If you’ve been told you’re a teeth grinder, you may wonder if orthodontic treatment can save your teeth from their nightly assault. Braces and Invisalign can help you reduce or stop grinding at night if your teeth or jaw are misaligned. Straightening and aligning teeth may be an excellent permanent strategy for curing teeth grinding however the issue is quite complex and the way your teeth are arranged may only play a minor part in predisposing you to grinding.
What is Bruxism (Teeth Grinding)?
Teeth grinding (bruxism) is the clenching or grinding of teeth that occurs most commonly during sleep at night but may occur whilst awake. Occasional teeth grinding doesn’t cause any harm, but regular grinding can cause significant tooth damage. Bruxism is a complex problem and people with abnormal bites, missing or crooked teeth may be more prone to grinding than people with normal bites.
Researchers seem to agree that many people are able to adapt their chewing and functional activities to these abnormal bites but those people who do not have the ability to adapt are more prone to grinding. Stress, anxiety and sleep disorders are some of the main contributing factors leading to teeth grinding.
There’s a link between some medications for depression, Parkinson’s disease and Huntington’s disease and bruxism.
People with sleep apnea are more likely to grind their teeth at night. Sleep apnea is a complex problem that may be related to obstruction of the airway and/or problems with the sensors in your body that measure the levels of oxygen in the blood. Enlarged tonsils and adenoids may obstruct breathing but in adults, increased body mass with excess tissue in the neck and airway block airflow when breathing, causing a pause between breaths and a reduction in oxygen in the blood. The brain tries to compensate for the pauses by signaling the jaw to clench and grind and protrude the jaw to hold the airway open.
The airway is also held open by normal muscle activity in the muscle surrounding the airway. A loss of tone in the airway may be encountered with increased age, clinical depression and factors such as increased alcohol intake. If you suspect that you have sleep apnea, it is probably wise to consider a consultation with a specialist sleep physician because there are many serious secondary health effects of sleep apnea.
Many people aren’t aware that they grind their teeth in their sleep until a dentist notices signs of wear or their partner tells them. Others may suffer the symptoms and still not know teeth grinding is to blame. They may experience a constant, dull headache or sore jaw but not know the cause.
The Problem with Bruxism
Chronic grinding can cause a range of dental problems including enamel wear, flattening and wear of a tooth’s surface, teeth to move out of alignment, tooth sensitivity, wearing down, broken and lost teeth after being loosened. Moreover, people with sleep apnea and increased body mass (BMI) may also have gastric reflux where acid from the stomach is regurgitated whilst asleep. The combination of the acid dissolving the teeth and the bruxism is a potent recipe for rapid tooth surface loss.
For some people, it’s not just their teeth that endure the effects of grinding, their tongue, and inside of their cheeks also suffer. Aching teeth, jaw and ear pain are common after a night of teeth grinding. Sufferers may also feel muscle aching and stiffness in the jaw, face and temples.
After years of grinding, people may require major dental work to fix the damage and save teeth. Damaged teeth may need treating with a crown, bridge, implant, or even dentures and often teeth olive as a consequence of the wear and orthodontics is required to return the teeth to their original positions before restoring the lost tooth substance. It’s the old story of getting the foundations right before building the house. Without treatment, teeth can loosen or fall out.
Grinding may also affect the jaw, with temporomandibular disorders (TMJ and TMD) causing major problems.
How to Prevent Teeth Grinding
There are some steps you can take to reduce the chance you’ll grind your teeth at night including:
- Stress is a major cause of teeth grinding, so anything you can do to reduce your stress levels can reduce your grinding
- Alcohol can predispose you to grinding, so reducing your consumption can help
- Reduce your consumption of foods and drinks containing caffeine
- Be aware of clenching your jaw during the day and stop yourself from doing it. Clenching while awake makes it even harder to break the habit during sleep.
- Mental concentration can increase grinding, so try to switch off and relax before falling asleep.
- Illness or dehydration can cause the body to grind, so go to bed well-hydrated
- Orthodontic treatment can help with abnormal arrangements of teeth (crooked teeth, overbite, under-bite, cross-bite) that will make it easier for you to adapt to the bite relationship.
A dentist or orthodontist can recognize the signs of grinding by examining teeth.
Braces are useful in fixing underlying bite problems that predispose to bruxism and make it easier for you to adapt. Bite alignment and straight teeth mean teeth fit together better within the jaw and eliminates the urge to grind the teeth.
In the early days of wearing braces, teeth grinding can worsen while your mouth adjusts. If you’re concerned with the severity of your teeth grinding and worried it may damage your teeth or braces, speak to your orthodontist about your concerns. Once the teeth shift into alignment, the grinding usually decreases and hopefully stops once teeth are completely aligned.
We can treat both adults and children with braces to help with their teeth grinding. Some people don’t experience a problem with teeth grinding until adulthood.
All types of braces are suitable for treating bruxism. Patients may choose the traditional metal braces or the more aesthetic options of clear braces or lingual (inside) braces.
After your braces are off, you’ll need to wear your clear retainers full time at first and then nightly to hold your teeth in their new position. The clear aligners (retainers) can act as a barrier to protect your teeth just in case you still grind your teeth. Some people continue to grind their teeth even when the bite is corrected and a customized strategy needs to be developed including management of stress however many patients are provided with a plastic ”splint” or guard that is worn to bed to reduce the impact of the grinding on the teeth. (see below)
Some people choose to treat their teeth grinding problem with clear aligners, called Invisalign.
Invisalign patients use a series of trays that make slight adjustments to shift their teeth to the desired position. Approximately every two weeks, patients start on the next set of trays to continue the straightening process. Most Invisalign treatments take 12 -18 months to complete. Patients wear the last set of trays as retainers to hold the teeth in the correct position long-term.
If you have a complex orthodontic case, your orthodontist may recommend you have braces instead. Braces have more pulling power than Invisalign so they’re more efficient at fixing an overbite, under-bite and cross-bite, overcrowding and very crooked teeth.
Some people who suffer from bruxism don’t undertake orthodontic treatment and instead, use a “splint” or night guard. While a night guard can’t fix the problem, it prevents teeth damage. The custom-fitted guard is worn while sleeping to prevent teeth rubbing against each other and damaging teeth. The night guard also prevents jaw and face pain because it acts as a cushion for the muscles in the jaw.
Night guards are available in different materials. The soft night guards are only suitable for those people who grind their teeth occasionally and not severely. Dual laminate night guards are for moderately severe teeth grinders with a hard outside and soft inside and hard night guards assist with severe grinding and TMJ.
If you grind your teeth at night, speak to an orthodontist about your options however, doubt exclude the possibility that the grinding might be part of a more serious general health problem such as sleep apnea. Orthodontic treatment can deliver a perfect smile and protect your teeth from years of damage caused by grinding. If you would like to know your options, find an orthodontist near you using this link https://caortho.org/locations?zip=92374&d=5 to make an appointment. An orthodontist will be able to examine you and advise you of the best course of management.