Bruxism, more commonly referred to as clenching and grinding, is a dental condition far more common than patients are aware. When asked by a dental professional if a patient clenches and grinds his/her teeth, the most common response I hear is “not that I am aware…and I would know”. Unfortunately, more often than not, the patient is completely unaware of the fact that this parafunctional habit is taking place in his/her mouth, and it is the dental hygienist or the dentist that brings it the patient’s attention. Most often, this activity is taking place while the patient is asleep and it has the potential to seriously damage the teeth, muscles, and joints of some patients. It is the responsibility of the dental professional to educate the patient on the clinical signs that are in his/her mouth that are tell tale signs of grinding, such as gum recession, wear facets on teeth, jaw and muscle soreness, and muscle spasms.Given that most patients that clench and grind often do so while sleeping, unknowingly and without the ability to control it. Because of this, a night guard (also known as an occlusal guard) is indicated for this population.
Here at Dr. King’s Family and Cosmetic Dentistry, we feel that it is critical to address the problem and have patients treated with the proper type of night guard. While the over the counter ones are tempting to buy due to the affordability, these boilable guards are truly the worst option. In many cases they can actually make the situation worse. We strongly recommend doing nothing at all rather than purchase and wear one of these. While there are a variety of options that are custom made for the patient by a dental professional, some are guards are better than others. Patients often express concern that the guard will be big and bulky. In many cases this is correct because they were fitted by a dentist with a “horse shoe” style night guard. Not only are these bulky, hard, and uncomfortable for the patient to wear thus reducing compliance, but they also set up resistance and actually cause the patient to grind MORE, making matters worse. Also, the patient’s jaw gets “locked in” because it forces the lower jaw forward. A more modern alternative is the one we recommend at Dr. King’s office. This “hard/soft” guard deprograms and shuts down the elevator muscles for clenching, thus allowing the muscles to stretch. These occlusal guards are small, soft inside, comfortable, and offer freedom of motion for the mandible. A discluding fin is an extension on the front of the appliance that prevents the jaw from getting locked in if the patient’s grinding pattern brings the lower jaw forward.
Occlusal guards are the often overlooked solution to numerous dental issues. Not only do they alleviate pain, protect teeth and joints, and allow muscles to stretch, they protect restorations from the tremendous occlusal forces that teeth are exposed to on a daily basis. Patients of ours that have complained of a sore jaw, headaches in the morning, achy teeth, or painful muscle spams have commented that wearing a night guard has literally changed his/her life. Contact us at 757-464-6228 for the opportunity to discuss how we can protect your mouth from the effects of clenching and grinding.