Clenching and grinding also known as parafunctional activity or bruxism by dentists is generally broken up into two different types: clenching while sleeping and clenching while awake. While both can wear and break teeth, they are caused by different factors. Generally, night time clenching and grinding is difficult to stop because we are sleeping and we cannot control what we do at night time. Daytime clenching, on the other hand, is much easier to control because we are awake, but it is still a habit that can take time to break. To understand daytime bruxism, the three factors are why do we do it and what happens to mouth, how do we treat the mouth, and how do we stop the habit.
Daytime bruxism is a habit that we develop usually from poor ergonomics. I see it most often in patients who do a repetitive task or have a repetitive posture. The two groups that I see it in most often are my patients who are truck drivers as well as those who are office workers and in front of a computer most of the day. What I find happens is that the person does a repetitive task and is unaware of how much they are grinding their teeth. The ways that this habit manifests itself is either by the patient developing muscle pain from overuse of the muscles which usually is most noticed at the end of the day during mealtime, the teeth will become sensitive to chewing or cold, or the teeth themselves crack and break due to the excessive forces placed on them throughout the day. For those with jaw muscle pain, it will generally come and go and will register as a 4, 5, 6 or 10 on the pain scale where 0 is no pain and 10 is the worst pain imaginable. For those with tooth sensitivity, so much pressure is applied to the teeth for so long that the nerve of the tooth becomes inflamed and any sensation bothers the tooth and the sensitivity will register as a 4, 5, 6, or 7 on the pain scale. For other groups, the teeth will chip and fracture but rarely will someone have much pain. For these patients, they are generally unaware of the chipping unless they chip a front tooth, but the dentist will notice it at the regular cleaning visit.
When we first notice signs of daytime bruxism, our treatment will depend on what symptoms are present. In the case of jaw or muscle pain, I recommend over the counter pain medication such as Advil or Tylenol, eating a soft diet for one month, and massages and moist heat compresses to the jaw muscles. For those with tooth sensitivity, I will recommend a sensitive toothpaste such as plain Sensodyne or plain Colgate Sensitive as well as over the counter pain medication. For those that have broken their teeth, I usually recommend fixing the tooth immediately so that more damage isn’t done. When people break teeth from clenching and grinding the best treatment is to place a crown on the tooth but occasionally bonding is an option as well. The major differences between the two is that generally the crown will last longer but the bonding will be less expensive and be quicker to do. It is also possible to opt to do no treatment in these cases but that can make the damage longer lasting and make a repair more expensive in the future.
To stop the habit of daytime clenching and grinding, I have three recommendations. First, this can be a sign of abnormal stress or consuming too many stimulants such as caffeine or nicotine. I know that is easier said than done but trying to limit stress and stimulants will help with clenching and grinding. The second recommendation is to try to stop the habit by catching yourself in action. The way to stop the habit is to have your cell phone or another alarm alert you every 15 minutes for a few weeks. This helps train the mouth that this is not a normal action. This can be frustrating though because the habit may take 4 to 8 weeks to break this way and there is no guarantee that it will not return in the future. The final way that I recommend is to create a habit appliance that makes grinding and clenching feel uncomfortable so that you don’t want to do it in the first place, but this is generally recommended as a last step. When patients admit that they are unable to stop themselves from this habit, I will make a whitening tray for their mouth that they wear when they suspect that they are clenching and grinding. They put the whitening tray in their mouth and as soon as they bite into it, it feels strange and they notice that they are about to clench and grind. When they don’t need it, they simply take it out of their mouth and place it in a small case that they can keep by their desk or in their purse.
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Daytime bruxism is an activity that most people will go through at some point in their life. It is generally found when we are most stressed and the body does this activity to relieve a bit of stress because it feels comfortable to the body. However, while it does feel good, it will hurt the teeth and jaw which is why we aim to prevent it from continuing before expensive and painful damage occurs. If you feel that you clench or grind during the day and need help managing it, give a phone call at NOLA Dentures and General Dentistry so that we can help you out.