Teeth Clenching and Grinding treatments at Hello Dental
Tooth clenching and grinding (bruxism) can cause significant amounts of damage to teeth and the supporting bone.
Teeth clenching and grinding is known as bruxism and is a fairly common condition with estimates of between 10 and 30% of people clenching or grinding their teeth regularly.
We don’t know exactly what causes bruxism. ITs likely to be caused by multiple things and some of these might be:
- stress and anxiety,
- alcohol and recreational drugs
- other sleep disorders like sleep apnoea and snoring
- certain medications
- It also seems that its prevalence decreases with age with children clenching or grinding at night much more than older adults.
Signs and symptoms of tooth clenching and grinding may include,
- headache and migraines,
- sensitive teeth,
- jaw joint (TMJ) and muscle pain,
- chipping or breaking teeth,
- worn and shortened teeth
- neck and back stiffness,
- sleep disruption and feeling groggy and unrested.
Clenching and Grinding can occur during the day or at night.
Daytime bruxism is more commonly seen as clenching and many adults will do it without being fully aware. It can often be controlled by making the person aware of doing it and putting into place techniques and strategies to help them stop. The damage done by daytime clenching is often quite limited as the individual is unlikely to clench to the point of hurting themselves or damaging their teeth without being aware of it.
Nighttime bruxism on the other hand can be much more destructive with more grinding forces, and the individual often not aware of the condition and unable to control it due to being asleep.
Night time bruxism (Parafunctional nocturnal bruxism)
Night time bruxism is thought to be less common but is under-diagnosed and the exact incidence is unknown.
IT is much more destructive due to a combination of several factors acting together:
- The forces being applied are greater as normal reflexes that prevent us damaging our teeth are reduced when we are asleep
- There is more grinding activity rather than clenching alone and so damage occurs to teeth and the bone surrounding it.
- It is much more affected by drugs, alcohol and stress.
- the damage is cumulative and as the teeth wear into the softer dentine the wear and break down of teeth accelerates by up to ten fold.
Management of bruxism
There is no “cure” for bruxism as such. We know it does become less of an issue as people get older and management is geared towards managing symptoms and minimising damage.
The main symptoms that need to be managed are headaches and migraines. These can be managed using medication, hypnosis techniques or a special splint to wear over the teeth at night which reduces the intensity of muscle clenching.
Tooth wear from clenching can lead to breaking of teeth and fillings, and can lead to dental abscesses and loss of teeth. In some people the additional loading can lead to breakdown of the bone and severe gum disease which lead to the teeth going lose and falling out. Because many teeth are involved the damage is often magnified as is the potential loss of teeth.
Treatments for Bruxism at Hello Dental
At Hello Dental we take a holistic view and try to manage and minimise the damage done to the teeth, but also advise on strategies to reduce other non-dental factors. Dr. Sanghavi has a particular interest in treating tooth clenching and grinding and the associated wear. We use conservative minimally invasive solutions which are possible with early diagnosis and intervention.
We manage bruxism in the following ways:
- Use of specialised hard splints
- Low level laser therapy for Bruxism, also known as Cold laser therapy.
- Teaching medical hypnosis and relaxation techniques to reduce the trigger factors
We can also recommend physiotherapists, osteopaths and acupuncturists that can help in managing symptoms and reducing other triggers such as posture.
Hard Splints for treatment of bruxism.
We use a splint called the NTI which has been shown to be very effective in reducing headaches and migraines.
The NTI splint can also be used to prevent teeth wearing but in these cases we will often make a custom hard splint that is adjusted and reviewed to ensure it is effective.
The cost of a hard splint varies depending on the type and complexity of the case and ranges from £120 to £470 and includes the custom fabrication of the splint and all adjustments and all reviews required.
Low level laser therapy for Bruxism.
Low level laser therapy is invaluable at reducing pain and discomfort especially during the acute phase.
The Cold laser beam helps block the pain pathways, but also has a positive effect in reducing inflammation and increasing blood flow with the overall effect of gradually releasing the spasm.
Treatment is non invasive and pleasant with almost immediate relief with resolution taking a few days in conjunction with a splint. On occasion 2-3 sessions are required to get the desired effect.
Low level laser therapy sessions cost from £25.
Medical hypnosis for Bruxism
Bruxism is a complex condition and recent research has shown that the triggers strat at the brain level with an increased activity measured followed by increase in heart rate before the actual teeth contact occurs.
Hypnosis practised especially before bed can have a calming and relaxing influence. By using certain suggestions it is possible that the bruxing could be much reduced.
Hypnosis sessions cost £180 per hour and include a recording of the session for self practice at home. We generally require one session. Our aim is to act as a guide to teach you various different techniques so you can choose one that resonates well with you and practice it yourself.