Wednesday, April 3, 2013

Clenching and Grinding



Clenching and grinding are very common issues that have plagued humanity throughout our history. Clenching is the act of closing the teeth tightly. Grinding is the act of  lateral movements of the jaw while clenching.

Causative Factors:

When we feel stress of any kind from life threatening events to minor events like traffic, we tend to clench and/or grind. Clenching and grinding can occur at any time during waking or sleeping hours. The intensity and duration of clenching depends on many factors. How we react to stress is a major factor. People that suffer from sleep apnea also clench and grind. This is because not breathing and not getting adequate oxygenation is very stressful. People that suffer from depression and anxiety are also far more likely to clench and grind.

Consequences:

The consequences from grinding are directly proportional to the intensity and duration of these acts. In other words, the more intense and the more time clenching/grinding, the more severe the consequences.

There are multiple problems that occur. In general, there are problems with either the teeth, the muscles or the joints. Each of these can have a wide range in problems but in general the teeth fracture and wear down. The muscles become tender and chronic headaches are common. The joints sustain damage and the pain can often be confused with earaches.


The teeth have developed notched areas from clenching.
Decay has subsequently developed.





The temporal mandibular joint (TMJ) and potential muscles affected.














The teeth have been worn down from grinding












Prevention and Treatment:
If we were aware of when we're clenching, then it would be easy to stop. Unfortunately we clench without ever being aware of it. I've had people tell me that they don't ever clench while I'm watching them clench!

Since we know that stress is the primary cause, then it makes sense to reduce or eliminate stress. However, it is not quite so simple. You can't just tell yourself to not stress. Some may find that prayer, yoga, meditation or exercise helps.

If all attempts to control stress are unsuccessful, then we often can prescribe an appliance that reduces the force of the bite by at least 70%.

If the oral appliance doesn't help, we sometimes will prescribe muscle relaxers to help control the intensity of muscular contraction. We only do this for acute cases and for only a short period of time.

If all methods fail to give us the results that we want, we can also administer Botox therapeutically (rather than cosmetically). Botox is a toxin produced by a certain bacterium that inhibits muscular contraction. This enables us to reduce the contraction force significantly. Treatments with Botox can typically last for six months.

If you feel that you have a chronic clenching or grinding habit, discuss it with your dentist to determine how best to resolve your particular issues.


Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit www.advanced-smiles.com










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