Bruxism is an oral parafunctional activity which commonly occurs with most people at some point in their lives. The two main characteristics of this condition are grinding the teeth and clenching of the jaw.
Bruxism is one of the most common known sleep disorders. Chewing is a neuromuscular activity controlled by a subconscious process, but more highly controlled by the brain. During sleep, the subconscious process may become active while the higher control is inactive (asleep), resulting in bruxism. The most common symptoms are headaches, facial muscle tenderness and tooth wear and sensitivity.
The exact cause of bruxism is typically unknown but may be brought on by stress, anxiety, alcohol consumption, caffeine or even sleep apnea. Malaligned teeth may cause you to brux as well.
Though there is no one cure for bruxism, there are a variety of devices and services available from our office to help treat bruxism.
- Mouthguard (NightGuard) – An acrylic mouthguard can be designed from teeth impressions to minimize the abrasive grinding action during sleep. Mouthguards are expected to be worn on a long-term basis to help prevent tooth damage.
- Behavioral management
- Stress/Anxiety reduction
- Botox injections – For severe cases
Once bruxing is under control, we can perform a variety of dental procedures to restore the pleasant aesthetic appearance to your smile such as crowns, veneers and gum procedures.
TMJ (temporomandibular joint) disorders are a family of problems related to your jaw joint. If you have had symptoms like pain or a “clicking” sound, you’ll be glad to know that these problems are more easily diagnosed and treated than they were in the past. These symptoms occur when the joints of the jaw and the chewing muscles do not work together correctly. TMJ stands for temporomandibular joint, which is the name for each joint (right and left) that connects your jaw to your skull. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.
TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disk, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking or grating noise when you open/close your mouth.
DO YOU HAVE A TMJ DISORDER?
- Are you aware of grinding or clenching your teeth?
- Do you wake up with sore, stiff muscles around your jaws?
- Do you have frequent headaches or neck aches?
- Does the pain get worse when you clench your teeth?
- Does stress make your clenching and pain worse?
- Does your jaw click, pop, grate, catch or lock when you open your mouth?
- Is it difficult or painful to open your mouth, eat or yawn?
- Have you ever injured your neck, head or jaws?
- Have you had problems (such as arthritis) with other joints?
- Do you have teeth that no longer touch when you bite?
- Do your teeth meet differently from time to time?
- Is it hard to use your front teeth to bite or tear food?
- Are your teeth sensitive, loose, broken or worn?
The more times you answered “yes”, the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.
There are various treatment options for TMJ that Dr. Goldin, Dr. Abjanich or Dr. Donovan can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, our doctors will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care combined with professional care.
The initial goals are to relieve the muscle spasms and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory or muscle relaxant. Self-care treatments can often be effective as well and include:
- Resting your jaw
- Keeping your teeth apart when you are not swallowing or eating
- Eating soft foods
- Applying ice and heat
- Exercising your jaw
- Practicing good posture
Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a temporary plastic appliance known as a nightguard. A nightguard fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. Appliances also help protect tooth wear.
WHAT ABOUT BITE CORRECTION OR SURGERY?
If your TMJ disorder has caused problems with how your teeth fit together you may need treatment such as bite adjustment (equilibration), orthodontics with or without jaw reconstruction, or restorative dental work. Surgical options, such as arthroscopy and open joint repair restructuring, are sometimes needed, but are reserved for severe cases.
Ask your prosthodontist about bruxism and TMJ Disorders if you have any questions.