Clenching, Tooth Grinding, & Bruxism

Most patients are completely unaware that they might be grinding or clenching teeth or bruxism while sleeping, inadvertently setting themselves up for dental problems in the near to middle future. For instance, many people sleep on their sides or stomach, placing their teeth into positions that they would not ordinarily be in during the day. They also tend to bite down much harder when their conscious mind is largely inactive and unable to control bite force.

Nocturnal tooth grinders often place between 300% and 1,000% of daytime biting pressure on their teeth when clenching or grinding teeth at night. Grinding and clenching, known collectively as “bruxism,” occur in brief but intense bursts while sleeping, usually during the delta phase of sleep. Over time, the hard, protective enamel coating of the teeth wears off, and the tooth interior starts to fray and fracture.

Worn tooth surfaces due to bruxism are prone to decay, as bacteria can easily penetrate the soft dentin as it is exposed by destruction of the enamel. Many of these teeth fracture, especially if silver mercury fillings are present. Some teeth develop root fractures requiring root canals or outright extraction. Gum recession, tooth mobility, damage to the jaw joint (TMJ), and bone loss can also result from this type of wear.

It is estimated that between 25% and 50% of people cause damage to their teeth through nocturnal grinding. There are several types of bite guards that can be used to prevent damage from bruxism. Each must be custom fitted and custom made for the individual patient. Depending on the dentist’s assessment of the situation and the patient’s needs, they can be hard or soft, thick or thin, and fitted to either the upper or lower teeth.