Grinding is something that most people who do it are unaware of.

In bygone times, grinding, or Bruxism, was thought to be caused by stress. In more recent times, it has been identified as a symptom of Temporomandibular Joint Dysfunction (TMD), and also linked with sleep apnoea, as something that is done unconsciously during sleep to reopen blocked airways. Over time, grinding damages the teeth and causes sensitivity and decay, possibly leading to permanent jaw pain and damage.

At Shields Dental & Implant Clinic Limerick, we have years of experience in the diagnosis and treatment of TMD and have been members of the British Society for Occlusal Studies for over 10 years.

Here are some of the key symptoms of Grinding Clenching and TMD that you should be aware of.

As grinding is something that people prone to it do whilst sleeping, its symptoms can include a ringing or buzzing in the ears; wear and tear on the surface of the teeth; sensitivity of the teeth; teeth that are constantly breaking; fillings that fracture; crowns that work loose; and toothache for no apparent reason. All of these symptoms can be signs of, and exacerbate, Temporomandibular Joint Dysfunction.

The Temporomandibular Joint (TMJ) is the joint connecting the lower jaw and skull, which enables you to open and close the mouth, and chew from side to side. Temporomandibular Joint Dysfunction (TMD) is the name given to problems with the jaw, and the muscles in the face that control it.

The most immediate signs occur first thing in the morning: a stiff jaw, or tenderness when you bite together. You may also be suffering from severe headaches or neck and shoulder pain; from pain and discomfort on the sides of the face around the ears or jaw joints; or difficulty moving the jaw. You may also notice loosened teeth and receding gums, and occasional prone to tiredness or spasm in the muscles that move the jaw.
‘Occlusion’ is the dental term used to describe the way the teeth meet when the jaws bite together. If the teeth do not fit together properly, this can create problems not only for the teeth but also the gums, the temporomandibular joint and the muscles that control it.
Conor and Cormac Shields have undertaken extensive postgraduate training with the British Society of Occlusal Studies and are experienced in the assessment and treatment of TMD.

Various muscles may be sore when testing, or broken and worn areas of the teeth can provide tell-tale evidence of clenching or grinding, a common sign of an incorrect bite.

The dentist may treat the problem by prescribing an Occlusal Splint, a hard plastic appliance that fits over the upper or lower teeth. This will be measured and fitted accurately so that when you bite on it, when your muscles are relaxed, all your teeth meet at exactly the same time.

The Occlusal Splint may have to be worn all the time, or at night only. If the appliance relieves the symptoms, it is possible that your bite will need permanent correction.

The options considered after diagnosis is confirmed include:
  • Occlusal Splint: In many cases, an occlusal splint (or Michigan splint) can help
  • Tooth adjustment: the direction and positioning of the slopes that guide your teeth together can often help to reposition the jaw
  • Teeth replacement: missing teeth may need to be replaced using bridges, dentures or implants to ensure the TMJ has equal support from both sides of the both jaws.
  • Medication: some drugs may assist, but this is usually only a temporary measure.
  • Diet & Exercise: a soft diet may help, so that there is less stress on the TMJ, as can corrective exercises, external heat, and, in some cases, physiotherapy. Caffeine may make you more likely to clench your teeth. It can also cause anxiety and that anxiety makes it harder to rest. Also avoid alcohol. Alcohol can give you a hangover, but it can also make you wake up with pain of a different kind.
  • Relaxation: counselling and relaxation therapy can help in some cases, assisting the patient to become more aware of how to manage stressful situations and control tension. Meditating before you go to sleep at night can help you relax. If you’re relaxed, you’re less likely to grind or clench your teeth. Think about training your mouth to relax while you’re awake. If you’re experiencing stress and feel your mouth clenching up, stop yourself. You can do that by first taking a deep breath. Then place the tip of your tongue between your teeth. That position keeps you from grinding. At night, wet a washcloth with warm water. Then place it against your cheek.