Bruxism and Nightguards

Bruxism is a parafunctional condition in which a person has excessive tooth grinding or jaw clenching. Both children and adults may have a bruxing habit develop which may be transient or chronic. If it occurs over an extended period of time, it may lead to headaches, tooth/jaw/muscle pain, sensitive teeth, or TMD (temporomandibular disorder).

Causes of bruxism include stress, sleep disorders, bite abnormalities or idiopathic factors. Normally Dr. Tang can see evidence of bruxism by looking for

  • Excessive wear of your teeth
  • Abfractions (indentations at the gumline)
  • Gum Recession
  • Tooth Mobility
  • Chipped Out Defects
  • Fractured or Worn Teeth or Fillings
  • Excursive Interferences
  • Exposed Dentinal Surfaces

Recommended treatment will depend on the severity of the bruxing habit, the symptoms, and the associated conditions. For example, if there is a sleep disorder involved, this condition should be treated first to see if the bruxism resolves. If stress is a factor, stress reduction or coping techniques may be helpful.

Often times a malocclusion (bite abnormality) plays a role in night time bruxism. When a person’s teeth don’t fit together correctly, natural reflexes may cause one’s mouth to move unconsciously while he or she sleeps, trying to find the most relaxed position. Because of the malocclusion, a resting position may not be attainable.  Therefore the stress and strain of the movement are transmitted to the teeth, bone, muscles, and temporal mandibular joint (TMJ). This is what produces the signs and symptoms above.

If a malocclusion is a factor in bruxism, orthodontic treatment (Invisalign or braces) and/or a custom nightguard are recommended. A custom nightguard is hard acrylic appliance worn on the either the upper or lower teeth which cushion the teeth.  Upon delivery, Dr. Tang carefully adjusts it to provide even contact with the teeth opposing it in resting position and anterior guidance with any movement. Anterior guidance is a key feature which allows the main muscles of closure to relax, further reducing the forces of clenching and grinding. These same results cannot be achieved with a soft, boil and bite, over the counter mouthguard because they cannot be adjusted properly.