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Why I Still Prescribe a Night guard for Teeth Grinding

Side view of female technicians using smoothing dental impressions

If you hear the word bruxism and it sounds like Greek to you, it turns out you’re not far off. The English version derives from brukhein, which means to gnash the teeth…in Greek. Today, bruxism reaches across the globe and crosses every border. And since it’s always night somewhere, teeth grinding during sleep never rests.

In fact, it’s estimated that 30 million Americans alone suffer from the effects of bruxism, or nearly 10% of the adult population. Although demographic variations exist, few groups show significant deviations from this percentage.

Your teeth should only touch together for about 5 minutes each day. Normal chewing results in brief intervals of contact between enamel surfaces, the hardest substance in the human body. Years of function slowly wear minuscule amounts of enamel, and bite edges can chip a little. But wear on these durable surfaces should be nearly undetectable, even in old age.

But what if teeth develop a flattened, worn appearance, even in young patients? Or dental x-rays show unusually thin layers of enamel across the chewing surfaces of the teeth? And what about unexplained headaches or facial pain? A few minutes of daily chewing just shouldn’t erode enamel or lead to so much discomfort.

Crushing, Abrading Forces

Powerful jaw muscles compress the upper and lower teeth together, generating remarkable force. In fact, one jaw muscle is considered the most powerful muscle in your body for its size. Research confirms that while chewing you may generate up to 162 pounds per square inch. But when you grind at night, the forces increase dramatically… up to six times beyond this level!

Imagine the destructive effect that results as crystallized teeth, delicate jaw joints, and overworked muscles absorb hundreds of pounds of tremendous force.

Even one cracked tooth resulting from grinding leads to treatment and expense that could be easily avoided with preventive measures. But bruxism rarely limits its damage to one tooth. A series of broken or worn teeth can run up a bill that costs thousands of dollars, regardless of the remedy you choose.

And teeth grinding ends up being about far more than the teeth. Next in line, the gums and bone that surround teeth may start to deteriorate under the strain of unnatural forces.

But headaches and pain in the face and jaw are the reasons people often realize something isn’t quite right. Jaw muscles quickly become strained, tired, and cramped from unnatural clenching and grinding. And since 90% of headaches originate in neck and jaw muscles, this easily leads to chronic pain conditions that severely affect the quality of life.

In fact, far too many people undergo extensive medical testing to determine headache causes without considering that teeth grinding might be the cause. And the jaw joints in front of the ear are the most complex joint in your body. Bruxism alters the delicate structure of these joints, resulting in arthritis, joint stiffness, and popping or clicking.

Once the changes occur, it’s often impossible to reverse the damage.

And still, other people grind their teeth at night and don’t experience any symptoms. If you notice someone with bulging muscles on the sides of their face, there’s little doubt what’s going on. Jaw muscles develop just like any other muscle in the body. The more they’re worked, the bigger they get

Where Does This All Come From?

Bruxism is often a symptom of a deeper problem, and it’s not always easy to know the exact cause. Some of the most common causes include:

  • Sleep disorders, including sleep apnea
  • Stress, tension, depression, or anxiety
  • Misaligned jaw or poor bite alignment
  • Acid reflux
  • Parkinson’s disease side effect
  • A side effect of certain medications, like anti-depressants
  • Excessive caffeine or alcohol intake

Recent research shows a strong link between bruxism and sleep apnea, a dangerous condition that leads to dramatic drops in the oxygen levels in your blood. Your airway is like a hose that allows air to flow to your lungs. But a collapse in the airway, frequently due to the altered sleep position of your jaw, turns it into a pinched straw. As you attempt to regain adequate airflow, your brain triggers grinding activity.

So if you’re grinding your teeth, or showing any suspicious signs of this abnormal activity, you should consult with your doctor. A sleep study helps determine the state of your sleep health. The truth is that apnea can kill you. In fact, people with apnea are three times as likely to die in their sleep than those without it.

Why A Night Mouth Guard Belongs In Your Arsenal

Even if you’re waiting to complete a sleep study, you should consider a proper mouth guard to immediately stop the grinding damage to your teeth and jaws. In reality, nearly everyone would be wise to consider a sleep study. And if you suffer from high blood pressure, diabetes, obesity, snoring, or excessive daytime sleepiness, you need to find out what’s happening when the lights go out.

The Gold Standard for treating apnea is Continuous Positive Airway Pressure (CPAP). Unfortunately, only 40% of patients prescribed CPAP actually use it. And using CPAP without adding a night mouth guard to the mix might be treating only part of the problem. CPAP may…or may not…eliminate the grinding problem.

And if you’re one of the 60% already prescribed CPAP but not using it, the bruxism probably is also going unchecked without a mouth guard. You should explore alternatives with your sleep doctor.

Research suggests that teeth grinding can be related to many causes that need exploration with each person. Periods of high stress and anxiety plague most of us, serving as well-known triggers for teeth grinding. A night mouth guard provides a quick and easy way to break the cycle of damage during periods of high stress. And if apnea and bruxism are both ganging up on you, properly treating both conditions helps protect your general and oral health at the same time.

Don’t Wait to Protect Yourself

Night guards offer an immediate step to halt the overload to your teeth and jaws. And they can be a tremendous relief for those suffering from headaches and sore muscles in the head and neck. Rapidly reducing the cycle of painful headaches alone proves to be a priceless benefit for many people, helping start the journey to better health.

A good night mouth guard provides a stepping stone to learning more about your sleep health. But be sure to explore possible sleep health issues further with your doctor. And if you end up using CPAP therapy, your protective appliance will enhance your treatment, keeping you healthy and comfortable!

Greg Grillo

Greg Grillo

Dr. Greg Grillo practices full-time clinical dentistry as senior partner in a group dental practice. A 1995 graduate of the University of Washington, Dr. Grillo utilizes innovative technology to provide a wide range of services to patients of all ages. He writes extensively for dentistry as a professional writer, and has published articles in journals such as The Sleep Magazine.  Dr. Grillo can be reached at www.writefulways.com.
Greg Grillo

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