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Clenching Grinding Teeth - Bruxism - You need a night-guard!

Do you suffer from jaw pain? You could be clenching & Grinding otherwise known as Bruxism. This is a condition in which you grind, or clench your teeth. If you have bruxism, you may unconsciously clench/grind your teeth when you’re awake (awake bruxism) or clench/grind them during sleep (sleep bruxism).

Sleep bruxism is considered a sleep-related movement disorder. People who clench or grind their teeth during sleep are more likely to have other sleep disorders, such as snoring and pauses in breathing (sleep apnoea).

Symptoms

Physical Symptoms

  • Headache
  • Temporomandibular joint (TMJ) discomfort and muscle aches
  • Facial myalgia -aching jaw & facial pain
  • Ear ache
  • Tightness and stiffness of the shoulders
  • Limitation of mouth opening and sleep disruption of the individual as well as the bed partner.

Oral Symptoms

Short-term effects of Bruxism:

  • Abnormal tooth wear
  • Fracture of the teeth, broken fillings & crowns
  • Inflammation and recession of the gums
  • Excess tooth mobility
  • Premature loss of teeth

Long term effects of Bruxism:

  • Temporomandibular Joint Disorder (sometimes called TMJD or just TMJ)
  • Tooth wear & breakage

Risk factors

These factors increase your risk of bruxism:

Stress. Increased anxiety or stress can lead to teeth grinding. So can anger and frustration.

Age. Bruxism is common in young children, but it usually goes away by adulthood.

Personality Type. Having a personality type that’s aggressive, competitive or hyperactive can increase your risk of bruxism.

Medications and other Substances. Bruxism may be an uncommon side effect of some medications, such as certain antidepressants. Smoking tobacco, drinking caffeinated beverages or alcohol, or using recreational drugs may increase the risk of bruxism.

Family members with Bruxism. Sleep bruxism tends to occur in families. If you have bruxism, other members of your family also may have bruxism or a history of it.

Other Disorders. Bruxism can be associated with some mental health and medical disorders, as Parkinson’s disease, dementia, gastroesophageal reflux disorder (GERD), epilepsy, night terrors, sleep-related disorders such as sleep apnea, and attention-deficit/hyperactivity disorder (ADHD).

What can you do?

Behavioural Approaches

Progressive relaxation, meditation, self-monitoring

Night-guards

Nightguard is a generic term often used to describe a device worn on the teeth at night to protect them from grinding and clenching. There are many types of Nightguard appliances.

Soft Night-guard

The most commonly prescribed splint for bruxism and TMD, The soft guard will protect the by separating and preventing them from coming into contact. These are for mild or occasional cases, not for severe teeth grinders.

Pros:

  • Most comfortable fit
  • Most adaptable/easy to get used to
  • Usually lower cost

Cons:

  • Some people unintentionally clench on to or chew the soft material
  • Not as durable/limited lifespan
  • Most warranties are only 6 months or less due to the limited life-span
  • Not a long-term solution

Dual laminate

These are made with bi-laminate material, they are soft on the fitting surface and hard on the top surface. This type of night guard for Bruxism is for moderately severe teeth.

Pros:

  • Comfortable
  • Handles heavier clenching and grinding
  • Lower cost

Cons:

  • Tend to be a little thicker than the other guards

Harder to adjust to

  • Could bite through

Hard Night Guards/ BRA (Bite Raising Appliance)

Hard night guards for Bruxism are made from acrylic and are extremely rigid but durable. They can be used for moderate to severe cases of grinding, as well as TMJ.

Pros:

  • Most durable
  • Prevents teeth from shifting
  • Usually offers the longest warranty

Cons:

  • Thicker than soft night guards
  • More uncomfortable than others
  • Difficult to get used to sleeping in
  • Can be more expensive than the others

Clench Inhibitor – (SCi & SCi+)

The SCi device is extremely effective in reducing the symptoms of grinding. Moreover, FDA have approved it for the treatment of medically diagnosed migraines. With excellent clinical results, SCi and SCi+ are proven to relieve the painful symptoms.

How does the SCi Work?

In a study by Clark GT et. al, tension-type headache patients without signs or symptoms of TMD clenched their jaws during sleep, on average, 14 times more intensely than asymptomatic controls. Moreover, it has been shown that temporalis contraction is twice as intense during sleep than in waking patients.

SCi reduces parafunctional intensity of the temporalis, masseters and the lateral pterygoids (the tiny muscles at your jaw joints that open your jaw), eliminating posterior and canine contact, thereby reducing temporalis clenching.

Indications for SCi

All cases requiring a disconnection of the occlusion and/or the relaxation of the masticatory musculature, such as:

  • The prevention of symptoms associated with bruxism
  • The treatment of certain types of TMD
  • The prevention of occlusal trauma, e.g. protection of restorations and implants in cases of severe bruxism
  • The prevention and treatment of chronic tension type headache and migraine pain

Michigan/ Tanner Splint

The Michigan Tanner Splint was developed at Michigan University (USA), with the object of treating dysfunction of the TMJ muscle and to control bruxism. The splint covers the biting surface of the teeth. While doing this, its design ensures that there is an even contact when the teeth come together. This stops pressure build-up. Michigan splints are typically constructed on the upper teeth and Tanner splints are constructed on the lower teeth.

Cons:

  • Most durable
  • Takes pressure off the disc /ligaments both of which may have associated inflammation that contributes to pain
  • Usually offers the longest warranty