Clenching, and grinding your teeth, also known as Bruxism, is a habit that affects a lot of people worldwide. In most cases, the person doing it might not realise they’re clenching their jaw and grinding their teeth, until they wake up with a sore jaw and teeth.
Dr Tareq Shabani is one of UAE’s most renowned and leading cosmetic dentists with more than 14 years’ experience in the industry. He takes us through a breakdown of Clenching or Bruxism, and how it's normally related to the way you close your mouth, and occlusion, with different reasons affecting it.
The Reason Behind Clenching and Grinding
Four reasons could lead to clenching and grinding problems with different levels of severity, Common symptoms are usually muscle and joint soreness, which leads to more severe pain that radiates down to the back, the head, neck and ears.
The four things we consider are: Muscles, Temporomandibular joint, Teeth and Gums.
The muscles involved are the ones that elevate and lower your lower jaw (mandible). Normally, these muscles are in balance with an existing space of 1mm and 2mm between your upper and lower teeth. But if you’re clenching and grinding, that means the space is not present and the muscles that close your jaw are the ones that are tense and active.
The habit, or condition, also happens to patients with malocclusion and poorly aligned teeth, in which the joint and muscles don’t acclimate easily to the position of the teeth, and the clenching and grinding would start. Other times, it also happens if your gums are inflamed or receded; and sometimes there's no specific reason for why it occurs.
What Happens If You Don’t Seek Treatment?
If you keep clenching and grinding, you’ll most likely start damaging your temporomandibular joint, muscles and teeth associated with chronic pain and discomfort. Your enamel would break off, the teeth would become shorter and you would end up with a smaller vertical dimension. For instance, have you ever noticed that most older people have a smaller lower face? This is because the teeth start to wear off as they get old. So, if you're doing it practically all the time, regardless if you are 25 years old, you’ll end up with a smaller lower face.
Treatment Options for Clenching and Grinding
Treatment options would depend on the reason for the clenching and grinding.
Crowns and Veneers: In advanced or serious cases of clenching and grinding the teeth, a more comprehensive approach is recommended.
For instance, if the teeth and enamel have been worn down, and you have already started losing your Vertical Dimension of Occlusion, which is the space between your upper and lower teeth, then you will need to undergo full mouth rehabilitation, restoring your teeth to the original position before the clenching the grinding started.
This is accomplished by performing additive dentistry and placing onlays or crowns for the posterior teeth and veneers or crowns for the anterior teeth.
Teeth Replacement: If the habit is as a result of inflamed gums or a missing tooth, then the treatment here would be to replace that tooth, and most probably it will stop.
Botox: Botulinum Toxin type A, commonly known as Botox, is another solution for clenching and grinding. This cosmetic injectable works by paralyzing the affected muscles, which stops the clenching. Unfortunately, this treatment option is temporary, and the clenching, grinding, and pain will still come back within 3 months or less because you’ve not treated the underlying cause.
Occlusal Guard: If you catch the condition early, the best treatment would be to use an Occlusal guard, which is a long-term solution. Depending on the case, this Occlusal guard would be worn at night to protect you from clenching and grinding, and at the same time, it will create around 2mm space between your upper and lower teeth, which would eventually program your muscles and jaw in their proper position. There are three different types of Occlusal guards; soft, medium soft, and a hard one. Your dental specialist will decide which one is the best for you depending on your condition.
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