The grinding of teeth at night (Nocturnal Bruxism) is often a result of exaggerated muscular activity beyond the patient’s control which can lead to excessive wear of the teeth, jaw joint problems and tension headaches. The treatment can be as simple as a simple bite plate, or ‘occlusal splint’, worn at nights.
It’s not uncommon for people suffering from jaw joint (temporomandibular joint or TMJ) disorders to first consult a medical practitioner with complaints of pain, usually on one side of the face and neck. In some cases the pain is intense and may be in the region of the temporomandibular joint just in front of the ear making eating painful and difficult. Frequently the sufferer is unable to open his or her jaws wide enough to insert normal amounts of food – instead, the food has to be cut up into tiny portions.
Diagnosis can be difficult, as the associated pain may not be restricted to the area of the joint but may be referred to almost any part of the head and neck. Other complaints include constant or repeated headaches, clicking in the jaw joints, apparent attacks of migraine and even the symptoms of a toothache. Neck pains from temporomanibular joint disorders may initially be attributed to something else altogether.
How Do The Problems Start?
The jaws are controlled by a very fine balance between many muscles and ligaments, which act together. Some of these muscles contract whole others expand in various movements of the jaws. Sometimes, because of interference to the normal movement of the jaws (perhaps teeth contacting unusually, or a poorly fitting denture), the lower jaw deviates slightly and the muscles are thrown out of balance. If this is repeated often, one or more of the muscles may go into spasm (like a cramp in a leg muscle) giving rise to severe pain. It is unlikely that the sufferer will be aware of the interference to the normal chewing pattern that set off the muscle spasm as this is likely to have developed slowly over many years.
Bruxism is an excessive clenching or grinding of the teeth that is not a part of normal chewing movements. It can lead to excessive wear on the teeth and may cause permanent damage to the teeth and the jaw joints.
Excessive clenching and grinding are not normal, healthy actions of the jaws. People typically have no conscious control over this excessive clenching and grinding, particularly when it occurs during sleep.
Treating TMJ Problems & Headaches
Once the problem has been diagnosed, the pain can often be stopped very quickly if the interference’s are eliminated. If the meshing of the teeth is at fault, careful grinding down of the offending area may achieve the required result For instance the cusps and grooves on the upper back teeth should fit snugly into the corresponding depressions and peaks on the biting surfaces of the back teeth in the lower jaw. If this snug fit does not exist, the dentist may attempt to reshape these cusps to correct the bite. To do this, the dentist may first take impressions of the upper and lower jaws and make models of the teeth. These models are then mounted in a mechanical device, called an articulator that simulates the movement of the patients jaw. By studying the models in this way the dentist is able to determine where and how much reshaping should take place.
For many patients, it is necessary for the dentist to make a small plastic appliance, called an occlussal splint, which fits over the biting surfaces of the upper teeth. The appliance is usually worn at night. The occlusal splint has the effect of separating biting surfaces of the upper and lower jaw, thereby allowing the chewing muscles to relax. Once these relax the pain usually disappears. By eliminating night grinding in bruxers, the occlusal splint also helps maintain the integrity of the teeth.