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Tag: Tooth Grinding

Categories
Bruxism Nightguards & Oral Appliances TMJ

Biteplates Need To Be Monitored

Thousands of people every year are prescribed biteplates by their dentists. There are two common scenarios that prompt a dentist to make this recommendation.

Scenario 1: Tooth Grinding

You went to your dentist for a routine appointment and you were told that there is evidence that you are grinding your teeth at night  (sleep bruxism). Your dentist may in fact show you areas of tooth wear on your teeth. You have no jaw or tooth  pain, which is good, but a biteplate is made to protect your teeth at night while you sleep. This biteplates may be made of hard acrylic, dual laminate materials with a soft inside and hard outer shell, or may be totally soft and pliable.

Since you have no symptoms of jaw or tooth pain, there is no need to do anything else. Your dentist should ask you to bring it with you when you go in for a routine tooth cleaning  appointment. Overtime it may have to be remade due to wear and tear, or adjusted if new dental restorations have been placed.

Scenario 2: Jaw Pain, Stiffness, and more…

You are experiencing pain/tightness/stiffness in the jaw muscles, pain in the Temporomandibular Joints (TMJ’s), or clicking that is new or getting worse. Your symptoms may be worse in the morning as many people often wake up with symptoms of jaw pain, diminished jaw motion, and even a jaw that feels locked and out of place. Your dentist will in this situation commonly make a biteplate that can be modified over time as your symptoms change. It may have a flat biting surface or inclines to address your specific problem.

These adjustable biteplates need to be monitored as your condition improves, or if it is not helping to reduce symptoms. Just like an orthopedic splint for the knee,  problems, modifications, or changes are required overtime as the situation dictates.

If your jaw problem was due to a specific trauma or injury  (sports related/eating/accidental) which lead to a joint sprain, muscle strain, or joint inflammation, as healing occurs you will likely wear the appliance less until you don’t need it at all.

However, if your jaw pain, locked jaw, decreased motion, sore teeth, or headaches resulted from persistent and aggressive sleep bruxism , then long term use of the biteplate may be required. Periodic visits to the dentist will be required to determine when, and if the biteplate use can be reduced or eliminated. Regardless of the reasons that you needed a biteplate to begin with, please make sure your dentist monitors its use at least once a year.

Learn more about biteplates and oral appliances.

Dr. Donald Tanenbaum is a specialist with offices in New York City and Long Island, NY. He is uniquely qualified to diagnose and treat facial pain associated with jaw problems, TMJ, referred pain, nerve pain, and migraines. Find out more at www.nytmj.com.

TMJ and Computer Use Donald Tanenbaum
Categories
Bruxism TMJ

Can Bruxism Be Caused by Poor Dental Work?

Several weeks ago a 38-year-old gentleman came to my office complaining that shortly after having three crowns (caps) put in his mouth, he began to grind his teeth at night for the first time in his life. On arising in the morning he was experiencing jaw muscle soreness and on some occasions more sharp pain which limited his breakfast selections, which are common symptoms of Bruxism (the clinical terms for teeth grinding).

The first comment out of his mouth was, “I want to rip these teeth out of my mouth!” Was poor dental work the cause of this patient’s Bruxism? More questioning revealed that my patient’s new teeth were in great shape; not sensitive to hot, cold, or chewing, and his bite did not feel off balance.

Is it possible that these three new crowns were responsible for the reported night grind and if so how is this possible?

Point number 1:
Night tooth grinding (Bruxism) has been shown to have little, if anything, to do with the type of bite a person has. People with good and bad bites grind and clench their teeth at night.

Point number 2:
Night tooth grinding (Bruxism) seems to be related to arousals that occur in the brain during sleep. These brain arousals can be due to a number of factors such as drinking alcohol or caffeine close to bedtime, poor sleep environments, crying babies, chronic pain problems (back and neck), asthma, sleep apnea and or chronic tension and stress to name just a few possibilities.

Point number 3:
In clinical studies that have been conducted in patients with known histories of night grinding, the placement of dental restorations made intentionally high and out of balance with the rest of the teeth, have actually led to a diminished amount of night grinding for several weeks. This suggests that throwing the bite out of balance can actually reduce the amount of teeth grinding at night!

Conclusion

Based upon what we know, it is unlikely that Bruxism can be caused by poor dental work (unless pain developed as a result of the work and disrupted a patient’s sleep). When similar scenarios occur, other factors are likely playing a role and it is very important to see your dentist for a full evaluation.

Mouthguards & Nightguards: How Long Do They Need to Be Worn? donald tanenbaum
Categories
Bruxism Nightguards & Oral Appliances TMJ

Mouthguards & Nightguards: How Long Do They Need to Be Worn?

This is a common question asked by patients in my practice. The answer to this question is based mainly on the reason it was recommended in the first place! So, if you are wondering if you will have to wear your nightguard forever, here are some common scenarios. There’s a good chance that one of them fits your situation exactly:

Scenario 1: You have no teeth grinding symptoms, but your dentist notices that your teeth are worn or chipped or that fillings and caps previously placed look worn.

The dentist then informs you that you have been grinding your teeth at night. You’re shocked! You have no pain in your teeth, no jaw muscle soreness in the morning, and you haven’t noticed any other signs to indicate that you are grinding your teeth. Your dentist recommends that you wear a nightguard while you’re sleeping, warning of the problems that will develop if you don’t wear it.

Now here’s the important thing: If you move ahead and get the nightguard, bring it with you and show it to the dentist when you go in for your twice-a-year dental cleaning. If the nightguard exhibits grooves and notches cut into the acrylic, then you have been grinding and you should continue to use it. If, however, there is no evidence of wear and tear, it’s probably in your best interest to bring this to the attention of the dentist and discontinue using it.

Scenario 2: You make an appointment with your dentist because “out of nowhere” your jaw muscles and teeth are aching in the morning.

You mention to your dentist that stress levels have been high in your life and will likely stay that way for an undetermined period of time. A TMJ nightguard is advised and you wear it for a while and notice that the achiness in the morning has decreased.

What next? This all depends on what is going on in your life: stress, fragile emotions, disrupted sleep, etc. As these factors may drive the night grinding it is probably advisable to stay with the nightguard until things calm down. Once life is calm and if your morning symptoms have gone away, you can begin to reduce the number of days the nightguard is worn during the week.

Over time you will likely find that you no longer need the nightguard. Keep in mind, if life issues arise again, the grinding will likely return and you may need the nightguard again, so don’t throw it away!

Scenario 3: You not only have morning jaw muscle soreness, but your teeth ache and you have persistent facial pain during the day. In addition, you feel that you can’t open your mouth wide and chewing has become a chore because your jaw joints click and/or lock.

This scenario suggests that you may have a more significant jaw problem often called ‘TMJ’. Unlike the first two scenarios, the level of muscle and joint compromise is more significant with TMJ. And beyond the night grind there are likely other factors that have led to and are perpetuating the symptoms. In this situation the use of a nightguard at night will likely be for an extended period of time (maybe forever).

I have many patients who return to my office 3-6 years after they were last seen looking to get their nightguard repaired or replaced. Many of these patients tried to stop wearing it when they felt better, but the symptoms began again. In this situation I ask my patient to visit me at least once a year to help maintain the integrity of the device and make sure it is doing the right thing and not causing harm.

Note: There are many different names for dental nightguards:

  • Nightguard
  • Mouthguard
  • Oral Appliance
  • Splint

There are many different types as well. The decision to pick one type over another is usually made by your dentist based on your diagnosis.

If you have more questions about TMJ, and you live or work in New York City or on Long Island, schedule a consultation with me here or call 212-265-0110

Thank You!

Dr. Donald Tanenbaum has been practicing in New York City and Long Island for over 20 years. He is uniquely qualified to diagnose and treat bruxism, TMJ and TMD problems, Sleep Apnea, facial pain,  muscle pain disorders, nerve pain disorders, tension headaches, and snoring. Learn more about Dr. Tanenbaum here.

Categories
Bruxism TMJ

Is Your Child Suffering from Bruxism?

For years, nighttime tooth grinders were thought to be adults who were overwhelmed by life’s stresses and worries. Though stress can certainly be one cause of nighttime tooth grinding, recent research suggests that anything that arouses the brain during sleep can cause excessive jaw movements.

This research explains why some children also suffer from nighttime teeth grinding, or bruxism. Nightly grinding results in sore TM joints and facial pain during the day, and can cause damage to your teeth. If your child is complaining of facial or jaw pain in the mornings, look for the following signs and symptoms of bruxism:

▪ Worn, chipped or sensitive teeth that look like they are getting shorter (the front incisors) or are getting flatter and yellow in color (the back molars)

▪ Morning headaches and/or facial and jaw pain

▪ Morning jaw noises such as clicking or popping

▪ Sensitive teeth when eating or exposed to hot or cold fluids

What Causes Bruxism in Children?

Though bruxism is often a cause of stress, it does not mean that it is what is causing your child’s nightly teeth grinding. However, persistent life stressors associated with school, unstable home environments, and social relationships may cause your child to sleep restlessly. Some of the risk factors that should be considered if you hear your child grinding his or her teeth excessively each night include:

▪ Problematic asthma conditions

▪ Enlarged tonsils and adenoids

▪ Childhood obesity that may compromise the airway at night

▪ Irritable bowel syndrome (IBS)

▪ Acid Reflux

▪ Insomnia

▪ Use of medication to treat ADHD

Can Childhood Bruxism Be Treated?

Identifying signs of bruxism early is the best way to end your child’s nightly teeth grinding habit. The good news is that once the cause is identified, there are several treatment option available. I look for enlarged tonsils and adenoids during an exam, especially with patients with histories of recurrent sore throats. If enlarged tonsils or adenoids are the cause of your child’s tooth grinding, they will likely be referred to an Ear, Nose, Throat specialist to be removed—ending the nightly bruxism.

If a child comes to my office with signs of worn teeth and loss of enamel on the biting surface of the molars, this usually indicates that a chemical erosion, like acid reflux, is occurring. This is due to stomach acid pooling on the teeth at night and is a direct result of the acid reflux. I send these kids to a Gastrointestinal doctor to be treated for reflux. If your child is taking medicine for ADHD, the solution may simple: administer the medication in the morning, not during the late afternoon or evening.

Bite appliances are used in kids even as young as 6 -12 years in an effort to buy time and protect teeth and jaws until the origin of the bruxism is determined and managed. Bruxism in children should be taken seriously as it can result in early destruction of the baby teeth, wear on the permanent teeth, jaw related problems, or tension headaches. Evaluation by a dentist with a broad understanding of teeth grinding is strongly advised.

Dr. Donald Tanenbaum has been practicing in New York City and Long Island for over 20 years. He is uniquely qualified to diagnose and treat bruxism, TMJ and TMD problems, Sleep Apnea, facial pain,  muscle pain disorders, nerve pain disorders, tension headaches, and snoring. Learn more about Dr. Tanenbaum here.