Stressing? Grinding? Don’t take it out on your teeth!

The last few years have been challenging for many.  As a dentist I see more fractured teeth, more jaw and muscle pain, and more headaches.  Why?  Well, we could have plenty to be stressed out about, but let’s not take it out on our teeth.

Here’s a common scenario:

The dentist tells you that you grind your teeth.  You just know you don’t.  And the stand off begins.  Who’s right?  Is the dentist trying to push treatment you don’t need?  Are you in denial?

Some of you know you grind or clench your teeth.  The more stress there is in your life, the more likely you are to grind or clench. Some do it consciously during the day, but the majority does it at night when they are sleeping.  You cannot consciously decide not to grind in your sleep.   (Hypnosis could influence sleep.) What if your spouse doesn’t hear you do it? Does it mean you don’t do it?

So how does a dentist come to the conclusion that you grind or clench your teeth?  Well, there is the evidence.  No matter what age you are, your teeth, under normal function of chewing, will not wear down.  Remember, enamel is the hardest substance in the body. So the first piece of evidence is worn teeth.  Frequently, we can see that the 1-2mm layer of enamel is gone from the top of the tooth, exposing the inner dentin layer.  The inner dentin layer wears even faster than enamel and you’ll see little divets in the tooth. 

The second piece of evidence is fractured teeth.  How could a tooth fracture when chewing something soft?  The likely answer is that it has been primed for fracture by extreme lateral (side to side) forces over the years. The soft bread wasn’t the culprit, rather the last straw that broke the camel’s back. 

The third piece of evidence is bone loss.  In the absence of bacterial causes of gum disease, what could be causing bone loss?  Stress on the teeth and the supporting bone structure can be to blame.  When the bite is not properly balanced and in harmony with where the joint and muscles want to take the jaw, the teeth get stressed severely. 

Most of the muscles in the head are associated with the jaw and the chewing muscles.  It may be difficult to understand, but a lot of muscle tension headaches could be prevented when there is coordination between the bite and the jaw joint. When theses two factors are working properly, the muscles of the masticatory system are able to function in a more relaxed state. Hurray! Relief!

The other aspect of this story is a bit of a paradigm shift for some.  You see, both you and the dentist have valid points.  Even if you don’t grind or clench your teeth, you could have the “evidence” mentioned above. Why?  The answer is occlusal disharmony.

 There are three things that need to be in balance in our chewing system; the joint, the muscles, and the teeth.  If the joint is blocked from its full seating by the position of the teeth, the muscles have to tense up to hold the jaw in an awkward  position.  This muscle hyperactivity leads to banging of teeth into each other in very unfavorable ways.  When you look in the mirror, you might say that it looks like your teeth meet up pretty well.  Neither you nor the dentist can tell how your bite looks just by peeking.   Truly the way to analyze the way your teeth come together and whether it is in harmony with your joint position is by your dentist working up an occlusal analysis with models.

The dentist can help get the teeth into the right place so that they are not in the way of proper joint seating.  This sometimes involves braces, but not always. The desired harmonious result can be achieved in other ways.   

So, relax, laugh and enjoy ... your teeth will greatly appreciate the effort.