Do I Really Grind My Teeth?

Some of our patients are surprised when we inform them that we see evidence in their mouths of teeth grinding, or bruxism.  Many people have no idea that they are grinding their teeth.  And what happens very frequently is they come back in six months and say, “You know . . . I think I might be grinding my teeth.  Ever since you told me that six months ago, I’ve been noticing {insert symptom here}.”

Signs vs. Symptoms

In order to explain this phenomenon of a dentist telling the patient about something they are doing which they are unaware of, it is important to understand signs vs. symptoms.  Signs are objective, observable facts.  This means they are not swayed by opinions or feelings, and they can be shown by a photograph, an x-ray or other type of image, a lab result, etc…  Signs are noted by the dentist during an evaluation of your mouth.  Signs can exist without any symptoms, so it is possible that a dentist can inform you of the signs of a condition without your being aware of any issues.

Symptoms are subjective evidences of a condition or disease of which the patient is aware.  For instance, pain is a symptom because it cannot be observed, and the patient must describe it to their doctor for it to be properly documented and used to aid in diagnosis.  Other examples of symptoms include anxiety, fatigue, or muscle tension.

Bruxism (Teeth Grinding)

Bruxism is a very common condition in which a person closes the upper and lower jaws, creating high pressure on the teeth, gums, supporting jaw bones, facial muscles and jaw joints.  It can include hard squeezing called clenching, or a side-to-side or back-and-forth movement called grinding.  When bruxism occurs, it will manifest in one or more clinical signs and possibly some symptoms.

Signs of Bruxism

• Attrition – the flattening of the biting surfaces of teeth and loss of enamel caused by clenching or grinding
• Potholes – a specific type of attrition where the enamel has been worn through, and the underlying dentin is exposed and worn down into a concavity
• Gum Recession – movement of the gum attachment away from stressful biting forces on the tooth to a position further toward the root, can cause exposure of the root and tooth sensitivity
• Tooth Abfraction – a loss of tooth structure at the gumline causing a notch or concavity
• Facial Muscle Enlargement – as with any other muscle in the body, when exercised frequently, they will enlarge
• Linea Alba – Latin for “white line”, this is a visible line on the inside of your cheeks caused by friction against the grinding teeth, like a callous

• Scalloped Tongue – the sides of your tongue can be pressed against the inner surfaces of the teeth when clenching or grinding, causing it to conform to the shape of the teeth and have a scalloped appearance

Symptoms of Bruxism

• Facial pain, including headaches – constant clenching of muscles can create muscle soreness in the cheeks, temples, forehead, and the neck
• Muscle tightness – a tight or tense feeling in the muscles of the cheeks and temples
• Joint pain or sounds – the jaw joints, located in front of your ears, can be tender to touch, have sharp shooting pains, or make popping, clicking, or crunching sounds
• Generalized tooth pain or sensitivity – the pressure of clenching or grinding can cause all of the teeth to be sore or sensitive to temperature

Not everyone who clenches or grinds his or her teeth will exhibit all of these signs or symptoms.  It is important for the dentist to get the whole picture and put together each patient’s specific signs and/or symptoms in order to accurately diagnose the condition of bruxism.

What Can I Do About It?

The most common treatment for bruxism is a hard, custom-made nightguard to protect the teeth, gums, bone, muscles and joints at night.  People who clench during the day can follow some habit-breaking techniques to prevent daytime damage.  If extensive damage is present, you will probably need some dental work to repair it before moving on to the preventive phase.

Will an Over-the-Counter Nightguard Work?

OTC nightguards are typically made of a soft, thermoplastic material that you can heat and shape to fit your teeth.  This material is not great at preventing the damage from bruxism because the soft, squishiness actually increases muscle action and deteriorates very quickly.  The best protection for your teeth, gums, bone, muscles and joints is a hard nightguard that is custom-made for you by your dentist.  These will actually reduce muscle force and provide real protection.

Need More Information?

If you think you may exhibit one or more of the listed signs and symptoms, please don’t hesitate to discuss it with Dr. Jill or Dr. Cara.  You can also call the office at 972-347-1145 to set up a consultation.