Bruxism is defined as the involuntary and unconscious grinding of teeth. The main cause for bruxism has not been determined but is held to involve multiple factors.
Health professionals believe wakeful bruxism has different causes from nocturnal bruxism. In bruxism, there will be strong contact between biting surfaces of the teeth.
The indications for bruxism management are mainly tenderness and stiffness of the jaw muscles, increased wear and flattening of teeth, tooth fractures, unpleasant noise during sleep, limited mouth opening, pain in the preauricular region, clicking and tenderness of the temporo-mandibular joint, and headaches resulting from muscle tension. Bruxism management relies on the recognition of the potential causative factors. Stress and other psychosocial parameters can be managed by considering interventions such as habit modification and relaxation therapy. Patients with sleep bruxism treatment might include appliance therapy and medication. Dietary counseling and management may be essential in some cases such as excessive use of caffeine and tobacco. The healthcare provider managing bruxism must understand that nocturnal or sleep bruxism is usually not cured by intervention. The behavior is likely to diminish with age.
Managing bruxism with occlusal adjustments
If there is the presence of any premature contacts or occlusal interferences, it can be corrected with occlusal adjustment. Before doing occlusal adjustment, muscles should be in their relaxed position for the jaw to resume its normal physiologic movements.
Managing bruxism with nightguards or occlusal splints
Nightguards and Splints can be used for the treatment of bruxism. Splints include night guards, occlusal splints, removable appliances or interocclusal orthopedic appliances and other customized appliances. Removable splints are worn at night to guide the movement, they are generally appreciated to prevent tooth wear and injury and reduce nighttime clenching. Splints should cover occlusal surfaces of the teeth. With the use of splint, there will be a reduction in increased muscle tone. They are especially helpful in managing the consequences of nocturnal bruxism. Other names are also used for the splint; it can be called occlusal bite guard, bruxism appliance, biteplate, or nightguard. Appliances vary in appearance and features depending on patients individual needs. It may be fabricated in the dental office or a laboratory from hard or soft material. The appliance typically covers either all of the maxillary or mandibular teeth. There is no significant differences regarding the outcome between hard and soft splints, but some clinicians feel that soft splints can increase clenching behavior in some patients. These appliances are also used to retrain daytime clenching.
The Nightguard has as objective to reduce the tension of the mastication muscles and thus reduce pressure on the temporo-mandibular joint. At the same time it protects the teeth and prevents wear. They rub against the softer acrylic instead of the opposing teeth. The Nightguard does not heal the clenching, teeth grinding or sleep apnea problems, its objective is only to reduce the damage. If you want to investigate more and find the real cause of the problem discuss it with your dentist.
- Brush well and floss your teeth.
- Depending on the type of Nightguard you received (instructions received in clinic), insert it directly in your mouth or immerse it in hot water (that doesn’t burn the fingers) for about 1 minute.
- After each use clean the Nightguard well under water and brush it without toothpaste.
- To get used to it more easily start by wearing it for 30min during the day and increase up the time until you’re ready to wear it all night.
- Try not to sleep directly on your face or with your hand under your jaw. This can cause an opening limitation or jaw pain for few days.
- If you have pain in your jaw, you can take anti-inflammatory drugs like Advils and apply warm compresses for 20 minutes 3-4 times a day. If the pain does not decrease after a few days call us.
- Bring your Nightguard with you at your cleaning appointments.
Possible complications from nightguard usage
- While removing the Nightguard from your mouth you might feel the teeth closing differently. This is due to muscle and lower jaw relaxation and gets back to normal after a few minutes.
- After a few days you may temporarily feel a little difference in your speech. It is very slight and almost unnoticeable by others.
- Jaw discomfort and pressure on some teeth (especially upper front ones). In this case avoid hard and chewy foods for a few days to allow your muscles to get used to the changes.
- You must allocate at least two weeks to get used to the changes and the new device in mouth. If after several weeks the problem persists, or you have any questions, call us.