One of the most common findings I noticed in my practice over the last few decades, is the increased complaint of tooth sensitivity and wear of my patient’s teeth. Since our daily lives have become more hectic and stressful, so have our habits to deal with the increased stress changes. Often, when examining a patient, I see wear of their teeth. Yes, it’s true that the vast majority of the population have some signs of “wear” making it a normal condition, but a growing percentage of individuals have negative consequences of these habits, which can be prevented or fixed.
Some of the side effects of clenching and grinding can manifest themselves as headaches, tightness in the jaw, and tooth chipping. Improper occlusal forces can lead to Temporomandibular joint issues, muscle and neck pain, sleep or stress issues. Removable appliance therapy can be an excellent tool to quickly and inexpensively aid in addressing some of these complaints. Splint therapy has multiple names associated with it such as Occlusal Splints or Nightguards. These splints are made of hard plastic material which is customized to fit over Upper or Lower teeth. They simply require impressions to be taken in office with bite records and sent to specialty lab for fabrication. Two weeks later, the patient returns to be fitted and adjustments to the appliance are made for proper bite equilibration.
Clenching or Bruxing usually occur at night while we sleep. These parafunctional habits cause damage to teeth and restorations. This is not an intentional activity and most patients don’t realize they have this destructive chewing habit, but stress and anxiety are some of the causes, along with anti-depressant medications, high caffeine and sugar diet, or misaligned teeth. Continual grinding will lead to wear of enamel, and if left untreated can kill the pulp inside a tooth or fracture teeth. Patients with abusive chewing habits destroy enamel up to 10 times faster than those without abusive chewing patterns.
There are many forms of occlusal appliance therapy used. Each is customized to patient’s individual concerns and problems. Sleep apnea and snoring, as well as splinting of loose teeth, preventing migration of teeth due to periodontal support are some of the other functional uses of splints. Store bought nightguards are a “one size fits all” approach. They can be cumbersome in fabrication, tend to fall out at night and do not address each patient’s individual concerns. They are not recommended as a definitive treatment. Occlusal appliances for patients with bruxism/clenching must be sturdy and relatively thick.
Bruxism sufferers, who grind and clench their teeth while sleeping, frequently wake up with a sore jaw. Hypertrophy of the chewing muscle “Masseter” may lead to the appearance of a square jaw. Treatments with Botox can provide relief of jaw soreness, headaches, and other unpleasant problems associated with Bruxism. These Botox injections can soften the appearance of the jaw line. By injecting small doses of Botox into the Masseter muscle relaxes and decreases wear and tear of teeth. Voluntary movements such as chewing and facial expression are not affected by Botox. Treatment lasts approximately 3-4 months.
As one can see, there are many variations of habits which can cause a multitude of dental and facial problems. With a proper evaluation, a specialized treatment catered to each individual patient can be achieved. If you feel you suffer from any of these conditions, please call our office for an evaluation.
Dr. Susanna Kayserman has been practicing dentistry since 1995, and is a graduate of New York University College of Dentistry and a member of the NJ dental association. She has a private practice in Warren, NJ.