Night-Time Tooth Grinding (Part 1)- A Possible Precursor to Other Conditions & What to do?
Credit: happytoothnc.com
Have you ever woken up with sore jaws? Ever chip your tooth without having remember on biting on anything out of the ordinary? Perhaps you are undergoing nighttime bruxism, the formal term of tooth grinding.
This is a parafunctional habit, which means that we are using our mouths for something other than drinking, eating, or talking.
Who does it, and why?
Estimates of tooth grinding suggest that it happens in approximately 8% of the population, but there have been reports of it being as high as 30% of the population.
With something this prevalent, the next logical step is to figure out what the causes of teeth grinding are.
Initially, it was thought that misaligned teeth and uneven bites were the primary cause of tooth grinding, and our jaws want to grind our teeth until we establish a stable bite between our upper and lower teeth. This has mostly been disproven as even people with ideal and stable bites may grind their teeth.
In the 1990's, stress was thought to be the major factor of tooth grinding. With the modern busy lives that people have, stress is a contributing factor to many chronic illnesses, including insomnia, high blood pressure, anxiety, and depression.
Along with stress, increased caffeine, tobacco, and alcohol usage are associated with grinding.
If only we could all sleep as soundly and quickly as her!
In the 2000's, there has been research into other factors related to bruxism which led to sleep quality studies. There has been growing evidence that bruxism is a cofounding factor and possibly a precursor to sleep apnea. This theory stems from the fact that people with sleep apnea have a partially or fully blocked airway. When people have this, they grind their teeth and shift their jaws to attempt opening the airway.
Unfortunately, nothing is conclusive as of yet, but the reason for bruxism is likely multifactorial: a combination of all the reasons mentioned previously and possibly even more that have not yet been determined.
What does it affect?
Bruxism can cause a multitude of problems, starting with its direct effect on our mouths and jaws.
After a few hours of nighttime grinding, people often report they wake up with sore jaws, sore joints, sore muscles, and a mild headache.
Over a longer period of time, our teeth also get worn away through a process called dental attrition. This results in our tooth structure being ground down, accelerating the destruction of any dental restorative work such as fillings, crowns, and bridges.
Untreated tooth grinding over many years causing upper molar enamel to be completely chipped off.
In more severe cases , there may be facial appearance changes, a collapsed bite, and possible fracture of teeth.
Red circle shows cracked cusp (tip) of upper left premolar which was freely movable and causing the patient a lot of pain. Unfortunately the tooth needed to be extracted. Orange circle shows exposed dentin (more yellow in colour) as enamel has worn away.
For people who have lost teeth and replaced them with dental implants, bruxing is also implicated in reduced implant success.
As mentioned, bruxism can be co-related to sleep apnea. In some situations, early signs of bruxism warrant a sleep study, especially if the individual has other risk factors for sleep apnea, such as snoring at night, having a large neck, and being overweight.
Next up, how do we prevent or treat bruxism?
Our team at MC2 Dental utilizes the latest techniques to help each individual achieve the best outcome possible.
Sources: B. R Chrcanovic et al., 2016: "Bruxism and dental implant treatment complications: a retrospective comparative study of 98 bruxer patients and a matched group". G. J Lavigne et al., 2008: "Bruxism physiology and pathology: an overview for clinicians.". S. Shetty et al., 2010: "Bruxism: A Literature Review".