

Bruxism includes the spectrum of clenching, of the teeth, grinding of the teeth, the very destructive form of clench and grind where the heaviest forces are placed on the teeth.  Bruxism can cause severe tooth wear as well as fractured restorations and even breaking of teeth.  Vertical fractures from bruxism can be painful and difficult to diagnose.  Abfractions (often misnamed cervical erosion)are stress fractures along the roots of the teeth at the gum line that can be extremely sensitive, especially to cold.

While this is not exactly a dangerous condition, it can still be problematic. Teeth can get gnashed or damaged in a variety of ways, especially if the condition is chronic. Even momentary clenching can cause tooth wear if it occurs on a regular basis. A bruxism appliance may be recommended to prevent ongoing damage to your teeth.

A bruxism appliance is made to be worn during sleep to prevent damage caused by clenching and grinding.  It is not the same as an orthotic designed to treat TMJ nor is it a treatment for sleep disordered breathing or sleep apnea.  The bruxism appliance is designed to absorb the forces of wear from the teeth. Because the plastic is softer than the teeth the plastic wears down instead of wearing down teeth.

The real trouble is that the clenching and grinding is an indication or possible cause of a TMJ disorder, which can easily lead to other physical problems such as migraines or other types of pain.  Patients who have pain only upon awakening should consider a bruxism appliance.  If the pain comes  and goes through the day or appears later in the day the presence of a TMJ disorder or TMD should be investigated.

What is TMJ?

The TMJ, medically termed as the temporo-mandibular joint, is located just below the ear and is a very complex part of the body. TMJ problems can lead to pain in the jaw, teeth, ears, and eyes. Some severe TMJ disorders even lead to TMJ headaches, often misdiagnosed as migraines.

Just because pain is experienced in a specific region does not mean the causation is local. The muscles and tissue surrounding the TMJ are stronger than most people realize because the mouth is used constantly during the course of a day. People tend to take this body function for granted, but it is clearly one of the most important things we do on an ongoing basis.

TMJ can cause a host of problems

TMJ disorders can also lead to other medical and dental problems.

  • An asymmetrical mouth can result in a bad bite, the inability to chew food properly, and damaged teeth.
  • Pain can develop in a range of places, including headaches and sore muscles down the back or chest.
  • Since the ear is located immediately above the TMJ, painful symptoms can also include the ear.

TMJ problems as well as airway problems can be treated with a DNA

Appliance and Epigenetic Orthodontics.

When there are problems caused by a narrow mouth and /or nose, breathing obstruction or significant crowding  the underlying structural problems can be addressed by orthopedically growing the upper and lower jaw bones and Pneumopedically growing the airway.

Protect your teeth whatever  the underlying cause

If you are experiencing clenching or grinding teeth, seek medical attention from a TMJ dental professional for an assessment in designing a personal TMJ orthotic that can provide some relief from this potential sleeping problem.

Grinding Teeth, Bruxism, Clenching and Anterior bracing

Dr. Shapira Teeth Grinding 0 Comments

Are you grinding teeth?


Do you find that you grind your teeth a lot? Sometimes, you just don’t know that you are doing it until someone else notices and asks you about it.

Teeth grinding is also called ‘bruxism’ and has a number of different causes. Teeth grinding can be painful and have an effect on your temporomandibular joint (TMJ), which is the joint between your jawbone and the rest of your skull.

There are many variations on bruxism;  Nocturnal Bruxism is the term used for bruxism that occurs during sleep.  Bruxism  can be divided into grinding, clenching, and anterior bracing.  Grinding and Clenching simultaneously  is the  most damaging of all nocturnal bruxism but severe damage can be caused by just grinding or just clenching.  Frequently the most severe damage to teeth is seen with grinding and gastric reflux or GERD.

It can be caused by a sleep disorder like obstructive sleep apnea (OSA). Nocturnal bruxism in patients with sleep apnea or upper airway resistance syndrome actually is a protective response to airway closure.  When the airway collapses clenching and/or grinding stiffens the oral and hypopharynx to maintain an open airway.  This may be a lifesaving effect of bruxism.  GERD frequently occurs in patients with snoring and sleep apnea.

If you suffer from depression you may have been prescribed a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI). This class of drugs includes fluoxdetine, setraline and paroxetine and have been associated with bruxism, too.  Excessive smoking and alcohol consumption can also give rise to bruxism.  Frquently drugs used to treat ADD and ADHD can cause severe bruxism.

The implications of teeth grinding

Teeth grinding is a dental problem as teeth can be damaged – sometimes beyond repair.  The teeth can have severe wear, fractures and chipping.  Your temporomandibular joint are also  affected,  meaning bite  correction may be required to repair the damage.

If you are grinding your teeth while you are asleep you may not be fully aware of the damage it is doing to your them. Your partner will know better than you by the sound of your teeth making grinding, clenching and gnashing noises all night.  Bruxism associated with sleep apnea and gastric reflux is more destructive.

Bruxism can make you look much older than you are.

When there is excessive grinding of the teeth there is a loss of  vertical dimension, or your face gets shorter as your teeth wear down.  The muscles and soft tissues of you face are now compressed with closure giving a permanent frown that often looks like your angry.  Wrinkles occur you over closure does not support your face.

Stop the wear and tear

stop-teeth-grindingThe first way you can help bring a stop to teeth grinding during sleep is to wear a splint or teeth grinding guard at night. When the custom made mouthguard is fitted between your lower and upper teeth it creates a barrier so that it protects both sets of teeth.  

The mouthguards look like the ones used by boxers. We get them fabricated from a flexible rubber or plastic material which fits comfortably in your mouth. We can also get a mouth splint made up of harder plastic which fits exactly over your lower or upper or lower teeth.

Another appliance we sometimes use is a mandibular advancement device (MAD), normally used for the management of sleep disorders, like snoring and obstructive sleep apnoea. This device can help prevent bruxism and damage from bruxism.  It will frequently eliminate nocturnal gastric reflex as well.

The device comprises of two mouth guards (one for the bottom teeth and the other for the top teeth) that are welded to form one piece. You wear it in your mouth throughout the night and it keeps your bottom jaw forward and closed while you sleep.

Find out which treatment is right for you:  The wrong treatment may make you worse!

If you are prone to teeth grinding and it is beginning to damage your teeth, it is wise to have a thorough evaluation to discover what is causing it. There may be other factors which can be tackled, like smoking, medication and alcohol consumption which all need to be addressed, too.

When you make a decision to reduce your teeth grinding with the help of dental treatment we can fit you with one or another of the modern devices which we have available, which can provide an effective solution.

Bruxism is frequently associated with sleep apnea but what many dentists don’t know is that some types of bruxism appliances can make sleep apnea more severe.  Ideally a dentist board certified in Dental Sleep Medicine should be consulted for sleep apnea and snoring treatment.  Their expanded knowledge into sleep disorders can make an enormous difference in the type of appliance selected.