Mary R. Isaacs, D.M.D., P.A.

In a Clench

Did Rip Van Winkle Wear a Nightguard?

How well did you sleep last night? Before you settle down for "a long winter’s nap" to have that "midsummer’s night dream," you might want to see if these questions apply to you:

• Do you wake up with an earache or headache?
• Do your jaw muscles feel sore or tight?
• Do your teeth or gums feel sensitive or tender?
• Do your teeth appear worn down or chipped?
• Do you frequently have unexplained facial pain?
• Does the inside of your cheek feel chewed up?
• Does anyone in your household (or college dorm room) complain that your teeth grinding wakes them up?
• Do you wake up tired?

Getting a good night's sleep

These are symptoms of bruxism. "Bruxism" means to grind, gnash, or clench the teeth. This condition can affect all ages. In fact, 50 to 96 percent of adults and 15 percent of children may show signs of bruxism. The sleeper might have 25 bruxism episodes each night.

An episode typically lasts four- to-five seconds, but those few seconds add up to severe dental damage to the teeth or jaw joint. There are several theories about the causes of bruxism, but stress is often a contributing factor. If bruxism is not treated, your teeth, fillings, or crowns may become worn down. Eventually you might grind away your tooth enamel and loosen the teeth themselves. Those loose teeth can then shift in the jawbone. You could also crack a tooth or a filling because of the heavy biting pressure during a bruxism episode. So, what can you do to alleviate stress that may be affecting your bruxism?

Tips for children

Even if children still have their baby teeth, they may display signs of bruxism. Some tooth grinding is normal in children, and they usually outgrow it. Children often clench or grind their teeth because a cold, earache or allergy makes them uncomfortable. They may also grind their teeth when they are losing their baby teeth and getting their permanent teeth.

If bruxism is causing your child discomfort, you might want to create a comfortable routine before bedtime. Try a warm bath or shower, soft music, a soothing story, or a cuddly stuffed animal to help the child relax.

Self-care tips for students

In middle-aged and older children, school exams may create extra stress, which may cause bruxism to escalate. In addition to the tips for children, here are some tips especially for students:

• Avoid "all nighters" (staying up all night to study for exams).
• Go easy on caffeine and stimulants such as "energy drinks".
• Do not use tobacco, alcohol, or drugs.
• Give your teeth some extra attention with brushing and flossing when exams are over.
• Schedule a dental checkup while you are home for the holidays.

Self-care tips for adults

Many adults do not know they have bruxism, or they do not believe they have it simply because they are unaware of it. Some people believe that their teeth must touch at all times; they unintentionally create bruxism over time. Unfortunately, bruxism episodes can go on for several years before the person realizes their teeth are ground down.

In addition to the tips for children and students, here are some tips especially for adults:

• Pay attention to your body. If you are feeling tense, angry, frustrated, aggressive, or overworked, notice where that feeling manifests itself and relax!
• Exercise every day and add a little more time to your exercise routine on those more stressful days.
• Avoid caffeine after mid-afternoon, and be careful not to consume too much caffeinated beverages in a one-day period of time.
• Gently press a warm, wet washcloth to the side of your face to help relax the muscles.
• Practice resting your tongue upward. Keep your teeth apart and lips together.

Additional care from dentists and hygienists

Another option is to prescribe a nightguard, which looks like a plastic retainer. We make an impression of your teeth so that the nightguard precisely fits your bite. (Over-the-counter nightguards don't fit as well, and they may become dislodged in your mouth while you sleep.) The nightguard takes the force of your biting and grinding to prevent further damage to your teeth and to keep them from shifting. By keeping your teeth apart, a nightguard relieves pressure off the jaw joint.

We may also recommend onlays or crowns to replace the worn parts of your teeth. Or we may recommend other techniques to help prevent your jaw from moving out of alignment and to relieve the pressures of bruxism.

If you've experienced any of the symptoms of bruxism, be sure to let us know. During your next checkup, we can look for signs of bruxism, such as worn-down teeth, broken restorations (such as fillings and crowns), or unusual sensitivity. We may examine your teeth, your jawbone structure, and the inside of your checks for damage, and we may want to take x-rays or plan treatments to follow your progress.

As always, be nice to your teeth so that they can be nice to you.