Something to gnaw on: Bruxism causes and solutions

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We all clench or grind our teeth at times. We may do it when we're sleeping, or we may do it when we are awake. Most times, bruxism is not a problem, and people learn that they grind their teeth only after their loved one hears them grinding at night.

However, continuous bruxism should not go unchecked. It could cause serious damage to the teeth, the jawbone, and the jaw joint. There are many causes of bruxism, and successful treatment depends on identifying the right one.

What causes bruxism?

Dr. Alvin Danenberg.Dr. Alvin Danenberg.

Sometimes a poorly fitted crown on a tooth or a filling on the chewing surface of a tooth may have "high spots," which create an interference with the tooth on the opposite arch when they bite together. If that is the case, patients may unconsciously grind their teeth to make them "fit together better." This cause of bruxism can create serious problems for the teeth, jawbone, and even the jaw joint.

Other times, orthodontic or bite treatment may cause teeth to move into positions in the jaw that do not fit well together with the opposing teeth in the opposing arch. This misalignment could cause interferences in the chewing surfaces of the teeth that cause a person to grind or clench.

Yet another cause of bruxism is if the jaw is not shaped correctly and the tongue does not have adequate room to function. This may result in breathing difficulty or even obstructive sleep apnea. When sleep apnea occurs, bruxism frequently occurs as well.

Last but not least, a common cause of bruxism is when a person is under emotional stress or is performing strenuous physical activity. During these times, patients may clench their teeth.

How can bruxism be treated?

To successfully treat bruxism, first, the most obvious potential causes must be addressed.

If the chewing surface of a tooth is interfering with the chewing surface of a tooth in the opposite arch, then the bite pressure must be adjusted. To correct these heavy pressure spots, the chewing surfaces of the teeth are selectively smoothed and polished to remove the interferences. This may be all that is necessary to stop the grinding.

At other times, orthodontic treatment might be necessary to correct the bite. In more complicated cases, the upper and lower arch may be too narrow to allow the tongue to fit comfortably between the lower teeth. In this case, the upper and lower jaw arches could be widened, the teeth properly positioned, and the tongue given more comfortable space. These efforts will open a compromised airway space thereby regaining normal function for the tongue, improved oxygenation, and reduced bruxism.

If a patient grinds his or her teeth habitually, sometimes a bite guard could be worn during sleep to reduce the pressure. If people go to the gym and perform strenuous workouts, they often clench their jaw. This also is a good time to wear a bite guard to protect the teeth and jaw joints.

Generally, the best bite guard is one that is made in a dental office. It fits the upper teeth and is hard rather than soft. This type of bite guard can guide the teeth in the lower jaw to slide gently on the bite guard during bruxism and prevent damage to the tooth, the jawbone, and the jaw joint. Dentists can even do a "compatibility blood test" to determine the best material to use to construct the bite guard in the dental lab for that patient.

A more inexpensive and immediate type of bite guard that could be used is a store-bought bite guard that is soft and just reduces the pressure from bruxism. But it won't have the same quality as one that comes from a dental professional.

When is grinding a cause for concern?

Almost everyone clenches or grinds their teeth at times. Most of the time, it is not a problem. When it becomes habitual and continuous, there can be serious damage caused to the tooth, the jawbone, and the jaw joint.

So how can you tell if your teeth grinding is cause for concern? Well, any pain in a tooth, the jaw muscles, or the jaw joint area is indicative of damage from bruxism. Also, headaches, especially upon wakening, could mean that a patient has been grinding their teeth at night.

The only way to determine the true extent of the damage is with an evaluation of the bruxism habit and the actual areas of the tooth and the jaw joint. It is incumbent on an individual who wants to be proactive to seek a proper diagnosis and pursue necessary treatment from a qualified dentist to prevent damage from bruxism.

Dr. Alvin Danenberg has retired from the private practice of periodontics in Bluffton, SC. He continues to be on the faculty of the College of Integrative Medicine and created its integrative periodontal teaching module. He also spent two years as chief of periodontics at Charleston Air Force Base earlier in his career. His website is

The comments and observations expressed herein do not necessarily reflect the opinions of, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization or as medical advice.

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