This is my first dental-related post. Every now and again I plan on sharing some dental-related information because I don't think people realise how much everything in the body is interconnected and co-influenced. There's a lot more to dentistry than just drilling and filling, and I believe it is our job as practitioners to educate all potential patients! Out of everything I write about on this blog, this is what I know best.
Bruxism (AKA clenching and grinding) is one of the most common yet least recognised problems in dentistry. Every night (and often during the day too) people spend hours unknowingly clenching and grinding their teeth, sometimes so loud it can wake their spouses or other halves, or even parents (yes, that's right, children do it too!).
How do you know if you perform bruxism? Well, one of the initial tell-tale signs of bruxism is waking up with a dull, deep headache very regularly, that does not really subside during the day. The reason for this headache is the clenching (and subsequent grinding) of teeth that puts a lot of pressure and strain on the temporomandibular joint (TMJ) and the Masseter (basically chewing) muscles that surround the joint and enable it to function.
The TMJ is one of the most active joints in the body. Assisted by the muscles surrounding it, its movement allows us to speak, eat, yawn, just about everything that we open and close our mouths for. All day long we put our TMJ and masseter muscles to good use, and like every heavily used joint (think knees, hips, shoulders etc..) and skeletal muscle (quadriceps, hamstrings, deltoids etc...) in the body we need to let the joint and muscles rest and recuperate during the night, so that they can work to their full potential the next day. If we don't allow for this downtime and instead spend the night clenching and grinding putting straight on our TMJ and masseter muscles, we suffer muscle fatigue (the headaches we were discussing earlier).
Other signs include 'flattened' teeth, cracked teeth and feeling cold sensitivity and/or slight tenderness when chewing food. Long term bruxism can put so much strain on teeth and surrounding tissues that is can cause receding gums. Abfraction may also occur, which appears as V shaped notches in the cervical area of the tooth (near the gum line) due to constant biomechanical forces - tension, compression and flexion - on the teeth.
Why do we perform bruxism? This is one of the most important points. One, easily treated cause is the misalignment of teeth. 15 to 33% of children will become bruxers for a time because of this reason, usually during the mixed dentition stages while they're losing baby teeth and gaining adult teeth (everything is a bit 'all over the place' so to speak).
In adults, however, the most common cause for bruxism is STRESS. Every day stressors (work, traffic, bills, illness, kids) can add up and represent themselves in many ways. Many people aren't aware of how stressed they are, especially those living in Dubai. Daily, we are faced with hideous traffic, work long hours in fast paced jobs, as well as partying hard on the weekend. We are constantly GO GO GO and this manifests itself in our health in multiple ways. We don't sleep as soundly because our minds are constantly distracted and under pressure. In turn, we may depend on caffeine to keep us going during the day. Even the hot climate means that most of the time, we are either dehydrated or well on our way there (once again, thank you caffeine). We spend hours either behind the wheel cursing maniac drivers, or at our desks staring into computer screens, usually with poor posture. A lot of the time, we are clenching and grinding during the day, without even realising.
So how do we stop? The hardest part, as with most things, is realising that we are, in fact, clenching and grinding. Once that has been established, there are many techniques to 'train' ourselves out of the habit. We dentists can make you night guards to wear while you sleep, which suspends open the TMJ by 1 to 2mm, in turn relieving contractive pressure from the surrounding muscles. It also protects the teeth from further damage. For those who have gone "too far" it may be advisable to building up the missing height of the teeth before fitting a night guard.
Other habits that help relieve tension include avoiding chewing gum or any excessively chewy foods like toffees or steaks. Learn some massaging techniques to help relax muscles, not only around the jaw but also in the neck area. Avoiding caffeinated drinks after 4pm can aid in quality of sleep, which can also be improved by going to bed and waking at a similar time every day (even on the weekend!). Keeping hydrated is very important; dehydration can lead to a lack of saliva flow, which in turn can cause a more acidic environment in the mouth, combined with grinding will cause a greater loss of tooth structure.
Finally, practice trying to relax your facial muscles during the day. Try not to sit with your chin resting on your hands as this forces complete closure of the jaw. Ideally, your tongue should provide a small opening between your teeth which put the TMJ into neutral position. Try to avoid stressful triggers as much as possible, keep your mind calm and unnecessary stress to a minimum. I talk a little about biological the causes of stress here which is all intrinsically linked within the body.
So give that TMJ a break, get a good night's sleep, and wake up without a headache tomorrow!
V x
