How does teeth grinding affect oral health?

Okay, so I’ve been waking up lately with a really sore jaw, like a dull ache that just won’t go away. My partner mentioned that they’ve heard me grinding my teeth in my sleep a few times too. I’m a little worried because I remember my dentist mentioning something about teeth grinding being bad at my last checkup, but I can’t recall the specifics.

So, I’m just wondering… How exactly does grinding your teeth (or clenching your jaw, I guess it could be that too) affect your oral health in the long run? Is it just the jaw pain, or are there other things I should be looking out for? Can it damage my teeth themselves? Could it mess with my gums or anything else? And are there different degrees of severity, or is any teeth grinding bad?

Answer

Teeth grinding, also known as bruxism, is a common oral parafunctional activity involving the clenching or grinding of teeth. It can occur consciously or unconsciously, both during the day (awake bruxism) and more commonly during sleep (sleep bruxism). While occasional teeth grinding may not cause significant harm, chronic bruxism can lead to a wide range of oral health problems.

Here’s how teeth grinding affects oral health:

1. Tooth Wear and Damage:

• Attrition: The most direct consequence of bruxism is the gradual wearing down of the tooth enamel. Over time, this attrition can expose the underlying dentin, the softer layer beneath the enamel.
• Abrasion: Bruxism can exacerbate abrasion, which is tooth wear caused by external forces like aggressive brushing or using abrasive toothpaste. The weakened enamel from grinding is more susceptible to abrasion.
• Chipping and Fractures: The excessive forces generated during grinding can cause small chips or larger fractures in the teeth. These fractures can occur in the enamel, dentin, or even extend into the root of the tooth. Fillings, crowns, and other dental restorations are also vulnerable to damage and may require frequent repairs or replacements.
• Tooth Sensitivity: As enamel wears away and dentin is exposed, teeth become more sensitive to temperature changes (hot and cold), sweet foods, and acidic substances. This sensitivity can range from mild discomfort to sharp, shooting pain.

2. Temporomandibular Joint (TMJ) Disorders:

• Muscle Pain and Fatigue: Bruxism puts significant strain on the muscles of mastication (chewing), especially the masseter and temporalis muscles. This can lead to muscle pain, tenderness, stiffness, and fatigue in the jaw, face, and neck.
• Joint Pain and Dysfunction: The temporomandibular joint (TMJ), which connects the jaw to the skull, can also be affected. The constant pressure and grinding can cause inflammation, pain, clicking or popping sounds in the joint, and limited jaw movement. In severe cases, it can lead to TMJ disorders (TMD), a complex condition involving chronic pain and dysfunction of the jaw joint and surrounding muscles.
• Lockjaw: In extreme cases, bruxism can contribute to the locking of the jaw, making it difficult or impossible to open or close the mouth fully.

3. Gum Recession and Bone Loss:

• Recession: The excessive forces from grinding can contribute to gum recession, where the gum tissue pulls back from the teeth, exposing the roots.
• Bone Loss: In some cases, the chronic inflammation and pressure associated with bruxism can accelerate bone loss around the teeth, potentially leading to tooth mobility and eventual tooth loss.

4. Headaches and Earaches:

• Tension Headaches: The muscle tension caused by bruxism can trigger tension headaches, which are often described as a tight band around the head.
• Earaches: The proximity of the TMJ to the ear means that TMJ dysfunction can sometimes cause earaches or a feeling of fullness in the ears.

5. Damage to Dental Restorations:

• Failure of Fillings, Crowns, and Bridges: The excessive forces from bruxism can weaken and fracture dental restorations like fillings, crowns, veneers, and bridges. This can lead to the need for frequent repairs or replacements, increasing the cost of dental care.
• Increased Risk of Implant Failure: Bruxism can also compromise the long-term success of dental implants by placing excessive stress on the implant and surrounding bone, potentially leading to implant failure.

6. Tongue and Cheek Damage:

• Tongue Indentations: Some individuals with bruxism may also clench their teeth and press their tongue against them, leading to indentations or scalloping along the sides of the tongue.
• Cheek Biting: Similarly, some people may bite their cheeks during sleep, resulting in sores or lesions on the inner cheeks.

The severity of the effects of teeth grinding depends on several factors, including the frequency and intensity of the grinding, the individual’s bite alignment, and the overall health of their teeth and gums. Early detection and management of bruxism are crucial to prevent or minimize these potential oral health problems. Management options include mouthguards, stress reduction techniques, muscle relaxants, and in some cases, dental work to correct bite problems.