Do you consider your daily work grind to be stressful? Well, believe it or not, stress during the day can translate into grinding your teeth while you’re asleep. Around 8% of the adult population experience unconscious nighttime teeth clenching or grinding. Many of us are unaware of our nocturnal habit until a dentist points it out and recommends a night guard that can cost between $300-$500. Skeptics may wonder, “Why would I pay so much for a thin piece of plastic?!” Well, a thin piece of plastic can be a powerful protector for your teeth and can prevent devastating and costly damage down the road.
First, let’s talk some history…
In 1931, Bertrand Frohman, a medical doctor, introduced the term “bruxism,” which we now use today to describe excessive teeth grinding or clenching in a non-functional way. Across many cultures today and throughout history, displaying clenched teeth portrays anger or hostility. Interestingly, one theory states that teeth clenching is an evolutionary instinct used for threatening predators by displaying teeth as weapons…GRRR.
So what is the difference between clenching and grinding anyway?
Both involve forceful contact between the biting surfaces of the upper and lower teeth. Grinding is the rubbing of the upper and lower teeth together forcefully in a back and forth or side-to-side motion. In some cases, grinding produces some pretty unpleasant sounds (cue: nails on a chalkboard). On the other hand, clenching is silent and involves sustained, excessive biting pressure with minimal jaw movement.
Is nocturnal bruxism a disorder?
Technically, yes. Nocturnal bruxism is considered to be a sleep-related movement disorder. The muscles of mastication, or chewing muscles, are the culprits here. These muscles (temporalis, masseter, medial and lateral pterygoids) move the lower jaw (aka mandible). During sleep, these muscles should be inactive. However, in bruxism cases, they contract causing rhythmic tooth contact with an extremely high force. Biting as hard as you can while awake generates about 30 pounds per square inch (psi) of force. During sleep bruxism, the force can exceed 100-150 psi! No wonder bruxism can cause damage.
What’s the cause?
There is no one cause. The general consensus is that the cause of sleep bruxism is multifactorial and bruxism is regulated by the brain and spinal cord (the central nervous system). Studies have shown that stress and anxiety during the day can be related to nocturnal bruxism.
Stress and anxiety are classic causes of noctural bruxism.
With that being said, the most relaxed person you know can also be someone who grinds at night. Alcohol, cigarette, and caffeine consumption are also risk factors. Medications, such as amphetamines can also cause severe grinding. In “meth mouth,” a user’s teeth can be so severely worn down that the teeth appear to be missing.
So…about that damage
For many people, the only sign of nocturnal grinding is tooth wear (such as teeth that are flattened and shorter in height). Your dentist is an expert at noticing signs of bruxism early, before the damage is severe. If grinding is severe, eventually the outer protective surface of the tooth, the enamel, is worn off, exposing the dentin layer underneath. The dentin is softer and more prone to cavities. Worn down teeth are also weaker and more likely to fracture requiring crowns and costly dental work. In some people, bruxism also manifests as jaw muscle pain, temporomandibular joint pain, headaches, and enlarged muscles of mastication (from over-use at night).
Once a grinder, always a grinder
Nocturnal bruxism is quite the mystery. There is no cure…for now that is. This means that if you are a grinder, your central nervous system and chewing muscles are always more susceptible to the activation of grinding. The good news is, there are ways to protect yourself from damage and even reduce the occurrence of grinding.
What should I do if I am a grinder?
Enamel does not grow back, so it’s recommended to protect your precious enamel by investing in a night guard. A night guard will not stop you from grinding per say, but it will protect your teeth from irreversible damage. Dentists custom-make night guards to ensure a comfortable and functional fit. But do keep in mind; integrating a piece of plastic between your teeth at night takes some getting used to. If you’d rather spend $300-$500 elsewhere, you can save money and make your own night guard DIY style. Be careful with over-the-counter nightguards, however, because they can alter the way your teeth fit together. Limiting caffeine, alcohol, and cigarette intake can decrease the frequency of sleep bruxism. Of course, a little less stress and anxiety in your day-to-day life may help too.
Now that you know about nocturnal bruxism, if you find yourself grinding, remember the importance of protecting your teeth from their powerful enemy…your other teeth!