“When I wake up, my teeth hurt. My jaw aches, too, and I often get headaches and pain up my neck. Why?”
Question from Ian in Newmarket, Brisbane
Here, Dr Panny Hou answers your questions and discusses teeth grinding Alderley and how to protect your smile from the damaging effects.
You could be grinding your teeth at night and not even know it. Actually, most people don’t know they’re grinding or clenching their teeth. The majority of patients who show the signs of what we call, in dental speak, bruxism are either unaware they’re doing it, or they don’t really associate the symptoms that they’re having with teeth grinding.
Obviously, our teeth, facial muscles and jaw joints aren’t designed to be in constant contact for more than about 40 minutes in a day (eating, etc). Now, if you grind and clench your teeth, they’re together for a lot more than that. It can be a solid six hours of ‘work’ there at night for your teeth!
Does everybody who grinds their teeth only do it in their sleep? No. People can do it during the day, however, more do it at night and aren’t aware of it going on.
Signs and symptoms of teeth grinding
Typically, patients complain of waking up in the morning with sore teeth and tight, tired jaw muscles. They can get clicking in their jaw joints and headaches, and complain of limited opening of their mouth.
If this gets worse and goes on for some period, they can get lockjaw – that’s associated with the overworking of the ball joints of the jaw, which we call the temporomandibular joints (TMJ).
Patients can get jaw pain and can sometimes feel like they have an earache but, really, it’s coming from the jaw joint because it’s so closely related and the pain can be referred.
What do the TMJs have to do with teeth grinding?
The temporomandibular joints are the joints that help our jaw open and close. So when we’re grinding or clenching our teeth, because of that extra pressure and work, over time it can cause damage to the TMJs. You can start to get TMJ symptoms,such as jaw locking and pain in the jaw joints.
How our Alderley dentists can tell if you’re grinding your teeth
When a patient comes in for an examination, one of the first things we do is:
- Check their jaw joints for a deviation of the jaw and their jaw muscles.
- See if there are any sounds coming from the joints on opening and closing.
- This is followed by an examination of the soft tissues within the mouth and, typically, with patients who suffer from bruxism, we tend to see a scalloped tongue. This is where the outer edges of the tongue are rippled or indented, along with white marks on the inside of the cheek.
- Then when we look at the teeth themselves, we see a lot more wear on the biting surfaces.
How can grinding damage my teeth?
If the patient has been teeth grinding aggressively or for some time, we start to see wear through the enamel – the protective outer shell of the tooth. This damage is irreversible and any enamel lost will never grow back.
Once the tooth enamel has been lost, the wear progresses more rapidly and we begin to see wear through the dentine – the softer, inner layer of the tooth. Once the dentine is exposed, the tooth can become quite sensitive.
If the grinding isn’t controlled, then as the tooth wears down, it becomes more sensitive, getting to a point where the nerve of the tooth may become exposed and damaged and the tooth may need root canal treatment.
Teeth grinding Alderley: what else?
Teeth grinding can also lead to cracked teeth (dental restorations will be required to repair lost structure) and, in severe cases, there can be tooth loss.
Also, people may be surprised to find that teeth grinding can change facial appearance. As the teeth shorten as a result of the wear, the upper and lower jaws come closer together, resulting in the shortening of the lower face height.
This, in turn, can be associated with thinning of the lips and the development of an inverted or slanted smile (where the corners of the mouth sag).
How can I stop grinding my teeth?
At the moment, there isn’t any treatment for teeth grinding itself. Often stress makes it worse, so we suggest patients take a bit of time before going to bed to relax and try some relaxation techniques.
To prevent wear around the teeth and reduce pressure on the jaw joints and muscles, we can look at making an occlusal splint or custom-fitted nightguard for the patient. This is a slim, hard piece of acrylic adapted to fit over the top teeth. It’s designed to be worn every night.
Nightguards – protection from the nightly grind
Because a nightguard has to be perfectly adapted to your top teeth, it takes a couple of visits to get one made. The first visit involves taking an accurate mould of the teeth, which gets sent to the laboratory for fabrication of a custom-made nightguard. This is fitted during the second visit.
Nightguards aren’t big or bulky, though patients sometimes do say that they feel strange to wear at first. What we find is that after wearing it for two weeks, no one really has troubles after that.
When can you stop wearing it? Because patients tend to go through phases when they grind more or less, or they may have grinding damage to their teeth, they should wear the nightguard continuously.
Been a hard night?
If you answered ‘yes’ to any of the teeth grinding symptoms above, please talk to one of our Alderley Dental team members.
Teeth grinding and children
A lot of kids grind their teeth and, as with adults, we don’t know the exact cause. As many as two to three out of every 10 kids will grind or clench their teeth at some point, but most will outgrow it.
Unless it’s causing a lot of problems, we generally tend to leave it and monitor it.