Bruxism (teeth clenching/grinding) and TMJ – Temporal Mandibular Joint Dysfunction

Bruxism (teeth clenching/grinding)

Diagnosis

During regular dental exams, your dentist likely will check for signs of bruxism.

Evaluation

If you have any signs, your dentist looks for changes in your teeth and mouth over the next several visits to see if the process is progressive and to determine whether you need treatment.

Determining the cause

If your dentist suspects that you have bruxism, she will try to determine its cause by asking questions about your general dental health, medications, daily routines and sleep habits.

To evaluate the extent of bruxism, your dentist may check for:

  • Tenderness in your jaw muscles
  • Obvious dental abnormalities, such as broken or missing teeth
  • Other damage to your teeth, the underlying bone and the inside of your cheeks, usually with the help of X-rays

A dental exam may detect other disorders that can cause similar jaw or ear pain, such as temporomandibular joint (TMJ) disorders, other dental problems or health conditions.

Referral

If your bruxism seems to be related to major sleep issues, your doctor may recommend a sleep medicine specialist. A sleep medicine specialist can conduct more tests, such as a sleep study that will assess for episodes of teeth grinding and determine if you have sleep apnea or other sleep disorders.

If anxiety or other psychological issues seem related to your teeth grinding, you may be referred to a licensed therapist or counselor.

Treatment

In many cases, treatment isn’t necessary. Many kids outgrow bruxism without treatment, and many adults don’t grind or clench their teeth badly enough to require therapy. However, if the problem is severe, options include certain dental approaches, therapies and medications to prevent more tooth damage and relieve jaw pain or discomfort.

Talk with your dentist or doctor to find out which option may work best for you.

Dental approaches

If you or your child has bruxism, your doctor may suggest ways to preserve or improve your teeth. Although these methods may prevent or correct the wear to your teeth, they may not stop the bruxism:

  • Splints and mouth guards. These are designed to keep teeth separated to avoid the damage caused by clenching and grinding. They can be constructed of hard acrylic or soft materials and fit over your upper or lower teeth.
  • Dental correction. In severe cases — when tooth wear has led to sensitivity or the inability to chew properly — your dentist may need to reshape the chewing surfaces of your teeth or use crowns to repair the damage or recommend alignment of teeth that do not mesh correctly.

Other approaches

One or more of these approaches may help relieve bruxism:

  • Stress or anxiety management. If you grind your teeth because of stress, you may be able to prevent the problem by learning strategies that promote relaxation, such as meditation. If the bruxism is related to anxiety, advice from a licensed therapist or counselor may help.
  • Behavior change. Once you discover that you have bruxism, you may be able to change the behavior by practicing proper mouth and jaw position. Ask your dentist to show you the best position for your mouth and jaw.
  • Biofeedback. If you’re having a hard time changing your habits, you may benefit from biofeedback, a method that uses monitoring procedures and equipment to teach you to control muscle activity in your jaw.

Medications

In general, medications aren’t very effective for treatment of bruxism, and more research is needed to determine their effectiveness. Examples of medications that may be used for bruxism include:

  • Muscle relaxants. In some cases, your doctor may suggest taking a muscle relaxant before bedtime, for a short period of time.
  • Botox injections. Injections of Botox, a form of botulinum toxin, may help some people with severe bruxism who don’t respond to other treatments.
  • Medication for anxiety or stress. Your doctor may recommend short-term use of antidepressants or anti-anxiety medications to help you deal with stress or other emotional issues that may be causing your bruxism.

Treating associated disorders

Treatment for associated disorders may include:

  • Medications. If you develop bruxism as a side effect of a drug, your doctor may change your medication or prescribe a different one.
  • Sleep-related disorders. Addressing sleep-related disorders such as sleep apnea may improve sleep bruxism.
  • Medical conditions. If an underlying medical condition, such as gastroesophageal reflux disease (GERD), is identified as the cause, treating this condition may improve bruxism.

Treatment of TMJ – Temporal Mandibular Joint Dysfunction

Temporomandibular Joint Dysfunction Syndrome (TMJ) is a common condition affecting a wide variety of people. TMJ is characterized by severe headaches, jaw pain of varying degrees, grinding teeth, and an intermittent ringing in the ears. The vast majority of TMJ sufferers are unaware that the root cause of these problems is something that a dentist can effectively treat.

The symptoms of TMJ are debilitating and can greatly interfere with every day life. The comfort and general well being of the patient is at the heart of the dental practice, so pain relief is the first consideration of the dentist. The dentist is able to test, diagnose, and devise an immediate plan to treat the underlying causes of the TMJ disorder.

Reasons for treating TMJ

TMJ sufferers report that their symptoms generally worsen during periods of prolonged or unexpected stress, and that intense outbreaks of the condition can lead to neck pain and dizziness.

The most common cause of TMJ is the misalignment of the teeth, often called “bad bite.” It is possible for the dentist to realign or adjust the teeth without the need for painful or expensive surgeries. The realignment/adjustment will stop the pounding headaches, the jaw pain, and the dizziness.

The grinding teeth symptom is particularly common and usually occurs at night. The grinding will eventually erode the structure of the teeth and lead to much more severe dental problems in the future. Untreated TMJ is one of the prime underlying factors in eroded jawbones and loose teeth.

It is important for anyone experiencing the symptoms of TMJ to visit the dentist for an exact diagnosis.

What does treating TMJ involve?

TMJ could be a result of several different problems. Bad bite is the most common, but an injury resulting from a blow to the meniscus cartilage is also a possibility. Initially, the dentist will thoroughly examine the jaw area, the patient’s bite, take X-rays, and review the patient’s history in order to make an accurate diagnosis and recommend necessary treatment.

Once a firm diagnosis is attained, there are several ways in which relief can be provided. A specially molded bite guard can be created to stop teeth grinding during the night. A bite relationship analysis may be recommended by the dentist. The dentist can also provide advice on relaxation techniques which will lessen the effects of stress. As a last alternative, the dentist is also able to prescribe muscle relaxants.

A better option is to change the shape of the teeth and get rid of the bad bite completely, often called “realignment.” This is especially useful because it alleviates TMJ symptoms and may improve the aesthetic appearance of the teeth as well. Realignment involves adjusting the relationship between how the upper teeth come together with the lower teeth. This may require new restorations and/or adjusting the natural teeth as well. It is not a painful procedure, and it is one the dentist has performed with great success numerous times. As with any procedure, the dentist will be happy to answer questions and discuss symptoms, options, and treatments.

If you are experiencing any symptoms of Bruxism or TMJ, we encourage you to contact our office today to schedule an appointment. Request appointment for more information!